Researchers at Hospital for Special Surgery (HSS) have uncovered a critical link between the immune system in early life and its function in adulthood. The study, published in Science Immunology, identifies a new role for specialized skin immune cells, called Langerhans cells, in shaping the development of lymphatic vessels—an essential part of the body’s immune network.
Lymphatic vessels act as communication highways, carrying signals from tissues to the immune system to alert it to infection, injury, or disease. When this system does not function properly, the body may struggle to fight infections, respond to vaccines, repair tissue, or control inflammation.
The new findings show that Langerhans cells play a key role during early life by helping lymphatic vessels grow and develop properly in the skin. This early “setup” has long-term consequences, influencing how well the immune system functions later in life.
“Our study shows that immune cells in the skin do much more than respond to threats—they help build the infrastructure the immune system depends on,” said senior author Theresa T. Lu, MD, PhD, who holds the St. Giles Chair for Research in the HSS Research Institute and is a member of Pediatric Rheumatology at HSS. “If this process is disrupted early in life, it can have lasting effects on immune health. Our results also underscore the critical role of skin health in regulating lymphatic vessel development and immune system function in health and disease.”
“These findings advance our understanding of how early-life biological processes influence long-term immune function,” explained JiHyun Sim, PhD, first author and Postdoctoral Fellow at HSS. “We are hoping to further understand if this physiologic process is disrupted to contribute to autoimmune disease.”
Key Findings
- Early-life development matters: Proper formation of lymphatic vessels in childhood is essential for strong immune responses in adulthood.
- New role for Langerhans cells: Beyond their known immune functions, these cells help guide the growth and programming of lymphatic vessels.
- Long-term impact: When Langerhans cells are reduced or impaired early in life, the immune system may be less effective later on.
Implications for Patients and Providers
The research suggests that conditions affecting skin health in early life—such as severe sunburn, burns, or certain autoimmune diseases like lupus—could interfere with Langerhans cells and, in turn, disrupt lymphatic development. This may contribute to weaker immune responses later in life, including reduced effectiveness of vaccines, increased susceptibility to infections, impaired healing, and potential autoimmune complications.
“These findings highlight the importance of protecting skin health early in life,” said Dr. Lu. “They also open the door to new approaches that could strengthen immune function by targeting the lymphatic system.”
A New Way of Thinking About Immune Health
The study adds to a growing body of evidence showing that early-life health and environmental factors can shape disease risk in adulthood. It also identifies a previously unknown mechanism by which immune cells influence tissue development—not just immune activation.
By uncovering how Langerhans cells regulate lymphatic vessel growth, researchers hope to pave the way for future strategies to improve immune responses and prevent disease across the lifespan.
Authors: JiHyun Sim, PhD, Richard Bell, PhD, Yurii Chinenov, PhD, Zhonghui Feng, PhD, Susan Chyou, BA, William D. Shipman, MD, PhD, Lionel Ivashkiv, MD, Theresa T. Lu, MD, PhD
About HSS
HSS is the world’s leading academic medical center focused on musculoskeletal health. At its core is Hospital for Special Surgery, nationally ranked No. 1 in orthopedics (for the 16th consecutive year), No. 3 in rheumatology by U.S. News & World Report (2025-2026), and the best pediatric orthopedic hospital in NY, NJ and CT by U.S. News & World Report “Best Children’s Hospitals” list (2025-2026). In a survey of medical professionals in more than 20 countries by Newsweek, HSS is ranked world #1 in orthopedics for a fifth consecutive year (2025). Founded in 1863, the Hospital has the lowest readmission rates in the nation for orthopedics, and among the lowest infection and complication rates. HSS was the first in New York State to receive Magnet Recognition for Excellence in Nursing Service from the American Nurses Credentialing Center five consecutive times. An affiliate of Weill Cornell Medical College, HSS has a main campus in New York City and facilities in New Jersey, Connecticut and in the Long Island and Westchester County regions of New York State, as well as in Florida. In addition to patient care, HSS leads the field in research, innovation and education. The HSS Research Institute comprises 20 laboratories and 300 staff members focused on leading the advancement of musculoskeletal health through prevention of degeneration, tissue repair and tissue regeneration. In addition, more than 200 HSS clinical investigators are working to improve patient outcomes through better ways to prevent, diagnose, and treat orthopedic, rheumatic and musculoskeletal diseases. The HSS Innovation Institute works to realize the potential of new drugs, therapeutics and devices. The HSS Education Institute is a trusted leader in advancing musculoskeletal knowledge and research for physicians, nurses, allied health professionals, academic trainees, and consumers in more than 165 countries. The institution is collaborating with medical centers and other organizations to advance the quality and value of musculoskeletal care and to make world-class HSS care more widely accessible nationally and internationally. www.hss.edu.
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