Stem cells show promising results for lymphoedema treatment – A literature review

Abstract

Lymphoedema is a debilitating condition, manifesting in excess lymphatic fluid and swelling of subcutaneous tissues. Lymphoedema is as of yet still an incurable condition and current treatment modalities are not satisfactory. The capacity of mesenchymal stem cells to promote angiogenesis, secrete growth factors, regulate the inflammatory process, and differentiate into multiple cell types make them a potential ideal therapy for lymphoedema. Adipose tissue is the richest and most accessible source of mesenchymal stem cells and they can be harvested, isolated, and used for therapy in a single stage procedure as an autologous treatment. The aim of this paper was to review all studies using mesenchymal stem cells for lymphoedema treatment with a special focus on the potential use of adipose-derived stem cells. A systematic search was performed and five preclinical and two clinical studies were found. Different stem cell sources and lymphoedema models were used in the described studies. Most studies showed a decrease in lymphoedema and an increased lymphangiogenesis when treated with stem cells and this treatment modality has so far shown great potential. The present studies are, however, subject to bias and more preclinical studies and large-scale high quality clinical trials are needed to show if this emerging therapy can satisfy expectations.

Adipose-derived regenerative cells and fat grafting for treating breast cancer-related lymphedema: Lymphoscintigraphic evaluation with 1 year of follow-up

“…While several microsurgical techniques have been presented over the last decades, they continue to be somewhat experimental due to the lack of clear evidence and therefore conservative management remains the standard of care. Preclinical and sparse clinical studies have suggested that cell therapy using autologous mesenchymal stromal cells from various sources including adipose tissue, muscle, and bone marrow can alleviate lymphedema [2]. The two studies performed so far in humans have been with cells derived from bone marrow [3,4].…”

Concise Review: A Safety Assessment of Adipose-Derived Cell Therapy in Clinical Trials: A Systematic Review of Reported Adverse Events

“…The cells from adipose tissue can be used for therapeutic purposes, either freshly isolated as the stromal vascular fraction (SVF, also called adipose‐derived regenerative cells [ADRC]), or culture‐expanded as the adipose‐derived stem cells (ASC). Adipose‐derived cell therapy has shown potential in almost every preclinical animal model and the time is ripe for clinical translation of this potential.…”

Multipotent Adult Progenitor Cells Support Lymphatic Regeneration at Multiple Anatomical Levels during Wound Healing and Lymphedema

“…Accordingly, stem/progenitor cells with, albeit limited, capacity to differentiate down the lymphatic endothelial cell lineage were found in cord/peripheral blood 21 – 25 and bone marrow/adipose tissue (stroma) 22 , 23 , 25 – 31 . Multiple cell types have been tested in various animal models to evaluate their efficacy for lymphatic regeneration, including mesenchymal stem cells (reviewed in refs 32 , 33 ), adipose tissue stem cells 31 , 32 , 34 , 35 , pluripotent stem cells 3 and bone marrow-derived endothelial cell precursors 27 . However, no studies have provided evidence for their therapeutic potential to support restoration of the lymphatic vasculature from the capillary to the collector level, which is a prerequisite for effective lymphedema treatment 9 .…”