According to Felmerer et al., even though VEGF-A and VEGF-D are implicated in the induction of vascular permeability [89,90], these findings, when tied to increased vascular endothelial growth factor C (VEGF-C; potent vascular permeability factor promoting lymphangiogenesis) in the blood sera of lipedema patients and downregulation of TIE-2, paint a picture of a feedback mechanism involved in repairing the impairment of vascular permeability [32]. This evidence concerns the gene TEK and Lipedema.