rating of pain to punctate stimuli, P1-3: skin areas adjacent to the area of RHP application, PCM acetaminophen, QT 100 mN cotton wool tip, RHP repetitive heat pain, SHP rating of suprathreshold heat pain, WDT warm detection threshold. Acknowledgments The authors thank Dr. Thomas Klein from the Department of Neurophysiology, Centre for Biomedicine and Medical Technology Mannheim, University of Heidelberg, Mannheim, Germany for helpful discussion of the study design. The treatment of cancer patients is often complicated by tumor angiogenesis and lymphangiogenesis, which are closely associated with tumor metastasis and growth. Identifying the molecules involved in these processes could help to advance therapeutic strategies for cancer patients. Both angiogenesis and lymphangiogenesis are exacerbated in tumors by the up-regulation of chemokines, growth factors, proteolytic enzymes, and prostaglandins in response to inflammatory stimuli. In fact, human malignancies are often initiated and promoted by inflammation, in close association with angiogenesis and lymphangiogenesis, while the recruitment of macrophages and neutrophils to the tumor microenvironment activates cells that support cancer progression. In the cornea, inflammatory cytokines such as interleukin -1a and IL-1b induce angiogenesis and lymphangiogenesis by enhancing the expression of angiogenic and lymphangiogenic factors in a sequence of events that can be blocked by macrophage depletion. Clinical studies have also demonstrated a close association between infiltration of tumor-associated 7039674 macrophages and poor prognosis in patients with various human malignancies, suggesting that elevated inflammatory responses in the tumor microenvironment are important for malignant progression. It has been proposed that TAMs are composed of functionally different populations of angiogenesis-, metastasis-, and inflammation-supporting macrophages, thereby allowing these cells to influence tumor development. The human lung cancer cell line NCI-H460-LNM35 is highly metastatic compared with its lower metastatic counterpart N15, and the cells have a propensity to cause lymph node metastases following subcutaneous or orthotopic injection in mice. Previous studies examining the mechanism underlying the lung and lymph node metastasis of these cells noted the following IL-1-Driven Lymphangiogenesis by Cancer Cell findings. First, cyclooxygenase 2 expression and invasion/ motility in vitro were higher in LNM35 than in N15 cells. In a xenograft model in vivo, lung cancer metastasis was blocked by COX2 inhibitors, indicating a role for prostaglandin pathways, as well as inflammatory activation, in metastasis. Second, LNM35 cells expressed slightly higher amounts of the potent lymphangiogenic factor vascular endothelial growth factor -C, together with activation of its cognate receptor . In highly metastatic tumors treated with soluble VEGFR-3 and a receptor tyrosine 20550119 kinase inhibitor, lymphangiogenesis, lymph node metastasis, and tumor growth were blocked. Third, the angiopoietin/Tie2 pathway was activated in highly metastatic cells, and an angiopoietin BS-181 2-blocking antibody suppressed lung and lymph node metastasis. Taken together, these findings suggest that the induction of lung and lymph node metastasis, lymphangiogenesis, and tumor growth by highly metastatic lung cancer cells is mediated by enhanced expression of COX2, VEGFR-3-driven signaling, and angiopoietin. The hypothesis underlying the present st