b'5. Epidemiologic and Longitudinal Data BASIC & TRANSLATIONAL Need for epidemiologic studies to realisticallySCIENCE GAPS determine the incidence and prevalence of lymphatic diseases in the US (primary and secondaryBasic research is often overlooked in terms of the lymphedema, lipedema, vascular malformations impact and significance it can have in the developmentand other rare lymphatic disorders).of novel therapies for diseases. Many of the We lack natural history studies for lymphatic diseasesadvancements in the fields of cancer, cardiovascularand require them for FDA clinical trials.disease, and neurology, for example, have been made More comprehensive registries are needed withdue to the efforts of researchers who investigated thebetter collaboration across the lymphatic communitybasic biology of those systems. Funding for this type to share and analyze the data.of research for lymphatics is of the utmost importance to advance the knowledge and treatment of lymphatic 6. Access to Care and Global Health diseases and lymphedema.Rural and global health disparities in people living1. The Developmental Origin ofwith lymphedema. the Lymphatic SystemImpact of climate change on chronic edema/ lymphedema. Including often neglected lymphatic muscle cells Remote education/telehealth interventions to (where do lymphatic muscle cells originate insupport those living remotely and rural people development?), contractile protein and ion channel living with lymphedema. expressions of lymphatics, and the regional 7. Standards for Outcomes Measures differences.2. Compendium of Lymphatic Biologyand PhysiologyDevelopment of validated patient reported outcomes in lymphatic disease. Development of validated clinical outcomes Create a compendium of lymphatic biology and(i.e., radiologic measures). physiology to better understand the basic physiology of normal lymphatic tissue so that we can understand 8. Patient Advocates Emphasized genetic and anatomic variations.These Gaps 3. Quantification of Lymphatic FunctionData collected from the NIH 2022 Yet to Be Charted: Lymphatics in Health and Disease Research Workshop We lack an understanding of the pressures and flowsImproved awareness and specialized training in healthy and dysfunctional lymphatic networks.Mechanisms that maintain vessel homeostasis and for medical staff to recognize, diagnose, and treatlymphatic diseases.role in optimizing function.Improved imaging of lymphatic diseases.Functional studies of human vessels, especially Non-invasive diagnostics and emphasis placed onof healthy vessels. establishing lymphatic medicine as a discipline. Studies to better understand the extent to which Need for more Centers of Excellence and need lymphatic contractile and valve dysfunction result from, or contribute to, other pathologies.for more specialists.Because it is technically difficult to study human Need for primary care givers to be more educatedlymphatic smooth muscle cells, this has resulted in in lymphatic diseases.relying on the study of lymphatic endothelial cells Need for creative state-of-the-art surgical approaches.(LECs). We have a paucity of research on the diversity Need for methods of transition of care from and function of lymphatic smooth muscle cells.pediatric to adult vascular anomaly patients andThis includes the developmental origin ofspecialty centers for pediatric and adult vascularlymphatic muscle cells, contractile protein andanomaly patients. ion channel expressions of lymphatics, and theNeed a method to include psychosocial counselingregional differences. for patients with lymphatic diseases that have beenFurther evaluation required to understand thehistorically neglected. consequences of having or not having a normal Identify the barriers to the routine referral of functioning thoracic duct.at-risk people for lymphatic disease and/orDo primary lymphedema-causing genetic lymphedema assessment, preventative exercises,mutations affect lymphatic vessel contractilityself-management education, and treatment asand permeability?needed across the lifespan. |Gaps in the Field of Lymphatic Research|2024 Update|4'