LymphedemaV1, Main, Exploration, bibRecord, 001B59

Lymphaticovenous Bypass Decreases Pathologic Skin Changes in Upper Extremity Breast Cancer-Related Lymphedema

Identifieur interne : 001B59 ( Main/Exploration ); précédent : 001B58; suivant : 001B60

Lymphaticovenous Bypass Decreases Pathologic Skin Changes in Upper Extremity Breast Cancer-Related Lymphedema

Auteurs : Jeremy S. Torrisi ; Walter J. Joseph ; Swapna Ghanta ; Daniel A. Cuzzone ; Nicholas J. Albano ; Ira L. Savetsky ; Jason C. Gardenier ; Roman Skoracki ; David Chang ; Babak J. Mehrara

Source :

Lymphatic Research and Biology [ 1539-6851 ] ; 2015.

RBID : PMC:4365441

Descripteurs français

KwdFr :
- Adulte, Adulte d'âge moyen, Biopsie, Facteur de croissance transformant bêta-1 (métabolisme), Femelle, Fibrose, Greffe vasculaire (), Humains, Kératose (anatomopathologie), Kératose (métabolisme), Lymphangiogenèse, Lymphoedème (), Lymphoedème (diagnostic), Lymphoedème (étiologie), Membre supérieur (anatomopathologie), Peau (anatomopathologie), Tumeurs du sein (), Vaisseaux lymphatiques (métabolisme).
MESH :
- anatomopathologie : Kératose, Membre supérieur, Peau.
- diagnostic : Lymphoedème.
- métabolisme : Facteur de croissance transformant bêta-1, Kératose, Vaisseaux lymphatiques.
- étiologie : Lymphoedème.
- Adulte, Adulte d'âge moyen, Biopsie, Femelle, Fibrose, Greffe vasculaire, Humains, Lymphangiogenèse, Lymphoedème, Tumeurs du sein.

English descriptors

KwdEn :
- Adult, Biopsy, Breast Neoplasms (complications), Female, Fibrosis, Humans, Keratosis (metabolism), Keratosis (pathology), Lymphangiogenesis, Lymphatic Vessels (metabolism), Lymphedema (diagnosis), Lymphedema (etiology), Lymphedema (surgery), Middle Aged, Skin (pathology), Transforming Growth Factor beta1 (metabolism), Upper Extremity (pathology), Vascular Grafting (methods).
MESH :
- chemical , metabolism : Transforming Growth Factor beta1.
- complications : Breast Neoplasms.
- diagnosis : Lymphedema.
- etiology : Lymphedema.
- metabolism : Keratosis, Lymphatic Vessels.
- methods : Vascular Grafting.
- pathology : Keratosis, Skin, Upper Extremity.
- surgery : Lymphedema.
- Adult, Biopsy, Female, Fibrosis, Humans, Lymphangiogenesis, Middle Aged.

Abstract

Introduction: Recent advances in microsurgery such as lymphaticovenous bypass (LVB) have been shown to decrease limb volumes and improve subjective symptoms in patients with lymphedema. However, to date, it remains unknown if these procedures can reverse the pathological tissue changes associated with lymphedema. Therefore, the purpose of this study was to analyze skin tissue changes in patients before and after LVB.

Methods and Results: Matched skin biopsy samples were collected from normal and lymphedematous limbs of 6 patients with unilateral breast cancer-related upper extremity lymphedema before and 6 months after LVB. Biopsy specimens were fixed and analyzed for inflammation, fibrosis, hyperkeratosis, and lymphangiogenesis. Six months following LVB, 83% of patients had symptomatic improvement in their lymphedema. Histological analysis at this time demonstrated a significant decrease in tissue CD4⁺ cell inflammation in lymphedematous limb (but not normal limb) biopsies (p<0.01). These changes were associated with significantly decreased tissue fibrosis as demonstrated by decreased collagen type I deposition and TGF-β1 expression (all p<0.01). In addition, we found a significant decrease in epidermal thickness, decreased numbers of proliferating basal keratinocytes, and decreased number of LYVE-1⁺ lymphatic vessels in lymphedematous limbs after LVB.

Conclusions: We have shown, for the first time, that microsurgical LVB not only improves symptomatology of lymphedema but also helps to improve pathologic changes in the skin. These findings suggest that the some of the pathologic changes of lymphedema are reversible and may be related to lymphatic fluid stasis.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4365441

DOI: 10.1089/lrb.2014.0022
PubMed: 25521197
PubMed Central: 4365441

Affiliations:

Le document en format XML

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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term>
<term>Biopsy</term>
<term>Breast Neoplasms (complications)</term>
<term>Female</term>
<term>Fibrosis</term>
<term>Humans</term>
<term>Keratosis (metabolism)</term>
<term>Keratosis (pathology)</term>
<term>Lymphangiogenesis</term>
<term>Lymphatic Vessels (metabolism)</term>
<term>Lymphedema (diagnosis)</term>
<term>Lymphedema (etiology)</term>
<term>Lymphedema (surgery)</term>
<term>Middle Aged</term>
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<term>Transforming Growth Factor beta1 (metabolism)</term>
<term>Upper Extremity (pathology)</term>
<term>Vascular Grafting (methods)</term>
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<keywords scheme="KwdFr" xml:lang="fr"><term>Adulte</term>
<term>Adulte d'âge moyen</term>
<term>Biopsie</term>
<term>Facteur de croissance transformant bêta-1 (métabolisme)</term>
<term>Femelle</term>
<term>Fibrose</term>
<term>Greffe vasculaire ()</term>
<term>Humains</term>
<term>Kératose (anatomopathologie)</term>
<term>Kératose (métabolisme)</term>
<term>Lymphangiogenèse</term>
<term>Lymphoedème ()</term>
<term>Lymphoedème (diagnostic)</term>
<term>Lymphoedème (étiologie)</term>
<term>Membre supérieur (anatomopathologie)</term>
<term>Peau (anatomopathologie)</term>
<term>Tumeurs du sein ()</term>
<term>Vaisseaux lymphatiques (métabolisme)</term>
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<keywords scheme="MESH" type="chemical" qualifier="metabolism" xml:lang="en"><term>Transforming Growth Factor beta1</term>
</keywords>
<keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr"><term>Kératose</term>
<term>Membre supérieur</term>
<term>Peau</term>
</keywords>
<keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Breast Neoplasms</term>
</keywords>
<keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Lymphedema</term>
</keywords>
<keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Lymphoedème</term>
</keywords>
<keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Lymphedema</term>
</keywords>
<keywords scheme="MESH" qualifier="metabolism" xml:lang="en"><term>Keratosis</term>
<term>Lymphatic Vessels</term>
</keywords>
<keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Vascular Grafting</term>
</keywords>
<keywords scheme="MESH" qualifier="métabolisme" xml:lang="fr"><term>Facteur de croissance transformant bêta-1</term>
<term>Kératose</term>
<term>Vaisseaux lymphatiques</term>
</keywords>
<keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Keratosis</term>
<term>Skin</term>
<term>Upper Extremity</term>
</keywords>
<keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Lymphedema</term>
</keywords>
<keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Lymphoedème</term>
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<term>Biopsy</term>
<term>Female</term>
<term>Fibrosis</term>
<term>Humans</term>
<term>Lymphangiogenesis</term>
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<term>Adulte d'âge moyen</term>
<term>Biopsie</term>
<term>Femelle</term>
<term>Fibrose</term>
<term>Greffe vasculaire</term>
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<front><div type="abstract" xml:lang="en"><title>Abstract</title>
<p><bold><italic>Introduction:</italic>
</bold>
 Recent advances in microsurgery such as lymphaticovenous bypass (LVB) have been shown to decrease limb volumes and improve subjective symptoms in patients with lymphedema. However, to date, it remains unknown if these procedures can reverse the pathological tissue changes associated with lymphedema. Therefore, the purpose of this study was to analyze skin tissue changes in patients before and after LVB.</p>
<p><bold><italic>Methods and Results:</italic>
</bold>
 Matched skin biopsy samples were collected from normal and lymphedematous limbs of 6 patients with unilateral breast cancer-related upper extremity lymphedema before and 6 months after LVB. Biopsy specimens were fixed and analyzed for inflammation, fibrosis, hyperkeratosis, and lymphangiogenesis. Six months following LVB, 83% of patients had symptomatic improvement in their lymphedema. Histological analysis at this time demonstrated a significant decrease in tissue CD4<sup>+</sup>
 cell inflammation in lymphedematous limb (but not normal limb) biopsies (<italic>p</italic>
<0.01). These changes were associated with significantly decreased tissue fibrosis as demonstrated by decreased collagen type I deposition and TGF-β1 expression (all <italic>p</italic>
<0.01). In addition, we found a significant decrease in epidermal thickness, decreased numbers of proliferating basal keratinocytes, and decreased number of LYVE-1<sup>+</sup>
 lymphatic vessels in lymphedematous limbs after LVB.</p>
<p><bold><italic>Conclusions:</italic>
</bold>
 We have shown, for the first time, that microsurgical LVB not only improves symptomatology of lymphedema but also helps to improve pathologic changes in the skin. These findings suggest that the some of the pathologic changes of lymphedema are reversible and may be related to lymphatic fluid stasis.</p>
</div>
</front>
</TEI>
<affiliations><list></list>
<tree><noCountry><name sortKey="Albano, Nicholas J" sort="Albano, Nicholas J" uniqKey="Albano N" first="Nicholas J." last="Albano">Nicholas J. Albano</name>
<name sortKey="Chang, David" sort="Chang, David" uniqKey="Chang D" first="David" last="Chang">David Chang</name>
<name sortKey="Cuzzone, Daniel A" sort="Cuzzone, Daniel A" uniqKey="Cuzzone D" first="Daniel A." last="Cuzzone">Daniel A. Cuzzone</name>
<name sortKey="Gardenier, Jason C" sort="Gardenier, Jason C" uniqKey="Gardenier J" first="Jason C." last="Gardenier">Jason C. Gardenier</name>
<name sortKey="Ghanta, Swapna" sort="Ghanta, Swapna" uniqKey="Ghanta S" first="Swapna" last="Ghanta">Swapna Ghanta</name>
<name sortKey="Joseph, Walter J" sort="Joseph, Walter J" uniqKey="Joseph W" first="Walter J." last="Joseph">Walter J. Joseph</name>
<name sortKey="Mehrara, Babak J" sort="Mehrara, Babak J" uniqKey="Mehrara B" first="Babak J." last="Mehrara">Babak J. Mehrara</name>
<name sortKey="Savetsky, Ira L" sort="Savetsky, Ira L" uniqKey="Savetsky I" first="Ira L." last="Savetsky">Ira L. Savetsky</name>
<name sortKey="Skoracki, Roman" sort="Skoracki, Roman" uniqKey="Skoracki R" first="Roman" last="Skoracki">Roman Skoracki</name>
<name sortKey="Torrisi, Jeremy S" sort="Torrisi, Jeremy S" uniqKey="Torrisi J" first="Jeremy S." last="Torrisi">Jeremy S. Torrisi</name>
</noCountry>
</tree>
</affiliations>
</record>

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Serveur d'exploration sur le lymphœdème

Lymphaticovenous Bypass Decreases Pathologic Skin Changes in Upper Extremity Breast Cancer-Related Lymphedema

Lymphaticovenous Bypass Decreases Pathologic Skin Changes in Upper Extremity Breast Cancer-Related Lymphedema

Source :

Descripteurs français

English descriptors

Abstract

Links toward previous steps (curation, corpus...)

Le document en format XML

Pour manipuler ce document sous Unix (Dilib)

Pour mettre un lien sur cette page dans le réseau Wicri

Pour générer des pages wiki

	Serveur d'exploration sur le lymphœdème
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