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Watanabe-Asaka T, Hayashi M, Harada T, Uemura S, Takai J, Nakamura Y, Moriguchi T, Kawai Y. Perturbed collagen metabolism underlies lymphatic recanalization failure in Gata2 heterozygous deficient mice. J Biochem 2024; 175:551-560. [PMID: 38168819 DOI: 10.1093/jb/mvad122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 12/27/2023] [Indexed: 01/05/2024] Open
Abstract
Lymphedema has become a global health issue following the growing number of cancer surgeries. Curative or supportive therapeutics have long been awaited for this refractory condition. Transcription factor GATA2 is crucial in lymphatic development and maintenance, as GATA2 haploinsufficient disease often manifests as lymphedema. We recently demonstrated that Gata2 heterozygous deficient mice displayed delayed lymphatic recanalization upon lymph node resection. However, whether GATA2 contributes to lymphatic regeneration by functioning in the damaged lymph vessels' microenvironment remains explored. In this study, our integrated analysis demonstrated that dermal collagen fibers were more densely accumulated in the Gata2 heterozygous deficient mice. The collagen metabolism-related transcriptome was perturbed, and collagen matrix contractile activity was aberrantly increased in Gata2 heterozygous embryonic fibroblasts. Notably, soluble collagen placement ameliorated delayed lymphatic recanalization, presumably by modulating the stiffness of the extracellular matrix around the resection site of Gata2 heterozygous deficient mice. Our results provide valuable insights into mechanisms underlying GATA2-haploinsufficiency-mediated lymphedema and shed light on potential therapeutic avenues for this intractable disease.
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Affiliation(s)
- Tomomi Watanabe-Asaka
- Division of Physiology, Tohoku Medical and Pharmaceutical University, School of Medicine
| | - Moyuru Hayashi
- Division of Physiology, Tohoku Medical and Pharmaceutical University, School of Medicine
| | - Takuya Harada
- Division of Physiology, Tohoku Medical and Pharmaceutical University, School of Medicine
| | - Satoshi Uemura
- Division of Medical Biochemistry, Tohoku Medical and Pharmaceutical University, School of Medicine
| | - Jun Takai
- Division of Medical Biochemistry, Tohoku Medical and Pharmaceutical University, School of Medicine
| | - Yasuhiro Nakamura
- Division of Pathology, Tohoku Medical and Pharmaceutical University, School of Medicine 983-8536 Japan
| | - Takashi Moriguchi
- Division of Medical Biochemistry, Tohoku Medical and Pharmaceutical University, School of Medicine
| | - Yoshiko Kawai
- Division of Physiology, Tohoku Medical and Pharmaceutical University, School of Medicine
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Clinical Characteristics and Implications of Indocyanine Green Lymphography-Identified Contralateral Inguinal Pathway of Lower-Limb Lymphedema. REHABILITATION ONCOLOGY 2022. [DOI: 10.1097/01.reo.0000000000000322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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3
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Russell PS, Hong J, Trevaskis NL, Windsor JA, Martin ND, Phillips ARJ. Lymphatic Contractile Function: A Comprehensive Review of Drug Effects and Potential Clinical Application. Cardiovasc Res 2021; 118:2437-2457. [PMID: 34415332 DOI: 10.1093/cvr/cvab279] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 08/18/2021] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND The lymphatic system and the cardiovascular system work together to maintain body fluid homeostasis. Despite that, the lymphatic system has been relatively neglected as a potential drug target and a source of adverse effects from cardiovascular drugs. Like the heart, the lymphatic vessels undergo phasic contractions to promote lymph flow against a pressure gradient. Dysfunction or failure of the lymphatic pump results in fluid imbalance and tissue oedema. While this can due to drug effects, it is also a feature of breast cancer-associated lymphoedema, chronic venous insufficiency, congestive heart failure and acute systemic inflammation. There are currently no specific drug treatments for lymphatic pump dysfunction in clinical use despite the wealth of data from pre-clinical studies. AIM To identify (1) drugs with direct effects on lymphatic tonic and phasic contractions with potential for clinical application, and (2) drugs in current clinical use that have a positive or negative side effect on lymphatic function. METHODS We comprehensively reviewed all studies that tested the direct effect of a drug on the contractile function of lymphatic vessels. RESULTS Of the 208 drugs identified from 193 studies, about a quarter had only stimulatory effects on lymphatic tone, contraction frequency and/or contraction amplitude. Of FDA-approved drugs, there were 14 that increased lymphatic phasic contractile function. The most frequently used class of drug with inhibitory effects on lymphatic pump function were the calcium channels blockers. CONCLUSION This review highlights the opportunity for specific drug treatments of lymphatic dysfunction in various disease states and for avoiding adverse drug effects on lymphatic contractile function.
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Affiliation(s)
- Peter S Russell
- Applied Surgery and Metabolism Laboratory, School of Biological Sciences, University of Auckland, Auckland, New Zealand.,Surgical and Translational Research Centre, Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Jiwon Hong
- Applied Surgery and Metabolism Laboratory, School of Biological Sciences, University of Auckland, Auckland, New Zealand.,Surgical and Translational Research Centre, Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Natalie L Trevaskis
- Monash Institute of Pharmaceutical Sciences, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia
| | - John A Windsor
- Surgical and Translational Research Centre, Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Niels D Martin
- Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Anthony R J Phillips
- Applied Surgery and Metabolism Laboratory, School of Biological Sciences, University of Auckland, Auckland, New Zealand.,Surgical and Translational Research Centre, Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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4
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Watanabe-Asaka T, Hayashi M, Uemura S, Takai J, Suzuki A, Moriguchi T, Kawai Y. GATA2 participates in the recanalization of lymphatic vessels after surgical lymph node extirpation. Genes Cells 2021; 26:474-484. [PMID: 33864419 DOI: 10.1111/gtc.12852] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 04/06/2021] [Accepted: 04/12/2021] [Indexed: 11/27/2022]
Abstract
Lymphatic recanalization failure after lymphadenectomy constitutes a major risk of lymphedema in cancer surgery. It has been reported that GATA2, a zinc finger transcription factor, is expressed in lymphatic endothelial cells and is involved in the development of fetal lymphatic vessels. GATA3, another member of the GATA family of transcription factors, is required for the differentiation of lymphoid tissue inducer (LTi) cells and is essential for lymph node formation. However, how GATA2 and GATA3 function in recanalization after the surgical extirpation of lymphatic vessels has not been elucidated. Employing a new model of lymphatic recanalization, we examined the lymphatic reconnection process in Gata2 heterozygous deficient (Gata2+/- ) and Gata3 heterozygous deficient (Gata3+/- ) mice. We found that lymphatic recanalization was significantly impaired in Gata2+/- mice, while Gata3+/- mice rarely showed such abnormalities. Notably, the perturbed lymphatic recanalization in the Gata2+/- mice was partially restored by crossing with the Gata3+/- mice. Our results demonstrate for the first time that GATA2 participates in the regeneration of damaged lymphatic vessels and the unexpected suppressive activity of GATA3 against lymphatic recanalization processes.
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Affiliation(s)
| | - Moyuru Hayashi
- Division of Physiology, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Satoshi Uemura
- Division of Medical Biochemistry, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Jun Takai
- Division of Medical Biochemistry, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Akane Suzuki
- Division of Physiology, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Takashi Moriguchi
- Division of Medical Biochemistry, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Yoshiko Kawai
- Division of Physiology, Tohoku Medical and Pharmaceutical University, Sendai, Japan
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5
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Bacalbasa N, Balescu I, Diaconu C, Savu C, Savu C, Neacsu A, Belu E, Bratu O, Cretoiu D, Halmaciu I, Iliescu L, Balalau C, Filipescu A, Vilcu M, Brezean I. Utility of indocyanine green injection in patients with cervical cancer besides the identification of sentinel lymph node (Review). Exp Ther Med 2020; 20:3523-3527. [PMID: 32905080 DOI: 10.3892/etm.2020.9095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 07/06/2020] [Indexed: 11/06/2022] Open
Abstract
Due to the wide introduction of screening tests, patients with neoplastic diseases of the uterine cervix trend to be diagnosed in early stages of the disease, and less invasive surgical procedures are needed in certain cases. In this respect, the technique of sentinel lymph node dissection has been widely implemented as part of the therapeutic strategy, indocyanine green (ICG) being one of the most reliable markers for sentinel lymph node detection. However, it seems that this agent is extremely useful in order to achieve better short-term and long-term results after cervical cancer surgery, due to its capacity to determine the uterine vascular perfusion in cases in which conservative treatment, such as trachelectomy, is performed, as well as to prevent and treat lower limb lymphedema. A literature review was conducted of the studies which focused on the role of ICG utility in cervical cancer patients besides sentinel lymph node detection, special focus was given to vascularization preservation and lower limb lymphedema prevention and treatment.
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Affiliation(s)
- Nicolae Bacalbasa
- Department of Obstetrics and Gynecology, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.,Department of Visceral Surgery, Center of Excellence in Translational Medicine, 'Fundeni' Clinical Institute, 022328 Bucharest, Romania.,Department of Obstetrics and Gynecology, 'I. Cantacuzino' Clinical Hospital, 030167 Bucharest, Romania
| | - Irina Balescu
- Department of Surgery, 'Ponderas' Academic Hospital, 021188 Bucharest, Romania
| | - Camelia Diaconu
- Department of Internal Medicine, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.,Department of Internal Medicine, Clinical Emergency Hospital of Bucharest, 105402 Bucharest, Romania
| | - Carmen Savu
- Department of Anesthesiology, 'Fundeni' Clinical Institute, 022328 Bucharest, Romania
| | - Cornel Savu
- Department of Thoracic Surgery, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.,Department of Thoracic Surgery, 'Marius Nasta' Institute of Pneumonology, 050159 Bucharest, Romania
| | - Adrian Neacsu
- Department of Obstetrics and Gynecology, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.,Department of Obstetrics and Gynecology, 'Sf. Ioan' Clinical Emergency Hospital, 042122 Bucharest, Romania
| | - Emil Belu
- Department of Oncology, 'Al. Trestioreanu' Institute of Oncology, 022328 Bucharest, Romania
| | - Ovidiu Bratu
- Department of Urology, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.,Department of Urology, Central Military Emergency Hospital, 010825 Bucharest, Romania
| | - Dragos Cretoiu
- Department of Cell and Molecular Biology and Histology, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.,'Alessandrescu-Rusescu' National Institute of Mother and Child Health, Fetal Medicine Excellence Research Center, 020395 Bucharest, Romania
| | - Ioana Halmaciu
- Department of Anatomy, 'George Emil Palade' University of Medicine, Pharmacy, Science and Technology, 540142 Târgu Mureş, Romania
| | - Laura Iliescu
- Department of Internal Medicine, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.,Department of Internal Medicine, 'Fundeni' Clinical Institute, 022328 Bucharest, Romania
| | - Cristian Balalau
- Department of Surgery, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.,Department of Surgery, 'Sf. Pantelimon' Clinical Hospital, 021659 Bucharest, Romania
| | - Alexandru Filipescu
- Department of Obstetrics and Gynecology, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.,Department of Obstetrics and Gynecology, 'Elias' Emergency Hospital, 125100 Bucharest, Romania
| | - Mihaela Vilcu
- Department of Surgery, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.,Department of Visceral Surgery, 'I. Cantacuzino' Clinical Hospital, 030167 Bucharest, Romania
| | - Iulian Brezean
- Department of Surgery, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.,Department of Visceral Surgery, 'I. Cantacuzino' Clinical Hospital, 030167 Bucharest, Romania
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6
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Asano K, Nakajima Y, Mukai K, Urai T, Okuwa M, Sugama J, Konya C, Nakatani T. Pre-collecting lymphatic vessels form detours following obstruction of lymphatic flow and function as collecting lymphatic vessels. PLoS One 2020; 15:e0227814. [PMID: 31940420 PMCID: PMC6961945 DOI: 10.1371/journal.pone.0227814] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Accepted: 12/30/2019] [Indexed: 01/21/2023] Open
Abstract
Background Previously, we showed that lymphatic vessels (LVs) formed detours after lymphatic obstruction, contributing to preventing lymphedema. In this study, we developed detours using lymphatic ligation in mice and we identified the detours histologically. Methods and results Under anesthesia, both hindlimbs in mice were subcutaneously injected with Evans blue dye to detect LVs. We tied the right collecting LV on the abdomen that passes through the inguinal lymph node (LN) at two points. The right and left sides comprised the operation and sham operation sides, respectively. Lymphography was performed to investigate the lymph flow after lymphatic ligation until day 30, using a near-infrared fluorescence imaging system. Anti-podoplanin antibody and 5-ethynyl-2’-deoxyuridine (EdU) were used to detect LVs and lymphangiogenesis. Within 30 days, detours had developed in 62.5% of the mice. Detours observed between two ligation sites were enlarged and irregular in shape. Podoplanin+ LVs, which were located in the subcutaneous tissue of the upper panniculus carnosus muscle, connected to collecting LVs at the upper portion from the cranial ligation site and at the lower portion from the caudal ligation site. EdU+ cells were not observed in these detours. The sham operation side showed normal lymph flow and did not show enlarged pre-collecting LVs until day 30. Conclusions Detours after lymphatic ligation were formed not by lymphangiogenesis but through an enlargement of pre-collecting LVs that functioned as collecting LVs after lymphatic ligation. Further studies are required to explore the developmental mechanism of the lymphatic detour for treatment and effective care of lymphedema in humans.
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Affiliation(s)
- Kimi Asano
- Department of Clinical Nursing, Graduate Course of Nursing Science, Division of Health Sciences, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
- School of Nursing, Kanazawa Medical University, Uchinada, Japan
| | - Yukari Nakajima
- Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Kanae Mukai
- Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Tamae Urai
- Faculty of Nursing, Toyama Prefectural University, Toyama, Japan
| | - Mayumi Okuwa
- Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Junko Sugama
- Advanced Health Care Science Research Unit, Innovative Integrated Bio-Research Core, Institute for Frontier Science Initiative, Kanazawa University, Kanazawa, Japan
| | - Chizuko Konya
- Faculty of Nursing, Ishikawa Prefectural Nursing University, Kahoku, Japan
| | - Toshio Nakatani
- Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
- * E-mail:
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7
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Schwarz GS, Grobmyer SR, Djohan RS, Cakmakoglu C, Bernard SL, Radford D, Al-Hilli Z, Knackstedt R, Djohan M, Valente SA. Axillary reverse mapping and lymphaticovenous bypass: Lymphedema prevention through enhanced lymphatic visualization and restoration of flow. J Surg Oncol 2019; 120:160-167. [PMID: 31144329 DOI: 10.1002/jso.25513] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Revised: 04/27/2019] [Accepted: 05/03/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND A lymphedema (LE) prevention surgery (LPS) paradigm for patients undergoing axillary lymphadenectomy (ALND) was developed to protect against LE through enhanced lymphatic visualization during axillary reverse mapping (ARM) and refinement in decision making during lymphaticovenous bypass (LVB). METHODS A retrospective analysis of a prospective database was performed evaluating patients with breast cancer who underwent ALND, ARM, and LVB from September 2016 to December 2018. Patient and tumor characteristics, oncologic and reconstructive operative details, complications and LE development were analyzed. RESULTS LPS was completed in 58 patients with a mean age of 51.7 years. An average of 14 lymph nodes (LN) were removed during ALND. An average of 2.1 blue lymphatic channels were visualized with an average of 1.4 LVBs performed per patient. End to end anastomosis was performed in 37 patients and a multiple lymphatic intussusception technique in 21. Patency was confirmed 96.5% of patients. Adjuvant radiation was administered to 89% of patients. Two patients developed LE with a median follow-up of 11.8 months. CONCLUSION We report on our experience using a unique LPS technique. Refinements in ARM and a systematic approach to LVB allows for maximal preservation of lymphatic continuity, identification of transected lymphatics, and reestablishment of upper extremity lymphatic drainage pathways.
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Affiliation(s)
- Graham S Schwarz
- Department of Plastic Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Stephen R Grobmyer
- Department of General Surgery, Division of Breast Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Risal S Djohan
- Department of Plastic Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Cagri Cakmakoglu
- Department of Plastic Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Steven L Bernard
- Department of Plastic Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Diane Radford
- Department of General Surgery, Division of Breast Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Zahraa Al-Hilli
- Department of General Surgery, Division of Breast Surgery, Cleveland Clinic, Cleveland, Ohio
| | | | - Michelle Djohan
- Department of Plastic Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Stephanie A Valente
- Department of General Surgery, Division of Breast Surgery, Cleveland Clinic, Cleveland, Ohio
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8
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Suami H, Koelmeyer L, Mackie H, Boyages J. Patterns of lymphatic drainage after axillary node dissection impact arm lymphoedema severity: A review of animal and clinical imaging studies. Surg Oncol 2018; 27:743-750. [PMID: 30449502 DOI: 10.1016/j.suronc.2018.10.006] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 10/01/2018] [Accepted: 10/10/2018] [Indexed: 11/29/2022]
Abstract
Upper extremity lymphoedema after axillary node dissection is an iatrogenic disease particularly associated with treatment for breast or skin cancer. Anatomical studies and lymphangiography in healthy subjects identified that axillary node dissection removes a segment of the lymphatic drainage pathway running from the upper limb to the sub-clavicular vein, creating a surgical break. It is reasonable to infer that different patterns of lymphatic drainage may occur in the upper limb following surgery and contribute to the various presentations of lymphoedema from none to severe. Firstly, we reviewed animal imaging studies that investigated the repair of lymphatic drainage pathways from the limb after lymph node dissection. Secondly, we examined clinical imaging studies of lymphatic drainage pathways after axillary node dissection, including lymphangiography, lymphoscintigraphy and indocyanine green fluorescence lymphography. Finally, based on the gathered data, we devised a set of general principles for the restoration of lymphatic pathways after surgery. Lymphoscintigraphy shows that restoration of the original lymphatic pathway to the axilla after its initial disruption by nodal dissection was not uncommon and may prevent lymphoedema. We found that regenerated lymphatic vessels and dermal backflow (the reflux of lymph to the skin) contributed to either restoration of the original pathway or rerouting of the lymphatic pathway to other regional nodes. Variation in the lymphatic drainage pathway and the mechanisms of fluid drainage itself are the foundation of new lymphatic drainage patterns considered to be significant in determining the severity with which lymphoedema develops.
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Affiliation(s)
- Hiroo Suami
- Australian Lymphoedema Education, Research and Treatment Centre, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia.
| | - Louise Koelmeyer
- Australian Lymphoedema Education, Research and Treatment Centre, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Helen Mackie
- Australian Lymphoedema Education, Research and Treatment Centre, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia; Mt Wilga Private Hospital, Hornsby, New South Wales, Australia
| | - John Boyages
- Australian Lymphoedema Education, Research and Treatment Centre, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia
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9
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10
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Ogata F, Fujiu K, Koshima I, Nagai R, Manabe I. Phenotypic modulation of smooth muscle cells in lymphoedema. Br J Dermatol 2015; 172:1286-93. [DOI: 10.1111/bjd.13482] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2014] [Indexed: 01/22/2023]
Affiliation(s)
- F. Ogata
- Department of Cardiovascular Medicine; Graduate School of Medicine; University of Tokyo; 7-3-1 Hongo Bunkyo Tokyo 113-8655 Japan
- Department of Plastic, Reconstructive and Aesthetic Surgery; Graduate School of Medicine; University of Tokyo; 7-3-1 Hongo Bunkyo Tokyo 113-8655 Japan
| | - K. Fujiu
- Department of Cardiovascular Medicine; Graduate School of Medicine; University of Tokyo; 7-3-1 Hongo Bunkyo Tokyo 113-8655 Japan
- Translational Systems Biology and Medicine Initiative; Graduate School of Medicine; University of Tokyo; 7-3-1 Hongo Bunkyo Tokyo 113-8655 Japan
| | - I. Koshima
- Department of Plastic, Reconstructive and Aesthetic Surgery; Graduate School of Medicine; University of Tokyo; 7-3-1 Hongo Bunkyo Tokyo 113-8655 Japan
| | - R. Nagai
- Jichi Medical University; 3311-1 Yakushiji Shimotsuke-shi Tochigi-ken 329-0498 Japan
| | - I. Manabe
- Department of Cardiovascular Medicine; Graduate School of Medicine; University of Tokyo; 7-3-1 Hongo Bunkyo Tokyo 113-8655 Japan
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11
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Kwon S, Agollah GD, Wu G, Sevick-Muraca EM. Spatio-temporal changes of lymphatic contractility and drainage patterns following lymphadenectomy in mice. PLoS One 2014; 9:e106034. [PMID: 25170770 PMCID: PMC4149501 DOI: 10.1371/journal.pone.0106034] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Accepted: 07/28/2014] [Indexed: 11/19/2022] Open
Abstract
Objective To investigate the redirection of lymphatic drainage post-lymphadenectomy using non-invasive near-infrared fluorescence (NIRF) imaging, and to subsequently assess impact on metastasis. Background Cancer-acquired lymphedema arises from dysfunctional fluid transport after lymphadenectomy performed for staging and to disrupt drainage pathways for regional control of disease. However, little is known about the normal regenerative processes of the lymphatics in response to lymphadenectomy and how these responses can be accelerated, delayed, or can impact metastasis. Methods Changes in lymphatic “pumping” function and drainage patterns were non-invasively and longitudinally imaged using NIRF lymphatic imaging after popliteal lymphadenectomy in mice. In a cohort of mice, B16F10 melanoma was inoculated on the dorsal aspect of the paw 27 days after lymphadenectomy to assess how drainage patterns affect metastasis. Results NIRF imaging demonstrates that, although lymphatic function and drainage patterns change significantly in early response to popliteal lymph node (PLN) removal in mice, these changes are transient and regress dramatically due to a high regenerative capacity of the lymphatics and co-opting of collateral lymphatic pathways around the site of obstruction. Metastases followed the pattern of collateral pathways and could be detected proximal to the site of lymphadenectomy. Conclusions Both lymphatic vessel regeneration and co-opting of contralateral vessels occur following lymphadenectomy, with contractile function restored within 13 days, providing a basis for preclinical and clinical investigations to hasten lymphatic repair and restore contractile lymphatic function after surgery to prevent cancer-acquired lymphedema. Patterns of cancer metastasis after lymphadenectomy were altered, consistent with patterns of re-directed lymphatic drainage.
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Affiliation(s)
- Sunkuk Kwon
- Center for Molecular Imaging, The Brown Foundation Institute of Molecular Medicine, The University of Texas Health Science Center, Houston, Texas, United States of America
- * E-mail:
| | - Germaine D. Agollah
- Center for Molecular Imaging, The Brown Foundation Institute of Molecular Medicine, The University of Texas Health Science Center, Houston, Texas, United States of America
- The University of Texas Graduate School of Biomedical Sciences at Houston, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
| | - Grace Wu
- Center for Molecular Imaging, The Brown Foundation Institute of Molecular Medicine, The University of Texas Health Science Center, Houston, Texas, United States of America
| | - Eva M. Sevick-Muraca
- Center for Molecular Imaging, The Brown Foundation Institute of Molecular Medicine, The University of Texas Health Science Center, Houston, Texas, United States of America
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12
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Ikomi F, Kawai Y, Ohhashi T. Recent advance in lymph dynamic analysis in lymphatics and lymph nodes. Ann Vasc Dis 2013; 5:258-68. [PMID: 23555523 DOI: 10.3400/avd.ra.12.00046] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Accepted: 06/15/2012] [Indexed: 01/30/2023] Open
Abstract
Lymphatics are a unidirectional transport system that carries fluid from the interstitial space and back into the blood stream. Initial lymphatics take up not only fluid but also high-molecular-weight substances, such as plasma proteins and hyaluronan; immune cells, such as lymphocytes, macrophages, and dendritic cells; and colloidal particles, such as carbon particles, bacteria, and tattoo dye. Interstitially injected colloidal particles are known to accumulate in the regional lymph nodes. This phenomenon is applied to find sentinel lymph nodes in cancer patients. Lymph flow rate and composition are influenced by interstitial fluid, lymphatic pump activity, and intra-lymphatic pressure. Lymph composition is changed during its flow downstream. In this review, the main focus is on the mechanisms of lymph formation at the initial lymphatics and lymph transport through the collecting lymphatics and lymph nodes. (*English Translation of J Jpn Coll Angiol, 2008, 48: 113-123.).
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Affiliation(s)
- Fumitaka Ikomi
- Department of Physiology, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
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13
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Buettner M, Bode U. Lymph node dissection--understanding the immunological function of lymph nodes. Clin Exp Immunol 2012; 169:205-12. [PMID: 22861359 DOI: 10.1111/j.1365-2249.2012.04602.x] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Lymph nodes (LN) are one of the important sites in the body where immune responses to pathogenic antigens are initiated. This immunological function induced by cells within the LN is an extensive area of research. To clarify the general function of LN, to identify cell populations within the lymphatic system and to describe the regeneration of the lymph vessels, the experimental surgical technique of LN dissection has been established in various animal models. In this review different research areas in which LN dissection is used as an experimental tool will be highlighted. These include regeneration studies, immunological analysis and studies with clinical questions. LN were dissected in order to analyse the different cell subsets of the incoming lymph in detail. Furthermore, LN were identified as the place where the induction of an antigen-specific response occurs and, more significantly, where this immune response is regulated. During bacterial infection LN, as a filter of the lymph system, play a life-saving role. In addition, LN are essential for the induction of tolerance against harmless antigens, because tolerance could not be induced in LN-resected animals. Thus, the technique of LN dissection is an excellent and simple method to identify the important role of LN in immune responses, tolerance and infection.
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Affiliation(s)
- M Buettner
- Institute of Functional and Applied Anatomy, Hannover Medical School, Hannover, Germany.
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Abstract
The growth of lymphatic vessels (lymphangiogenesis) is actively involved in a number of pathological processes including tissue inflammation and tumor dissemination but is insufficient in patients suffering from lymphedema, a debilitating condition characterized by chronic tissue edema and impaired immunity. The recent explosion of knowledge on the molecular mechanisms governing lymphangiogenesis provides new possibilities to treat these diseases.
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Affiliation(s)
- Tuomas Tammela
- Molecular/Cancer Biology Laboratory and Haartman Institute, University of Helsinki, Finland
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15
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Affiliation(s)
- Françoise Bruyère
- Laboratory of Tumor and Development BiologyGroupe Interdisciplinaire de Génoprotéomique Appliqué-Cancer (GIGA-Cancer)University of LiegeLiegeBelgium
| | - Agnès Noël
- Laboratory of Tumor and Development BiologyGroupe Interdisciplinaire de Génoprotéomique Appliqué-Cancer (GIGA-Cancer)University of LiegeLiegeBelgium
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16
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Schacht V, Luedemann W, Abels C, Berens von Rautenfeld D. Anatomy of the Subcutaneous Lymph Vascular Network of the Human Leg in Relation to the Great Saphenous Vein. Anat Rec (Hoboken) 2009; 292:87-93. [DOI: 10.1002/ar.20765] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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17
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Nagai T, Ikomi F, Suzuki S, Ohhashi T. In situ lymph dynamic characterization through lymph nodes in rabbit hind leg: special reference to nodal inflammation. J Physiol Sci 2008; 58:123-32. [PMID: 18325146 DOI: 10.2170/physiolsci.rp001208] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2008] [Accepted: 03/05/2008] [Indexed: 11/05/2022]
Abstract
In some lymph nodes, water and water-soluble substances of smaller molecular weight are known to be absorbed into blood vessels, and consequently the protein concentration of lymph within the nodes increases. In this study, we examined pressure-flow relationships of lymph nodes in situ and exchange properties of water and water-soluble substances through the nodes with special reference to inflamed lymph nodes. A lymph perfusion model through the lymph node in situ was constructed by cannulating one of the afferent lymphatics and an efferent lymphatic. Increasing infusion pressure (0 to 150 cmH(2)O) or decreasing outflow pressure (10 to -5 cmH(2)O) in the model caused a significant increase of the lymph outflow rate through the node. This rate was also increased significantly with increases in both intranodal venous pressure (range: control, 20, 30, and 40 mmHg) and prenodal lymph albumin concentration (range: 0%, 2.6%, and 10%). When formyl-Met-Leu-Phe-OH (fMLP)-mediated acute inflammation was produced in the lymph nodes, the lymph outflow rate through the node was significantly decreased. These results indicate that colloid osmotic pressure and hydrostatic pressure within the lymph node may play important roles in the transport of water and water-soluble substances through the node. Acute fMLP-mediated inflammation of lymph nodes also produced a significant decrease of the lymph flow rate through lymph nodes.
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Affiliation(s)
- Takashi Nagai
- Department of Physiology, Shinshu University School of Medicine, Matsumoto, Japan
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18
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Tammela T, Saaristo A, Holopainen T, Lyytikkä J, Kotronen A, Pitkonen M, Abo-Ramadan U, Ylä-Herttuala S, Petrova TV, Alitalo K. Therapeutic differentiation and maturation of lymphatic vessels after lymph node dissection and transplantation. Nat Med 2007; 13:1458-66. [DOI: 10.1038/nm1689] [Citation(s) in RCA: 275] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2007] [Accepted: 10/26/2007] [Indexed: 01/22/2023]
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