Critical review: Cardiac telocytes vs cardiac lymphatic endothelial cells

The study of cardiac interstitial Cajal-like cells (ICLCs) began in 2005 and continued until 2010, when these cells were renamed as telocytes (TCs). Since then, numerous papers on cardiac ICLCs and TCs have been published. However, in the initial descriptions upon which further research was based, lymphatic endothelial cells (LECs) and initial lymphatics were not considered. No specific antibodies for LECs (such as podoplanin or LYVE-1) were used in cardiac TC studies, although ultrastructurally, LECs and TCs have similar morphological traits, including the lack of a basal lamina. When tissues are longitudinally cut, migrating LECs involved in adult lymphangiogenesis have an ICLC or TC morphology, both in light and transmission electron microscopy. In this paper, we present evidence that at least some cardiac TCs are actually LECs. Therefore, a clear-cut distinction should be made between TCs and LECs, at both the molecular and the ultrastructural levels, in order to avoid obtaining invalid data.