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Lymphatic endothelial cells (LECs) are a specialized subset of endothelial cells that form the inner lining of lymphatic vessels and the sinuses within lymph nodes. These cells play essential roles in fluid homeostasis, immune surveillance, lipid absorption, and the regulation of immune responses. LECs enable the uptake and return of interstitial fluid from tissues back into blood circulation, preventing edema. They produce chemokines such as CCL21 to recruit dendritic cells and other immune cells to lymph nodes for antigen presentation and initiation of adaptive immunity. LECs can acquire, present, and exchange antigens and express molecules like PD-L1 to help maintain peripheral tolerance by presenting tissue-specific antigens for deletion or anergy induction in self-reactive T-cells. Specialized intestinal lymphatics called lacteals absorb dietary fats packaged as chylomicrons for transport into circulation. Dysfunction in LEC structure or signaling leads to impaired drainage resulting in lymphedema and contributes to diseases including obesity, atherosclerosis, inflammation-related disorders, graft rejection, myocardial infarction recovery issues, glaucoma risk elevation due to impaired ocular drainage pathways, and cancer metastasis through facilitation of tumor cell entry into the lymphatics system for dissemination throughout the body.
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