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Cooperative ETS transcription factors are required for lymphatic endothelial cell integrity and resilience
Myung Jin Yang, Seok Kang, Seon Pyo Hong, Hokyung Jin, Jin-Hui Yoon, Cheolhwa Jin, Chae Min Yuk, Lydia Getachew Gebeyehu, Junho Jung, Sung-Hwan Yoon, Hyuek Jong Lee, Gou Young Koh
Myung Jin Yang, Seok Kang, Seon Pyo Hong, Hokyung Jin, Jin-Hui Yoon, Cheolhwa Jin, Chae Min Yuk, Lydia Getachew Gebeyehu, Junho Jung, Sung-Hwan Yoon, Hyuek Jong Lee, Gou Young Koh
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Research Article Cell biology Development Vascular biology

Cooperative ETS transcription factors are required for lymphatic endothelial cell integrity and resilience

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Abstract

Lymphatics maintain fluid homeostasis, immune surveillance, and tissue integrity. Here, we identified the E26 transformation-specific transcription factors Erg and Fli1 as essential cooperative regulators of lymphatic integrity and function. Using inducible lymphatic endothelial cell–specific deletion in mice, we demonstrated that combined loss of Erg and Fli1 in adults results in fatal lymphatic failure, including chylothorax, chylous ascites, and impaired lymphatic drainage. Single-cell transcriptomic analysis revealed that loss of Erg and Fli1 causes disrupted lymphatic heterogeneity and dysregulation of key lymphatic genes, including valve-specific gene profiles. Erg and Fli1 coordinated lymphatic-immune crosstalk by transcriptionally regulating C-C motif chemokine ligand 21, which mediates DC trafficking. Erg or Fli1 loss also induced proinflammatory and prothrombotic gene expression, further contributing to lymphatic dysfunction. During embryonic development, the codeletion led to lymphatic mispatterning and loss of valve-initiating lymphatic endothelial cell clusters. The impact of loss of Erg and Fli1 function on lymphatic development in mice is consistent with FOXC2 mutations in lymphedema-distichiasis syndrome or ERG gene variants underlying primary lymphedema in humans. Moreover, Erg and Fli1 were required for regenerative lymphangiogenesis and lymphatic repair following injury in adults. Our findings establish Erg and Fli1 as core transcriptional regulators of lymphatic identity, integrity, and function.

Authors

Myung Jin Yang, Seok Kang, Seon Pyo Hong, Hokyung Jin, Jin-Hui Yoon, Cheolhwa Jin, Chae Min Yuk, Lydia Getachew Gebeyehu, Junho Jung, Sung-Hwan Yoon, Hyuek Jong Lee, Gou Young Koh

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Figure 2

Erg and Fli1 double knockout impairs lymphatic drainage function.

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Erg and Fli1 double knockout impairs lymphatic drainage function.
(A and...
(A and B) Bright-field images and comparison of the width of the thoracic duct at 2 weeks after the first of 3 consecutive days of tamoxifen (Tmx) administrations among the indicated adult mice. Scale bars: 0.5 mm. Each dot indicates a value from 1 mouse, and n = 5 mice/group from 2 independent experiments. Data are shown as the mean ± SD; P value versus WT by 1-way ANOVA followed by Dunnett’s post hoc test. (C) Diagram showing intradermal injection of Evans blue into the right hind paw of the adult mice at 2 weeks after the first of 3 consecutive days of Tmx administration and analysis 30 min later. Bright-field images of the thoracic duct in the indicated mice. Similar findings were obtained from n = 5 mice in 3 independent experiments. Scale bars: 0.5 mm. (D) Generation of PG-WT and PG-Erg/Fli1iΔLEC mice, diagram showing i.p. administrations of Tmx for 3 consecutive days in the adult mice, and 2 weeks later, an intravital imaging of mesenteric lymphatics at 9 h after oral gavage of 150 μL of BODIPY C11. (E–G) Fluorescence images and fluorescence intensity (FI) profile analysis of BODIPY C11 in the mesenteric lymphatics between PG-WT and PG-Erg/Fli1iΔLEC mice at 9 h after the oral gavage. Yellow lines indicate the regions measured for profile analysis. Scale bars: 200 μm. Green shaded regions in the plots represent the mesenteric lymphatic lumens. LV, lymphatic vessel; BV, blood vessel. The letters F and G indicate the regions where BODIPY fluorescence was measured in F and G. (H and I) Comparisons of mean and retained BODIPY C11 FI in the mesenteric lymphatics of PG-WT and PG-Erg/Fli1iΔLEC mice. Mean FIs of 3 regions within the lymphatics (Within LV) or adjacent nonlymphatic regions (Outside LV) are shown. Retained BODIPY C11 FI (ΔBODIPY FI) was defined as FIWithin LV – FIOutside LV. Each dot indicates a value from 1 mouse, and n = 5 mice/group from 2 independent experiments. Data are shown as the mean ± SD; P value versus WT by 2-tailed Mann-Whitney U test.

Copyright © 2026 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)

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