Tissue engineering has witnessed remarkable advancement in various fields of medicine and has the potential of revolutionizing the management of lymphedema. Combining approaches of biotechnology with the evolving understanding of lymphangiogenesis may offer promising treatment modalities for patients suffering from lymphedema. The strategies to lymphatic vessels tissue engineer can be grouped into four main categories: Delivery of chemokines, cytokines, and other growth factors to induce lymphangiogenesis; cell-based approach using lymphatic endothelial cells or stem-cells; scaffold-based tissue engineering; or a combination of these. This review will summarize the current approach to cancer-related lymphedema and advances in lymphatic tissue engineering strategies and the challenges facing the regeneration of lymphatic vasculature, particularly in an oncologic setting.
Impact statement
Tissue engineering of lymphatic vasculature holds great promise in revolutionizing the management of lymphedema. Significant progress has been achieved so far with identifying cellular markers and growth factors for lymphatic tissue, designing scaffolds that sustain lymphatic endothelial cells and lymphatic capillary development, and studying the interplay between stem cells, biochemical stimuli, interstitial flow, and various extracellular matrix components to devise the ideal biomaterial construct for lymphatic regeneration. However, there is still much to decipher in achieving an engineered functional lymphatic network in an oncologically safe fashion.
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