Lymphoscintigraphy for the Assessment of Autologous Stem Cell Implantation in Chronic Lymphedema

Quián, Yamilé Peña; Ramírez, Porfirio Hernández; Cuellar, Juan F. Batista; Pintado, Alejandro Perera; Pérez, M.

doi:10.1097/rlu.0000000000000688

Cited by 9 publications

(4 citation statements)

References 6 publications

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“…They exert antiwrinkle effects by reducing ultraviolet-B-induced apoptosis, stimulating collagen synthesis of dermal fibrosis [26], and modifying the local microenvironment [27]. Three studies that used ADSC transplantation for the therapy of human lymphedema had been reported [28][29][30]. In these clinical studies, a greater number of lymph nodes and an improvement in the patient-reported outcomes were confirmed after therapies.…”

Section: Introductionmentioning

confidence: 99%

Adipose-Derived Stem Cells Promote Intussusceptive Lymphangiogenesis by Restricting Dermal Fibrosis in Irradiated Tissue of Mice

Ogino

Hayashida

Yamakawa

et al. 2020

IJMS

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Currently, there is no definitive treatment for lymphatic disorders. Adipose-derived stem cells (ADSCs) have been reported to promote lymphatic regeneration in lymphedema models, but the mechanisms underlying the therapeutic effects remain unclear. Here, we tested the therapeutic effects of ADSC transplantation on lymphedema using a secondary lymphedema mouse model. The model was established in C57BL/6J mice by x-irradiation and surgical removal of the lymphatic system in situ. The number of lymphatic vessels with anti-lymphatic vessel endothelial hyaluronan receptor 1 (LYVE-1) immunoreactivity increased significantly in mice subjected to transplantation of 7.5 × 105 ADSCs. X-irradiation suppressed lymphatic vessel dilation, which ADSC transplantation could mitigate. Proliferative cell nuclear antigen staining showed increased lymphatic endothelial cell (LEC) and extracellular matrix proliferation. Picrosirius red staining revealed normal collagen fiber orientation in the dermal tissue after ADSC transplantation. These therapeutic effects were not related to vascular endothelial growth factor (VEGF)-C expression. Scanning electron microscopy revealed structures similar to the intraluminal pillar during intussusceptive angiogenesis on the inside of dilated lymphatic vessels. We predicted that intussusceptive lymphangiogenesis occurred in lymphedema. Our findings indicate that ADSC transplantation contributes to lymphedema reduction by promoting LEC proliferation, improving fibrosis and dilation capacity of lymphatic vessels, and increasing the number of lymphatic vessels via intussusceptive lymphangiogenesis.

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Section: Introductionmentioning

confidence: 99%

Adipose-Derived Stem Cells Promote Intussusceptive Lymphangiogenesis by Restricting Dermal Fibrosis in Irradiated Tissue of Mice

Ogino

Hayashida

Yamakawa

et al. 2020

IJMS

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show abstract

“…Peña Quián et al[ 46 ] provided a case report on a patient with edematous lower limbs resulting from recurrent lymphangitis. Autologous ADSCs (1-2.2 × 10 9 ) were injected and a greater number of new lymphatic ramifications and lymph nodes were observed at 6 mo post-treatment via lymphoscintigraphy.…”

Section: Adsc-based Therapiesmentioning

confidence: 99%

Adipose-derived stem cell therapy shows promising results for secondary lymphedema

Pan

2020

WJSC

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Lymphedema is mainly identified by progressive soft tissue swelling in impaired lymphatic system. Secondary lymphedema attributed to cancer therapy, parasite infection, and trauma remains a serious global disease. Patients with lymphedema suffer swelling, pain, and fatigue, with the dysfunction of the deformed extremities reducing the quality of life and increasing the risk of infection and lymphangiosarcoma. Adipose-derived stem cells (ADSCs) possess prominent regenerative potential to differentiate into multilineage cells, and produce various lymphangiogenic factors, making ADSC therapy a promising approach for lymphedema. The development of lymphedema consists of local inflammation, the fibrosis of lymphatic vessels, and the deposition of adipose fat. Existing animal models do not mimic the chronic inflammation environment, therefore suitable models are required in further studies. Some signal pathways and molecular mechanisms in physiological and pathological lymphagiogenesis remain unclear. In previous animal and human trials, ADSC therapy reduced edema in varying degrees. A larger number of trials with larger samples and longer follow-up periods are required to verify the efficiency and feasibility of ADSC therapy. ADSCs are of easy availability and immune exemption, making them a candidate for lymphedema treatment. Whether ADSCs enhance malignant characteristics or trigger the malignant change deserves further exploration and study before ADSC therapy can be made widely available.

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“…Lymphatic system imaging in nuclear medicine directly reflects the function of lymphatic drainage [9–16] . For many years, lymphoscintigraphy has been widely considered as the first-line imaging to confirm the diagnosis of lymphedema and to visualize the functional state of the lymphatic system [15,17–23] …”

Section: Introductionmentioning

confidence: 99%

“…[9][10][11][12][13][14][15][16] For many years, lymphoscintigraphy has been widely considered as the first-line imaging to confirm the diagnosis of lymphedema and to visualize the functional state of the lymphatic system. [15,[17][18][19][20][21][22][23] The purpose of this study was to investigate the relationship between iliolumbar LNs, inguinal LNs, and unilateral pelvic cancer-related lymphedema by retrospective analysis of 99m Tcantimony sulfide colloid (ASC) lymphoscintigraphy data.…”

Section: Introductionmentioning

confidence: 99%

The relationship between the drainage function of inguinal lymph nodes and unilateral pelvic cancer-related lymphedema

et al. 2021

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The aim of this study was to investigate the relationship between iliolumbar lymph nodes (LNs), inguinal LNs, and unilateral pelvic cancer-related lymphedema by retrospective analysis of lymphoscintigraphy data. Ninety-six patients (3 men and 93 women; mean age, 53.3 ± 11.3 years) with pelvic cancer-related lymphedema were enrolled in this retrospective study. Lymphoscintigraphy was performed at 1 hour and 4 to 6 hours after injection. The visualization of inguinal LNs and iliolumbar LNs were recorded. According to statistical analysis, the display of inguinal LNs in lymphoscintigraphy has a significant negative correlation with ipsilateral lower limb lymphedema ( P < .01, r = –0.561). However, there is no correlation between the show of iliolumbar LNs and ipsilateral lower extremity lymphedema ( P = .056, r = –0.138). When lymphoscintigraphy was performed at 1 hour after injection, there were 13 out of 96 patients without inguinal LNs revealed on imaging, but at 4 to 6 hours after injection, inguinal LNs were seen in lymphoscintigraphy. The drainage function of inguinal LNs has a significant negative correlation with ipsilateral pelvic cancer-related lymphedema. Treatment dedicated to restoring the drainage function of LNs in the inguinal region may effectively relieve lymphedema. The image acquisition at 4 to 6 hours after injection is necessary for significant additional information.

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Lymphoscintigraphy for the Assessment of Autologous Stem Cell Implantation in Chronic Lymphedema

Cited by 9 publications

References 6 publications

Adipose-Derived Stem Cells Promote Intussusceptive Lymphangiogenesis by Restricting Dermal Fibrosis in Irradiated Tissue of Mice

Adipose-Derived Stem Cells Promote Intussusceptive Lymphangiogenesis by Restricting Dermal Fibrosis in Irradiated Tissue of Mice

Adipose-derived stem cell therapy shows promising results for secondary lymphedema

The relationship between the drainage function of inguinal lymph nodes and unilateral pelvic cancer-related lymphedema

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