Lipomatosis-associated inflammation and excess collagen may contribute to lower relative resting energy expenditure in women with adiposis dolorosa

Herbst, Karen L.; Coviello, Andrea D.; Chang, Anna; Boyle, D L

doi:10.1038/ijo.2009.119

Cited by 20 publications

(26 citation statements)

References 48 publications

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“…Interestingly, pericytes can exert pro-fibrotic activity in that they dedifferentiate into activated fibroblasts producing collagen [55]. Fibroproliferation during hypertrophic scarring might be due to the high sensitivity of pericytes or transdifferentiated myofibroblasts to hypoxic states, resulting in occluded or even partially occluded (micro)vessels [50,56]. …”

Section: Angiogenesis In Skin Wound Healingmentioning

confidence: 99%

Skin Wound Healing: An Update on the Current Knowledge and Concepts

Sorg

Tilkorn²,

Hager³

et al. 2016

Eur Surg Res

956

691

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Background: The integrity of healthy skin plays a crucial role in maintaining physiological homeostasis of the human body. The skin is the largest organ system of the body. As such, it plays pivotal roles in the protection against mechanical forces and infections, fluid imbalance, and thermal dysregulation. At the same time, it allows for flexibility to enable joint function in some areas of the body and more rigid fixation to hinder shifting of the palm or foot sole. Many instances lead to inadequate wound healing which necessitates medical intervention. Chronic conditions such as diabetes mellitus or peripheral vascular disease can lead to impaired wound healing. Acute trauma such as degloving or large-scale thermal injuries are followed by a loss of skin organ function rendering the organism vulnerable to infections, thermal dysregulation, and fluid loss. Methods: For this update article, we have reviewed the actual literature on skin wound healing purposes focusing on the main phases of wound healing, i.e., inflammation, proliferation, epithelialization, angiogenesis, remodeling, and scarring. Results: The reader will get briefed on new insights and up-to-date concepts in skin wound healing. The macrophage as a key player in the inflammatory phase will be highlighted. During the epithelialization process, we will present the different concepts of how the wound will get closed, e.g., leapfrogging, lamellipodial crawling, shuffling, and the stem cell niche. The neovascularization represents an essential component in wound healing due to its fundamental impact from the very beginning after skin injury until the end of the wound remodeling. Here, the distinct pattern of the neovascularization process and the special new functions of the pericyte will be underscored. At the end, this update will present 3 topics of high interest in skin wound healing issues, dealing with scarring, tissue engineering, and plasma application. Conclusion: Although wound healing mechanisms and specific cell functions in wound repair have been delineated in part, many underlying pathophysiological processes are still unknown. The purpose of the following update on skin wound healing is to focus on the different phases and to brief the reader on the current knowledge and new insights. Skin wound healing is a complex process, which is dependent on many cell types and mediators interacting in a highly sophisticated temporal sequence. Although some interactions during the healing process are crucial, redundancy is high and other cells or mediators can adopt functions or signaling without major complications.

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Section: Angiogenesis In Skin Wound Healingmentioning

confidence: 99%

Skin Wound Healing: An Update on the Current Knowledge and Concepts

Sorg

Tilkorn²,

Hager³

et al. 2016

Eur Surg Res

956

691

View full text Add to dashboard Cite

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“…Dr Dercum and others found an infiltration of nerves (neuritis) [185,201] but this has not been substantiated. Increased connective tissue around nerves, blood vessels and as thickened septae has been noted [185,202,203] . Perivascular cells [203] , giant cells [204] , and granulomas suggestive of a foreign body reaction are apparent in some areas [205] .…”

Section: Diagnosismentioning

confidence: 99%

“…These include thyroid dysfunction [185] , pituitary dysfunction, polyglandular disease, infection, neuritis, alcohol, trauma, a defect in the synthesis of long chain fatty acids [205] , lower resting energy expenditure [202] , and altered responses to norepinephrine and insulin. 210 Ballet may have been closest to the actual etiology when he stated that it is a "chronic intoxication of endogenous origin" [211] .…”

Section: Physiology Of Ddmentioning

confidence: 99%

Rare adipose disorders (RADs) masquerading as obesity

2012

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Rare adipose disorders (RADs) including multiple symmetric lipomatosis (MSL), lipedema and Dercum's disease (DD) may be misdiagnosed as obesity. Lifestyle changes, such as reduced caloric intake and increased physical activity are standard care for obesity. Although lifestyle changes and bariatric surgery work effectively for the obesity component of RADs, these treatments do not routinely reduce the abnormal subcutaneous adipose tissue (SAT) of RADs. RAD SAT likely results from the growth of a brown stem cell population with secondary lymphatic dysfunction in MSL, or by primary vascular and lymphatic dysfunction in lipedema and DD. People with RADs do not lose SAT from caloric limitation and increased energy expenditure alone. In order to improve recognition of RADs apart from obesity, the diagnostic criteria, histology and pathophysiology of RADs are presented and contrasted to familial partial lipodystrophies, acquired partial lipodystrophies and obesity with which they may be confused. Treatment recommendations focus on evidencebased data and include lymphatic decongestive therapy, medications and supplements that support loss of RAD SAT. Associated RAD conditions including depression, anxiety and pain will improve as healthcare providers learn to identify and adopt alternative treatment regimens for the abnormal SAT component of RADs. Effective dietary and exercise regimens are needed in RAD populations to improve quality of life and construct advanced treatment regimens for future generations.

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“…Recently, Herbst et al [19] found multinucleated giant cells in three patients with this condition. However, when these patients were compared with healthy obese controls, no differences in the inflammatory reaction were seen.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, Herbst et al [19] found multi-nucleated giant (MNG) cells in three of the DD patients (n = 5) and in none of the controls (n = 5). Multi-nucleated giant cells are produced by activated, pro-inflammatory macrophages.…”

Section: Introductionmentioning

confidence: 99%

Histology of adipose tissue inflammation in Dercum's disease, obesity and normal weight controls: a case control study

Hansson

Svensson

Stenram

et al. 2011

Journal of Inflammation

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BackgroundDercum's disease (DD) is characterised by obesity and chronic pain (> 3 months) in the adipose tissue. The pathogenesis of DD is unknown, but inflammatory components have been proposed. In previous reports and studies, an inconsistent picture of the histological appearance of the adipose tissue in DD has been described. The aim of this investigation was to examine the histological appearance of adipose tissue in patients with DD, with particular focus on inflammatory signs.MethodsFat biopsies were sampled from painful regions from 53 patients with DD. In 28 of the patients, a control adipose tissue biopsy was taken from a location where the patient did not experience any pain. In addition, fat biopsies were sampled from 41 healthy pain-free obese control patients and 11 healthy pain-free normal weight control patients. The extent of inflammation was evaluated on histological sections stained with haematoxylin-eosin.ResultsThere was no statistically significant difference in the extent of inflammation between the biopsies from the painful knee and the biopsies from the non-painful area (p = 0.5), nor between the biopsies from the abdomen, and the biopsies from the non-painful area (p = 0.4), in patients with DD. A statistically significant difference in extent of inflammation was observed between DD and obese control patients regarding the abdomen (p = 0.022), but not the knee (p = 0.33). There were no differences in extent of inflammation between DD patients and normal weight controls (p = 0.81).ConclusionThe findings suggest that there is an inflammatory response in the adipose tissue in DD. However, this response is not more pronounced than that in healthy obese controls. This contradicts inflammation as the aetiology of DD.

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Lipomatosis-associated inflammation and excess collagen may contribute to lower relative resting energy expenditure in women with adiposis dolorosa

Cited by 20 publications

References 48 publications

Skin Wound Healing: An Update on the Current Knowledge and Concepts

Skin Wound Healing: An Update on the Current Knowledge and Concepts

Rare adipose disorders (RADs) masquerading as obesity

Histology of adipose tissue inflammation in Dercum's disease, obesity and normal weight controls: a case control study

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