Project Grant R01AR086509

The National Institute of Arthritis and Musculoskeletal and Skin Diseases awarded The University of Texas Southwestern Medical Center $613,036 on August 1, 2026, for investigator-initiated research under the Arthritis, Musculoskeletal and Skin Diseases Research program (CFDA 93.846).

The project, "Leveraging Lymphatics to Reverse Heterotopic Ossification," addresses the pathologic formation of extra-skeletal bone occurring in approximately twenty percent of patients following hip arthroplasty, burns, or severe musculoskeletal injury. Current therapeutics cannot reverse established heterotopic ossification, and surgical intervention rarely restores baseline function and frequently results in recurrence. The research investigates lymphatic signaling and immune pathways underlying this condition, with preliminary data showing activation of lymphatic signaling concurrent with changes in T-cell RANKL expression and myeloid-to-osteoclast cell differentiation. The project hypothesis posits that mesenchymal progenitor cell-derived VEGFD stimulates VEGFR3-expressing lymphatic ingrowth into heterotopic ossification sites, creating an opportunity to resorb existing bone lesions.

Aim 1 determines lymphatic localization in skeletal and heterotopic bone post-injury and elucidates the role of VEGFR3 and lymphangiogenesis in regulating heterotopic ossification formation, including investigation of whether interfering with lymphangiogenic responses exacerbates disease.

Performance occurs in Dallas, Texas, with a period of performance from August 1, 2026, through July 31, 2031. The award is a project grant.