b'Lymphatic research has experienced a near explosion of activity in recent years, as awareness of the importance of lymphatic mechanisms to the continuum of human biology and disease has grown. This lymphatic continuum now easily encompasses cardiovascular disease, respiratory inflammation, obesity, autoimmune disease, and chronic transplant rejection, among many other pathologic conditions. An exponential growth in technological tools for research has made possiblea similar growth in our comprehension of the molecular regulatory processes that govern the normal development and function of the lymphatic system.Stanley Rockson, M.D., LE&RN Co-Founder, Allan and Tina Neill Professor of Lymphatic Research andMedicine at Stanford University School of MedicineCLINICAL GAPS There is a clinical need for development of non-invasive imaging of lymphatic physiology to aid 1. Early Diagnosis diagnosis and understanding of all lymphatic diseases, including lymphedema andlipedema (e.g., non-invasive One of the most frustrating aspects of caring forMRL, anatomical and sodium MRI, spectrometry MRI).patients living with lymphatic disease is the relativeBiomarkers: lack of highly sensitive and specific non-invasiveDevelopment of non-invasive assessment for tests and blood biomarkers. Without theseessential diagnostic tools, a delay in diagnosis isgenotyping of somatic mutations that are saferinevitable and often results in increased morbidity than biopsy (i.e., circulating free DNA).and mortality. Novel biomarkers utilizing bodily fluids (urine,Imaging: cyst fluid, pleural effusions, edematous fluid, saliva, An urgent need in novel non-invasive imagingand blood). techniques and devices. Omics: A need for further investigation of proposedTranscriptomics, proteomics and metabolomics, and microbiome studies:techniques:Define transcriptional machinery of lymphangiogenicFat-weighted whole-body MRI (e.g., Lipedemafatpathways.to water ratio is greater than obesity) Characterizing the role of the lymphatic vasculature Water-weighted MRI of soft tissue in immune activation (outside lymphoid organs).Standardized sodium 23NA-MRIDeveloping therapeutic lymphangiogenesis concepts.MR Lymphangiogram techniquesIn solid organ transplants, would competent Non-tracer MRL sensitive to edema and vascular lymphatics enhance graft health?morphology In breast cancer patients, can preemptive and Procedure for comparative analysis of ICG imaging targeted therapy safely accelerate lymphatic repair?of lymphatic vessels Single Cell RNA techniques and atlas mappingOtherPET? Functional MRI?How does the microbiome affect lymphatic health? |Gaps in the Field of Lymphatic Research|2024 Update|2'