Involvement of neurons and retinoic acid in lymphatic development: new insights in increased nuchal translucency

Nicole B Burger, Kyra E Stuurman, Evelien Kok, Tanja Konijn, Dennis Schooneman, Karen Niederreither, Mark Coles, William W Agace, Vincent M Christoffels, Reina E Mebius, Serge A van de Pavert, Mireille N Bekker

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19 Citations (Scopus)


ObjectiveIncreased nuchal translucency originates from disturbed lymphatic development. Abnormal neural crest cell (NCC) migration may be involved in lymphatic development. Because both neuronal and lymphatic development share retinoic acid (RA) as a common factor, this study investigated the involvement of NCCs and RA in specific steps in lymphatic endothelial cell (LEC) differentiation and nuchal edema, which is the morphological equivalent of increased nuchal translucency. MethodsMouse embryos in which all NCCs were fluorescently labeled (Wnt1-Cre;Rosa26(eYfp)), reporter embryos for in vivo RA activity (DR5-luciferase) and embryos with absent (Raldh2(-/-)) or in utero inhibition of RA signaling (BMS493) were investigated. Immunofluorescence using markers for blood vessels, lymphatic endothelium and neurons was applied. Flow cytometry was performed to measure specific LEC populations. ResultsCranial nerves were consistently close to the jugular lymph sac (JLS), in which NCCs were identified. In the absence of RA synthesis, enlarged JLS and nuchal edema were observed. Inhibiting RA signaling in utero resulted in a significantly higher amount of precursor-LECs at the expense of mature LECs and caused nuchal edema. ConclusionsNeural crest cells are involved in lymphatic development. RA is required for differentiation into mature LECs. Blocking RA signaling in mouse embryos results in abnormal lymphatic development and nuchal edema. (c) 2014 John Wiley & Sons, Ltd
Original languageEnglish
Pages (from-to)1312-1319
Number of pages8
JournalPrenatal diagnosis
Issue number13
Publication statusPublished - 2014


  • Animals
  • Cell Differentiation
  • Endothelial Cells/cytology
  • Female
  • Lymphatic Vessels/cytology
  • Mice
  • Neural Crest/physiology
  • Nuchal Translucency Measurement
  • Pregnancy
  • Tretinoin/metabolism

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