Lymphatic research and biology最新文献

{"title":"Effectiveness of a Nonpneumatic Active Compression Device in Older Adults with Breast Cancer-Related Lymphedema: A Subanalysis of a Randomized Crossover Trial.","authors":"Stanley G Rockson, Roman Skoracki","doi":"10.1089/lrb.2022.0085","DOIUrl":"10.1089/lrb.2022.0085","url":null,"abstract":"<p><p><b><i>Background:</i></b> A recently completed clinical trial compared a novel nonpneumatic compression device (NPCD) with a traditional advanced pneumatic compression device (APCD) for the treatment of breast cancer-related lymphedema (BCRL); the study revealed that the NPCD produced superior clinical and quality-of-life (QOL) outcomes. In this subanalysis, we sought to examine these results within the subset of trial subjects aged ≥65 years. <b><i>Methods:</i></b> A randomized crossover head-to-head trial was conducted to compare the NPCD with a commercially available APCD. Patients were randomly assigned to one or the other device for 28 days of use, followed by a 4-week washout period before a comparable 28-day utilization of the alternate device. Limb edema, adherence to daily device use, and QOL measures were collected at day 0 and 28 of each period. <b><i>Results:</i></b> A total of 14 subjects were aged ≥65. During NPCD use, subjects experienced a mean decrease in limb edema of 100.3% (<i>p</i> = 0.0082) as well as improvements in mean overall and subscale scores of the Lymphedema Quality of Life Questionnaire (LYMQOL). By comparison, during APCD use limb edema decreased by a mean of 2.9% (<i>p</i> = 0.8899) with no significant changes in any LYMQOL scores. Mean adherence was significantly higher during NPCD use (96.6%) than during APCD use (58.3%, <i>p</i> < 0.0001). <b><i>Conclusions:</i></b> The novel NPCD produced superior clinical and QOL outcomes in older subjects with BCRL. ClinicalTrials.gov ID: NCT04908254.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":"581-584"},"PeriodicalIF":1.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10753982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41137389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recent Advances in Therapeutic Modalities Against Breast Cancer-Related Lymphedema: Future Epigenetic Landscape.","authors":"Kuo Chen, Narasimha M Beeraka, Xinliang Zhang, Mikhail Y Sinelnikov, Maria Plotnikova, Cuiping Zhao, Vijaya Basavaraj, Jin Zhang, Pengwei Lu","doi":"10.1089/lrb.2022.0016","DOIUrl":"10.1089/lrb.2022.0016","url":null,"abstract":"<p><p><b><i>Background:</i></b> Lymphedema is a significant postsurgical complication observed in the majority of breast cancer patients. These multifactorial etiopathogenesis have a significant role in the development of novel diagnostic/prognostic biomarkers and the development of novel therapies. This review aims to ascertain the epigenetic alterations that lead to breast cancer-related lymphedema (BCRL), multiple pathobiological events, and the underlying genetic predisposing factors, signaling cascades pertinent to the lapses in effective prognosis/diagnosis, and finally to develop a suitable therapeutic regimen. <b><i>Methods and Results:</i></b> We have performed a literature search in public databases such as PubMed, Medline, Google Scholar, National Library of Medicine and screened several published reports. Search words such as epigenetics to induce BCRL, prognosis/diagnosis, primary lymphedema, secondary lymphedema, genetic predisposing factors for BRCL, conventional therapies, and surgery were used in these databases. This review described several epigenetic-based predisposing factors and the pathophysiological consequences of BCRL, which affect the overall quality of life, and the interplay of these events could foster the progression of lymphedema in breast cancer survivors. Prognosis/diagnostic and therapy lapses for treating BCRL are highly challenging due to genetic and anatomical variations, alteration in the lymphatic vessel contractions, and variable expression of several factors such as vascular endothelial growth factor (VEGF)-E and vascular endothelial growth factor receptor (VEGFR) in breast cancer survivors. <b><i>Conclusion:</i></b> We compared the efficacy of various conventional therapies for treating BCRL as a multidisciplinary approach. Further substantial research is required to decipher underlying signaling epigenetic pathways to develop chromatin-modifying therapies pertinent to the multiple etiopathogenesis to explore the correlation between the disease pathophysiology and novel therapeutic modalities to treat BCRL.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":"536-548"},"PeriodicalIF":1.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10753987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9565591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lymphatic Vascular Insufficiency and Focal Edema in Early Stages of Noncancer-Related Lymphedema.","authors":"Marzanna T Zaleska, Natalia E Krzesniak","doi":"10.1089/lrb.2023.0008","DOIUrl":"10.1089/lrb.2023.0008","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Lymph flows along the lymphatics due to spontaneous contraction. However, injury and inflammation may deteriorate lymphatic' s endothelial and muscle cells and valves. In consequence, lymphatic vessels (LVs) become insufficient. Their contraction strength and rate slow down, and then lymph flow stops. Our study aimed to investigate the changes in lymph flow in early lymphedema cases. <b><i>Methods and Results:</i></b> In 36 patients with unilateral lymphedema stages 0 and I, we performed indocyanine green (ICG) lymphography, lymphoscintigraphy, skin water concentration, and stiffness measurement. We compared lymph flow velocity, LVs' appearance, contraction pattern, and rate between swollen and healthy limbs. ICG lymphography revealed (1) slower lymph flow after 3 minutes of foot movement; in lower calf level, lymphatics are seen in 22 (61.1%) swollen limbs compared with 36 (100%) healthy limbs (<i>p</i> < 0.0001); (2) dye spots in the foot (47.1%) and calves (13.9%) in swollen limbs; (3) dilated foot (41.7%) and calves' lymphatics (52.8%); (4) different patterns of lymphatics contractility with slower contractions rate and (5) higher fluorescent intensity in edema limbs. There was higher skin water concentration at foot and ankle level and higher skin stiffness in the foot. <b><i>Conclusions:</i></b> Our studies have shown the distortion in lymphatic function as dilatation, slower lymph flow, slower contraction rate, presence of areas with occluded lymphatics (dermal backflow in foot and calves-focal edema), and higher skin water concentration in these regions in limbs with early lymphedema. ICG lymphography can be used for the early detection of LV insufficiency, which allows early prophylactic implementation.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":"585-593"},"PeriodicalIF":1.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9970226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Function of T Cell Immunity in Lymphedema: A Comprehensive Review.","authors":"Ao Fu, Chunjun Liu","doi":"10.1089/lrb.2023.0002","DOIUrl":"10.1089/lrb.2023.0002","url":null,"abstract":"<p><p>Lymphedema is a debilitating disease characterized by extremity edema, fibroadipose deposition, impaired lymphangiogenesis, and dysfunctional lymphatics, often with lymphatic injury secondary to the treatment of malignancies. Emerging evidence has shown that immune dysfunction regulated by T cells plays a pivotal role in development of lymphedema. Specifically, Th1, Th2, Treg, and Th17 cells have been identified as critical regulators of pathological changes in lymphedema. In this review, our aim is to provide an overview of the current understanding of the roles of CD4+ T cells, including Th1, Th2, Treg, and Th17 subsets, in the progression of lymphedema and to discuss associated therapies targeting T cell inflammation for management of lymphedema.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":"556-564"},"PeriodicalIF":1.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9541495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lymphoscintigraphy as a Therapeutic Guidance Tool Can Improve Manual Lymphatic Drainage for the Physical Treatment of Patients with Upper Limb Lymphedema: Randomized Clinical Trial.","authors":"Romain Barbieux, Sabrina Doyenard, Agathe Pluska, Keoma Enciso, Mirela Mariana Roman, Olivier Leduc, Albert Leduc, Pierre Bourgeois, Steven Provyn","doi":"10.1089/lrb.2022.0056","DOIUrl":"10.1089/lrb.2022.0056","url":null,"abstract":"<p><p><b><i>Background:</i></b> The purpose of this study was to measure the effects of lymphoscintigraphically guided manual lymphatic drainage (LG-MLD) and to compare it with standardized manual lymphatic drainage (St-MLD). <b><i>Materials and Methods:</i></b> Fifty-two patients with lymphedema of the upper limb who underwent lymphoscintigraphy were randomly allocated into two groups. Following the phase of physical activity, the control group underwent two phases of St-MLD as the experimental group underwent a first phase of St-MLD followed by a second phase of LG-MLD. Areas of interest were then selected [in particular, dermal backflow (DBF) and axillary lymph nodes (LN)], radioactive activities were quantified for each of these areas. <b><i>Results:</i></b> If a first phase of St-MLD increased the LN activity by 28% on average, the findings indicated that for the second phase of DLM, LG-MLD was 19% more efficient than St-MLD in increasing LN activity. If a period of rest does not influence the lymph charge of DBF areas, physical activity leads to an average activity increase of 17%, whereas LG-MLD and St-MLD lead to an activity decrease of 11%. <b><i>Conclusions:</i></b> For patients with lymphedema, the findings indicate that MLD can increase the lymphatic flow toward the lymphatic nodes by 28% on average and can decrease the charge in the areas of DBF by 11% on average. Moreover, lymphoscintigraphy can be an important therapeutic tool because LG-MLD significantly increases lymphatic flow by 19% more than St-MLD. Concerning the areas of DBF, the LG-MLD and St-MLD decrease the charge in these areas with the same intensity.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":"594-600"},"PeriodicalIF":1.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9833395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Mobiderm Autofit in the Intensive Phase of Breast Cancer-Related Lymphedema Treatment: A Case Series.","authors":"Sławomir Mazur, Dorota Szczęśniak, Hanna Tchórzewska-Korba","doi":"10.1089/lrb.2022.0079","DOIUrl":"10.1089/lrb.2022.0079","url":null,"abstract":"<p><p><b><i>Background:</i></b> The objective of this case series was to evaluate the effectiveness of wearing Mobiderm^® Autofit compressive garment as part of the complete decongestive therapy (CDT) of upper limb lymphedema. <b><i>Materials and Methods:</i></b> Ten women and men with stage II breast cancer-related lymphedema underwent a CDT intensive phase for 12 days, combining Mobiderm Autofit compression garment with manual lymphatic drainage. Arm volume was calculated with the truncated cone formula using circumferential measurements taken at each appointment. The pressure under the garment and the overall satisfaction of patients and physicians were also assessed. <b><i>Results:</i></b> The mean (standard deviation [SD]) age of the patients was 60.50 (11.70) years. The mean (SD) lymphedema excess volume decrease was 343.11 (266.14) mL, which represents a 36.68% decrease between day 1 and day 12, whereas the mean (SD) absolute volume difference was 420.03 (251.27) mL corresponding to a 10.12% decrease during this same period. The mean (SD) device pressure by using the PicoPress^® was 30.01 (0.45) mmHg. The majority of patients were satisfied with the ease of use and the comfort of wearing Mobiderm Autofit. Such positive assessment was confirmed by the physicians. During this case series, no adverse event was reported. <b><i>Conclusion:</i></b> A lymphedema volume decrease of the upper limb was reported after 12 days of treatment with Mobiderm Autofit during the CDT intensive phase. Moreover, the device was well tolerated, and its use was appreciated by the patients and the physicians.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":"608-613"},"PeriodicalIF":1.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10753983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9859933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of the Risk Factors of Breast Cancer-Related Lymphedema and Construction and Evaluation of a Prediction Model.","authors":"Hui Li, Wei-Bo Li, Zeng-Xin Sun, Jing Yu, Pei-Yuan Lv, Chun-Xiao Li, Xiao Liang, Yin Yu, Zhen-Biao Zhao","doi":"10.1089/lrb.2022.0058","DOIUrl":"10.1089/lrb.2022.0058","url":null,"abstract":"<p><p><b><i>Objective:</i></b> The occurrence of breast cancer-related lymphedema (BCRL) in postoperative breast cancer survivors is described and the independent risk factors of BCRL are analyzed. A BCRL nomogram prediction model is constructed, and its effectiveness is evaluated to screen out high-risk patients with BCRL. <b><i>Methods:</i></b> A univariate analysis was carried out to determine the risk factors possibly related to BCRL, and a logistic regression analysis was utilized to determine the independent risk factors related to BCRL. A BCRL nomogram prediction model was built, and a nomogram was drawn by R software v4.1.0. The area under the curve (AUC) of the receiver operating characteristic (ROC) and the Hosmer-Lemeshow test were used to evaluate the efficacy of the constructed model to assess its clinical application value. <b><i>Results:</i></b> The risk factors independently associated with BCRL were body mass index (BMI), handedness on the operation side, no BCRL-related rehabilitation plan, axillary lymph node dissection (ALND), taxane-based chemotherapy, and radiotherapy (all <i>p</i> < 0.05). The BCRL nomogram prediction model was built on this basis, and the results of the efficacy evaluation showed a good fit: AUC = 0.952 (95% confidence interval: 0.930-0.973) for the ROC and χ² = 6.963, <i>p</i> = 0.540 for the Hosmer-Lemeshow test. <b><i>Conclusions:</i></b> The risk factors for BCRL included higher BMI, handedness on the operation side, no BCRL-related rehabilitation plan, ALND, taxane-based chemotherapy, and radiotherapy. In addition, the BCRL nomogram prediction model accurately calculated the risk of possible BCRL among breast cancer survivors and effectively screened for high-risk patients with BCRL. Therefore, this prediction model can provide a basis for rehabilitation physicians and therapists to formulate early and individualized prevention and treatment programs.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":"565-573"},"PeriodicalIF":1.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41133970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research Matters.","authors":"","doi":"10.1089/lrb.2023.29152.wr","DOIUrl":"10.1089/lrb.2023.29152.wr","url":null,"abstract":"","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":"21 6","pages":"641"},"PeriodicalIF":1.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139040226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of Pressure Sensors to Help Support Community Lymphedema Monitoring: A Scoping Review.","authors":"Omnia Rajab, Emily Armstrong, Martin Ferguson-Pell","doi":"10.1089/lrb.2022.0095","DOIUrl":"10.1089/lrb.2022.0095","url":null,"abstract":"<p><p>Breast cancer-related lymphedema is a condition occurring after a partial or full mastectomy, where there is a buildup of interstitial fluid in the body, particularly in the upper limb. There is a lack of at-home sensors that can help monitor the progression of lymphedema. The purpose of this scoping review is to gather relevant information on sensors for remote lymphedema monitoring. A literature search of Medline, PubMed, Scopus, Web of Science, and BMC databases yielded 96 studies. A total of six studies were selected for data extraction. Data were extracted from each study and organized into tables for analysis. A total of six different devices were mentioned in the six studies included in the scoping review, divided into wearable and nonwearable sensors. Nonwearable sensors were more likely to be adaptable for remote sensing as they were further along in development and commercially available on the market. Nonwearable sensors are more developed than wearable sensors for the purpose of remote lymphedema monitoring. This review advocates further development and validation of sensors for lymphedema management, particularly for remote monitoring and health assessments.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":"549-555"},"PeriodicalIF":1.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9997250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Update December 2023.","authors":"Francine Blei","doi":"10.1089/lrb.2023.29154.fb","DOIUrl":"10.1089/lrb.2023.29154.fb","url":null,"abstract":"","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":"21 6","pages":"614-640"},"PeriodicalIF":1.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139040228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}