"The lymphatic system is found in most tissues of the body and plays an important role in lipid transport from the intestine to the circulation (19). Most dietary lipids are absorbed in the small intestine and packaged in triglyceride-rich particles known as chylomicrons, and are then transported to the blood stream through the lymphatic system. Impaired lymphatic drainage in mice results in lipid accumulation in the interstitium (20). Similarly, patients with lymphedema appear to have compromised lipid transport and accumulate large lipid deposits. Some reports have also shown that several lipoprotein fractions are present in the lymph, including HDL. Indeed, the concentration of HDL cholesterol in the lymph is 30% greater than in the blood, suggesting a key role of lymphatic circulation in regulating RCT [Reverse Cholesterol Transport] (21). [Reverse Cholesterol Transport]
In the present study, Martel et al. provide definitive evidence that impairment of lymphatic circulation compromises RCT from peripheral tissues, including the skin and a transplanted aortic vessel (14). It would be interesting to further assess whether the patients with lymphedema or those who undergo surgery or node removal have RCT defects, lower circulating HDL cholesterol, and increased risk of CHD.
This study suggests that therapeutic interventions to improve lymphatic circulation might enhance lipid clearance from the artery wall and prevent atherosclerotic vascular disease.'
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