ACTA1 and lymphedema: Finally, studies performed in mice also suggested the existence of a lymphatic endothelial-to-myofibroblast transition (Ly-EndMT) process, as testified by the fact that α-SMA expression could be induced in lymphatic ECs either in vitro by TGFβ stimulation or in vivo during wound repair, with the number of α-SMA+ lymphatic vessels being correlated to the severity of lymphedema and fibrosis [30].