Penn is part of a $135.7M federal effort to demystify a blind spot in medicine: the lymphatic system
With its $7.8 million slice of the ARPA-H funding, a team at Penn will develop ways to image the lymphatic system and identify hidden signs of disease.
The University of Pennsylvania is getting $7.8 million over the next two years to study an overlooked aspect of human health: the lymphatic system.
Often described as the body’s sewer system, its main job is to maintain the body’s balance of fluid and filter out waste. Millions of Americans live with dysfunction in the system, often unknowingly.
The time to diagnose some lymphatic disorders is at least five years, said Maxim Itkin, an interventional radiologist who directs Penn’s center specializing in lymphatic disorders.
He’s even had a patient who experienced unexplained symptoms for 50 years before getting treatment.
“Right now, most healthcare providers simply aren’t equipped — or trained — to recognize lymphatic dysfunction, and the tools they need are virtually nonexistent,” said Kimberley Steele, a program manager at the Advanced Research Projects Agency for Health (ARPA-H), the federal agency organizing the research effort.
That’s why the government, through ARPA-H, is investing $135.7 million toward research headed by 11 institutions in the U.S. and Canada, including Penn, to improve detection of issues in the lymphatic system.
With its slice of funding, the team at Penn will develop ways to image the network and identify hidden signs of disease.
An inside look
Similar to plumbing, fluids in the lymphatic system can be flowing, obstructed, or leaking.
Doctors are able to “close” these leaks and even “open” obstructed areas, but the problem is knowing when those procedures are needed.
Existing contrast agents — substances used to increase visibility of tissues during imaging — for the lymphatic system are largely considered obsolete and offer poor resolution, said Itkin, who is leading the Penn project, which started last October.
When he began researching the system 20 years ago, he “started to realize that it’s of enormous importance, and it’s forgotten primarily because nobody can image [it] and do interventions,” he said.
Itkin and his team have come up with ways of imaging by injecting dye into lymph nodes and tissues and tracing the dye’s location. This has enabled him to diagnose hidden conditions and develop new treatment methods.
The ARPA-H funding will allow them to go even further, developing imaging agents that focus on the parts of the lymphatic system in the liver and gut — organs that generate the majority of the network’s flow in the body.
These will be used for CT (computed tomography) and MRI (magnetic resonance imaging) scans.
One of the imaging candidates is designed to be swallowed and absorbed in the intestine, so doctors can see the lymphatic system in the gut. The second imaging agent will be administered via IV to show the system in the liver.
“It was my dream to see the lymphatic system from inside by itself,” Itkin said.
The Penn team will also be looking for biomarkers, or molecules in the body that indicate biological processes, that could give early hints of disease.
They’ll be using an approach called AI-driven multi-omics, where AI will analyze samples for unique molecules being excreted by the lymphatic system in the liver.
Penn and several other funded groups are working with the New York-based nonprofit Lymphatic Education and Research Network to help with research and patient recruitment.
Current funding is for two years, with the potential to extend for another three years.
Itkin says seeing the lymphatic system in the liver will be a thrill.
“It’s absolutely a black hole,” he said.