Lymphatic vessels are lined by lymphatic endothelial cells (LECs), and are critical for health. However, the role of metabolism in lymphatic development has not yet been elucidated. Here we report that in transgenic mouse models, LEC-specific loss of CPT1A, a rate-controlling enzyme in fatty acid β-oxidation, impairs lymphatic development. LECs use fatty acid β-oxidation to proliferate and for epigenetic regulation of lymphatic marker expression during LEC differentiation. Mechanistically, the transcription factor PROX1 upregulates CPT1A expression, which increases acetyl coenzyme A production dependent on fatty acid β-oxidation. Acetyl coenzyme A is used by the histone acetyltransferase p300 to acetylate histones at lymphangiogenic genes. PROX1–p300 interaction facilitates preferential histone acetylation at PROX1-target genes. Through this metabolism-dependent mechanism, PROX1 mediates epigenetic changes that promote lymphangiogenesis. Notably, blockade of CPT1 enzymes inhibits injury-induced lymphangiogenesis, and replenishing acetyl coenzyme A by supplementing acetate rescues this process in vivo.

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We thank R. Adams and T. Mäkinen for providing the VE-cadherin(PAC)-creERT2 and Prox1-creERT2 mice, respectively. This work was supported by: fellowships from FWO (to B.W.W., X.W., B.T., J.K., R.M., U.B., J.G., B.G.), Marie Curie (to B.W.W., M.G., U.B.), EMBO (to H.H.) and LE&RN/FDRS (A.Z.); and supporting grants from IUAP P7/03 (P.C.), Methusalem funding by the Flemish Government (P.C.), FWO (G.0598.12, G.0532.10, G.0817.11, G.0834.13, Krediet aan navorsers, to P.C.), Leducq Transatlantic Network Artemis (P.C.), AXA Research Fund (1465, to P.C.), Foundation against Cancer (P.C.), ERC Advanced Research Grant (EU-ERC269073, to P.C.), ERC Starting Grant (IMAGINED-201293, to A.L.), German Research Foundation (D.F.G.) Grants (CRC629, CRC656, to F.K.), and co-funding by KU Leuven Methusalem (S.M.F.). We would like to thank A. Bouché, A. Carton, A. Manderveld, K. Peeters, N. Dai, J. Souffreau, A. van Nuffelen, B. Tembuyser, A. Van Den Eynde, S. Christen, K. Feyen, W. Martens, K. Brepoels, P.J. Coolen, M. Nijs, P. Vanwesemael, B. Verherstraeten, G. Dubois, E. Van Dyck, E. Gils, B. Vanwetswinkel, D. Smeets, G. Peuteman, T. Van Brussel, B. Boeckx, A. Acosta Sanchez and D. Verdegem for their technical assistance, and various laboratory members for their feedback and discussions. We thank S. Aerts, H. Gerhardt and M. Mazzone for critical suggestions and discussions.

Author information

Author notes

    • Brian W. Wong
    • , Xingwu Wang
    •  & Annalisa Zecchin

    These authors contributed equally to this work.


  1. Laboratory of Angiogenesis and Vascular Metabolism, Department of Oncology, KU Leuven, Leuven B-3000, Belgium

    • Brian W. Wong
    • , Xingwu Wang
    • , Annalisa Zecchin
    • , Ivo Cornelissen
    • , Joanna Kalucka
    • , Rindert Missiaen
    • , Hongling Huang
    • , Ulrike Brüning
    • , Stefan Vinckier
    • , Jermaine Goveia
    • , Chenyan Shi
    • , Veronica Moral-Dardé
    • , Sabine Wyns
    • , Martin Lippens
    • , Luc Schoonjans
    • , Mieke Dewerchin
    • , Guy Eelen
    •  & Peter Carmeliet
  2. Laboratory of Angiogenesis and Vascular Metabolism, VIB Vesalius Research Center, VIB, Leuven B-3000, Belgium

    • Brian W. Wong
    • , Xingwu Wang
    • , Annalisa Zecchin
    • , Ivo Cornelissen
    • , Joanna Kalucka
    • , Rindert Missiaen
    • , Hongling Huang
    • , Ulrike Brüning
    • , Stefan Vinckier
    • , Jermaine Goveia
    • , Chenyan Shi
    • , Veronica Moral-Dardé
    • , Sabine Wyns
    • , Martin Lippens
    • , Luc Schoonjans
    • , Mieke Dewerchin
    • , Guy Eelen
    •  & Peter Carmeliet
  3. Laboratory of Translational Genetics, Department of Oncology, KU Leuven, Leuven B-3000, Belgium

    • Bernard Thienpont
    • , Hui Zhao
    •  & Diether Lambrechts
  4. Laboratory of Translational Genetics, VIB Vesalius Research Center, VIB, Leuven B-3000, Belgium

    • Bernard Thienpont
    • , Hui Zhao
    •  & Diether Lambrechts
  5. Laboratory of Biology of Tumor and Development, Groupe Interdisciplinaire de Génoprotéomique Appliquée-Cancer (GIGA-Cancer), University of Liège, Liège B-4000, Belgium

    • Melissa García-Caballero
    • , Silvia Blacher
    •  & Agnès Noel
  6. Brain Research Institute, Faculty of Medicine and Science, University of Zurich, Zurich 8057, Switzerland

    • Marlen Knobloch
    •  & Sebastian Jessberger
  7. Mammalian Cell Signaling Laboratory, Department of Vascular Cell Biology, Max Planck Institute for Molecular Biomedicine, Münster 48161, Germany

    • Cathrin Dierkes
    • , René Hägerling
    •  & Friedemann Kiefer
  8. Metabolomics Core Facility, VIB Vesalius Research Center, VIB, Leuven B-3000, Belgium

    • Veronica Moral-Dardé
    •  & Bart Ghesquière
  9. Laboratory of Cellular Metabolism and Metabolic Regulation, VIB Vesalius Research Center, VIB, B-3000 Leuven, Belgium

    • Sarah-Maria Fendt
  10. Laboratory of Cellular Metabolism and Metabolic Regulation, Department of Oncology, KU Leuven and Leuven Cancer Institute (LKI), B-3000 Leuven, Belgium

    • Sarah-Maria Fendt
  11. Center for Molecular and Vascular Biology, Department of Cardiovascular Sciences, KU Leuven, Leuven B-3000, Belgium

    • Aernout Luttun
  12. Laboratory of Neural Circuit Development and Regeneration, Animal Physiology and Neurobiology Section, Department of Biology, KU Leuven, Leuven B-3000, Belgium

    • Lieve Moons


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B.W.W., X.W., A.Z., B.T., I.C., J.K., M.G., R.M., H.H., U.B., S.B., S.V., J.G., H.Z., C.D., C.S., R.H., V.M., S.W., M.L., B.G., L.S., M.D., G.E. performed research and/or analysed the data; B.W.W., X.W., A.Z., B.T., I.C., M.D., D.L., P.C. designed experiments; M.K., S.J., F.K., S.M.F. provided mice and/or advice; A.L., A.N., L.M., D.L. provided reagents and discussed results; B.W.W., A.Z. made the figures; B.W.W., P.C. wrote the paper; P.C. conceptualized the study. All authors discussed the results and commented on the manuscript.

Competing interests

P.C. declares to be named as inventor on patent applications, claiming subject matter related to the results described in this paper. The other authors declare no competing financial interests.

Corresponding author

Correspondence to Peter Carmeliet.

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    Supplementary Figure

    Uncropped scans with size marker indication for Fig. 1d, Fig. 3e, Fig. 3i, Fig. 4d, Fig. 6b, Fig. 6c and Extended Data Fig. 5a.

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    Supplementary Information

    This file contains Supplementary Discussion 1-4 and an additional reference.

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    Supplementary Table 1

    This file shows peaks from Prox1-FLAG Chip-seq and mapping of Prox1, H3K9ac and P300 Chip-seq data.

  2. 2.

    Supplementary Table 2

    This fie shows peaks from H3K9ac Chip-seq in pLECs versus VECs and pLECs upon CPT1aKD versus pLECs at baseline.

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