AIBP-CAV1-VEGFR3 axis dictates lymphatic cell fate
and controls lymphangiogenesis
Abstract The lymphatics control tissue fluid homeostasis; its dysfunction contributes to lymphedema. VEGFR3 signaling dictates LEC fate specification and lymphangiogenesis. Cholesterol is essential for cell function and organ development, yet the molecular mechanism by which cholesterol controls lymphangiogenesis is unknown. Here, we show that APOA1 binding protein (AIBP), a secreted protein, enhances LEC specification and increases lymphangiogenesis. Mechanistically, AIBP-mediated cholesterol efflux disrupts LEC caveolae, which abolishes CAV-1-dependent inhibition of VEGFR3 signaling. Loss of Aibp2, the zebrafish paralog of human AIBP, reduces LEC progenitors and impairs lymphangiogenesis; the impairment can be rescued by caveolae disruption. CAV-1 mutant that is deficient in VEGFR3 binding, thereby abolishing its inhibition, enhances VEGFR3 signaling and accelerates lymphatic growth. Furthermore, AIBP expression is reduced in the epidermis of human lymphedema. Administrating recombinant AIBP augments VEGFC-induced lymphangiogenesis and increases secondary tail lymphedema resolution in adult mice. Our studies reveal AIBP and CAV-1 as critical regulators of VEGFR3 signaling and identify previously unidentified therapeutic targets for lymphedema treatment.