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Ozawa M, Sone M, Sugawara S, Itou C, Kimura S, Arai Y, Kusumoto M. Feasibility and safety of direct percutaneous embolization of lymphopseudoaneurysm for postoperative lymphatic leakage. J Med Imaging Radiat Oncol 2024. [PMID: 38742662 DOI: 10.1111/1754-9485.13666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Accepted: 04/18/2024] [Indexed: 05/16/2024]
Abstract
The treatment strategy for refractory postoperative lymphatic leakage is controversial. While the utility of direct percutaneous embolization of lymphopseudoaneurysm has been investigated, only a few reports on this topic exist. The aim of this study was to evaluate the technical and clinical feasibility and safety of direct percutaneous embolization of lymphopseudoaneurysm for refractory postoperative lymphatic leakage. This case series included six consecutive patients who underwent direct percutaneous embolization of lymphopseudoaneurysm for refractory postoperative lymphatic leakage. Technical success (successful percutaneous approach and injection of NBCA glue to the lymphopseudoaneurysm), clinical success (unnecessity of percutaneous drainage tube of the lymphatic leakage), treatment duration (the duration from the treatment to the achievement of clinical success) and procedure-related complications were mainly evaluated. Direct percutaneous embolization of the lymphopseudoaneurysm using NBCA glue was successfully performed in all cases. Clinical success was achieved in five of the six cases (83%). The mean treatment period was 9 days for the cases with clinical success. No major complications occurred postoperatively. In conclusion, direct percutaneous embolization of lymphopseudoaneurysm may become a feasible and safe treatment option for cases of refractory postoperative lymphatic leakage.
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Affiliation(s)
- Mizuki Ozawa
- Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan
| | - Miyuki Sone
- Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan
| | - Shunsuke Sugawara
- Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan
| | - Chihiro Itou
- Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan
| | - Shintaro Kimura
- Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan
| | - Yasuaki Arai
- Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan
| | - Masahiko Kusumoto
- Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan
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Ayed A, Sohail SK, Rizvi SF, Alwadai RI. Bilateral renal lymphangiectasia: Literature review of a rare entity. Saudi Med J 2024; 45:537-540. [PMID: 38734432 DOI: 10.15537/smj.2024.45.5.20231019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 04/16/2024] [Indexed: 05/13/2024] Open
Abstract
Renal lymphangiectasia (RL) is a rare condition in which lymphatic vessels are dilated giving rise to cyst formation in peripelvic, perirenal and intrarenal locations. Knowledge about RL is limited and based upon individual case reports. This can be genetic or acquired. There is no significant association with any gender or age. It can be manifested as focal or diffuse forms and can be unilateral or bilateral. Most of the cases present with abdominal or flank pain. The diagnosis is based on radiological imaging. Due to rarity of diseases, it has potential to be misdiagnosed as other cystic disease of kidneys. The treatment is mainly conservative but prolonged follow up for associated complications like hypertension and renal vein thrombosis is required. We have presented a case of bilateral renal lymphangiectasia with the review of available literature.
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Affiliation(s)
- Abdullah Ayed
- From the Department of Surgery (Ayed), from the Department of Pathology (Sohail, Rizvi), College of Medicine, University of Bisha; and from the Department of Urology (Alwadai), King Abdullah Hospital, Ministry of Health, Bisha, Kingdom of Saudi Arabia
| | - Shahzada Khalid Sohail
- From the Department of Surgery (Ayed), from the Department of Pathology (Sohail, Rizvi), College of Medicine, University of Bisha; and from the Department of Urology (Alwadai), King Abdullah Hospital, Ministry of Health, Bisha, Kingdom of Saudi Arabia
| | - Syeda Fatima Rizvi
- From the Department of Surgery (Ayed), from the Department of Pathology (Sohail, Rizvi), College of Medicine, University of Bisha; and from the Department of Urology (Alwadai), King Abdullah Hospital, Ministry of Health, Bisha, Kingdom of Saudi Arabia
| | - Raed I Alwadai
- From the Department of Surgery (Ayed), from the Department of Pathology (Sohail, Rizvi), College of Medicine, University of Bisha; and from the Department of Urology (Alwadai), King Abdullah Hospital, Ministry of Health, Bisha, Kingdom of Saudi Arabia
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Cordella A, Stock E, Cornillie P, Fouriez-Lablée V, Skarbek A, Germonpré J, Saunders J. Diagnostic imaging descriptions and prevalence of presumed phrenic lymph nodes in dogs. Vet Radiol Ultrasound 2024; 65:36-44. [PMID: 38111229 DOI: 10.1111/vru.13320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 11/15/2023] [Accepted: 11/22/2023] [Indexed: 12/20/2023] Open
Abstract
The phrenic lymph node (PLN) has been described in bovine, equine, and feline anatomic references but descriptions in canine anatomic references are currently lacking. Authors have observed a well-defined, soft tissue attenuating, contrast-enhancing structure in a location consistent with previous anatomic descriptions of the PLN in dogs that underwent thoracic CT for neoplastic staging. The aims of this two-part, retrospective/prospective, anatomic, prevalence study were (1) to describe the presence of a soft tissue structure close to the thoracic caudal vena cava, defined as the presumed PLN, in a series of dogs that underwent CT as part of the staging for metastatic disease; (2) to confirm the lymphatic origin of the presumed PLN in a dog through postmortem examination; (3) to assess the prevalence of the presumed PLN in a population of dogs that underwent thoracic CT or MRI for different clinical purposes; and (4) to assess the possibility to visualize the presumed PLN with ultrasonography. The lymphatic origin of the presumed PLN was confirmed by postmortem examination in one dog. The presumed PLN was visible in 29 of 777 canine CT examinations (prevalence 3.7%). The presumed PLN was not visible in 9 of 10 prospectively recruited ultrasound cases. Most dogs with visible presumed PLNs were large-medium breeds that were presented for neoplastic staging purposes. Findings indicated that a structure consistent with the previously reported anatomic features of PLN in cattle, horses, and cats may be detected with a low prevalence in canine CT and MRI examinations.
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Affiliation(s)
- Alessia Cordella
- Department of Morphology, Imaging, Orthopedics, Rehabilitation and Nutrition, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
- Queen Mother Hospital for Animals, Royal Veterinary College, University of London, Hatfield, UK
| | - Emmelie Stock
- Department of Morphology, Imaging, Orthopedics, Rehabilitation and Nutrition, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Pieter Cornillie
- Department of Morphology, Imaging, Orthopedics, Rehabilitation and Nutrition, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Virginie Fouriez-Lablée
- Queen Mother Hospital for Animals, Royal Veterinary College, University of London, Hatfield, UK
| | - Adrianna Skarbek
- Queen Mother Hospital for Animals, Royal Veterinary College, University of London, Hatfield, UK
| | - Jolien Germonpré
- Department of Morphology, Imaging, Orthopedics, Rehabilitation and Nutrition, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Jimmy Saunders
- Department of Morphology, Imaging, Orthopedics, Rehabilitation and Nutrition, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
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Martín NG, Miño ED. Computed tomography and magnetic resonance imaging are potential noninvasive methods for evaluating the cisterna chyli in cats. J Am Vet Med Assoc 2024; 262:1-7. [PMID: 37770017 DOI: 10.2460/javma.23.07.0390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 09/07/2023] [Indexed: 10/03/2023]
Abstract
OBJECTIVE There is limited information on the normal appearance of the cisterna chyli (CC) in cats on CT and MRI. The aim of this retrospective study was to describe the CT and MRI characteristics of the CC in a group of cats without lymphatic system pathology. SAMPLE A total of 31 CT and 63 MRI images were obtained of client-owned cats between January 2017 and March 2022. METHODS The presence, location, shape, maximum width, MRI-signal intensity, mean attenuation, and contrast enhancement of the CC were recorded from CT and MRI scans. RESULTS The CC was identified in all the CT scans and in 60 MRI studies. The CC was located level with the cranial mesenteric artery in 56 of 91 cases. It was crescent shaped in 34 of 54 cases. On precontrast CT images, the mean attenuation of the CC was 17 HU, and the mean postcontrast attenuation was 28 HU. On T2-weighted sequences, the CC was isointense to CSF and hyperintense to the muscles, while on T1-weighted images, it was isointense to the muscles. Contrast enhancement was variable in both techniques. CLINICAL RELEVANCE CT and MRI have the potential for noninvasive evaluation of CC in cats.
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Kossack ME, Tian L, Bowie K, Plavicki JS. Defining the cellular complexity of the zebrafish bipotential gonad. Biol Reprod 2023; 109:586-600. [PMID: 37561446 PMCID: PMC10651076 DOI: 10.1093/biolre/ioad096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/11/2023] Open
Abstract
Zebrafish are routinely used to model reproductive development, function, and disease, yet we still lack a clear understanding of the fundamental steps that occur during early bipotential gonad development, including when endothelial cells, pericytes, and macrophage arrive at the bipotential gonad to support gonad growth and differentiation. Here, we use a combination of transgenic reporters and single-cell sequencing analyses to define the arrival of different critical cell types to the larval zebrafish gonad. We determined that blood initially reaches the gonad via a vessel formed from the swim bladder artery, which we have termed the gonadal artery. We find that vascular and lymphatic development occurs concurrently in the bipotential zebrafish gonad and our data suggest that similar to what has been observed in developing zebrafish embryos, lymphatic endothelial cells in the gonad may be derived from vascular endothelial cells. We mined preexisting sequencing datasets to determine whether ovarian pericytes had unique gene expression signatures. We identified 215 genes that were uniquely expressed in ovarian pericytes, but not expressed in larval pericytes. Similar to what has been shown in the mouse ovary, our data suggest that pdgfrb+ pericytes may support the migration of endothelial tip cells during ovarian angiogenesis. Using a macrophage-driven photoconvertible protein, we found that macrophage established a nascent resident population as early as 12 dpf and can be observed removing cellular material during gonadal differentiation. This foundational information demonstrates that the early bipotential gonad contains complex cellular interactions, which likely shape the health and function of the mature gonad.
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Affiliation(s)
- Michelle E Kossack
- Pathology and Laboratory Medicine Department, Brown University, Providence, RI, USA
| | - Lucy Tian
- Pathology and Laboratory Medicine Department, Brown University, Providence, RI, USA
| | - Kealyn Bowie
- Pathology and Laboratory Medicine Department, Brown University, Providence, RI, USA
| | - Jessica S Plavicki
- Pathology and Laboratory Medicine Department, Brown University, Providence, RI, USA
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Khilnani NM, Wasan SM, Pappas PJ, Deol Z, Schoonover JP, Daugherty SF, Attaran RR, Cartee TV, Straight TM, Fish J, Granzow JW, Winokur RS, Desai KR, Salazar G, Stoughton J, Gibson K, Jones AD, Lohr JM, Vayuvegula S, Meissner MH. Core content for venous and Lymphatic Medicine: 2022 revision. Phlebology 2023:2683555231212302. [PMID: 37934910 DOI: 10.1177/02683555231212302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
The core content for a medical specialty outlines the scope of the discipline as well as the categories of knowledge considered essential to practice in the field. It provides a template for the development of curricula for medical school, graduate, and postgraduate education, as well as for creating certification standards. Venous and Lymphatic Medicine (VLM) is a specialty that has benefitted from contributions from specialists from several medical disciplines. Optimally, the societies, boards, and residency review committees representing these disciplines would uniformly recognize the scope of VLM to develop education and assessment standards to allow training and identification of qualified practitioners. In order to inform the standard setting bodies and other stakeholders of the current scope of VLM, a task force of VLM experts from cardiology, dermatology, emergency medicine, general surgery, interventional radiology, vascular medicine, and vascular surgery was formed to revise a 2014 consensus document defining the core content of the specialty of VLM.
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Affiliation(s)
- N M Khilnani
- Division of Interventional Radiology, Weill Cornell Medicine-New York Presbyterian Hospital, New York, NY, USA
| | - S M Wasan
- REX Vascular Speicalists, UNC Health, Raleigh, NC, USA
| | - P J Pappas
- Center for Vein Restoration, Morristown, NJ, USA
| | - Z Deol
- Center for Vein Restoration, Toledo, Ohio and Detroit, MI, USA
| | | | | | - R R Attaran
- Department of Cardiology, Yale School of Medicine, Norwich, CT, USA
| | - T V Cartee
- Division of Dermatology, Penn State College of Medicine, Hershey, PA, USA
| | | | - J Fish
- Department of Medicine, Jobst Vascular Instituteof Promedica, Toledo, OH, USA
| | - J W Granzow
- Granzow Lymphedema and Lipedema Center, Jacksonville, FL, USA
| | - R S Winokur
- Division of Interventional Radiology, Weill Cornell Medicine-New York Presbyterian Hospital, New York, NY, USA
| | - K R Desai
- Division of Interventional Radiology, Northwestern UniversityFeinberg School of Medicine, Chicago, IL, USA
| | - G Salazar
- Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - J Stoughton
- Department of Vascular Surgery, Massachusetts General Hospital, Stoneham, MA, USA
| | - K Gibson
- Lake Washington Vascular Surgeons, Bellevue, WA, USA
| | - A D Jones
- Inova Vein Specialty Center, Bend, OR, USA
| | - J M Lohr
- Division of Vascular and Endovascular Surgery, William Jennnings Bryan Dorn VA, Columbia, SC, USA
| | | | - M H Meissner
- Department of Surgery, University of WashingtonSchool of Medicine, Seattle, WA, USA
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Abramov R, Rufizen L, Gilshtein H. Resection of Extrapulmonary Lymphangiomyoma and Post-Operative Management Considerations. Vasc Endovascular Surg 2023; 57:756-759. [PMID: 36952511 DOI: 10.1177/15385744221144503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2023]
Abstract
Background: Lymphangiomyomatosis is a rare disease involving the lymph vessels, causing obstruction and cystic formation with an incidence of 3-8 per million women. The disease might be sporadic or inherited. Lymphangiomyomatosis mostly affects the pulmonary system, whereas extrapulmonary Lymphangiomyomatosis may present in various site, occasionally as a localized abdominal mass. The diagnostic process might entail surgical resection to obtain a specimen for pathology that may also help to achieve a long-term control of the disease. Methods: Herein, we present a case of a 45 years old female, who suffered from pulmonary symptoms, and during her workup an abdominal mass was found. The patient underwent exploratory laparotomy with resection of a left retroperitoneal bilobar mass. Results: Histopathological report revealed Lymphangiomyoma. She had a complication of a lymphatic leakage that required a second laparotomy with satisfactory clinical outcome. Conclusions: Surgeons should be aware of the pathological lymphatics and manage post-operative complications by a trial of conservative.
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Affiliation(s)
- Roi Abramov
- Department of General Surgery, Rambam Health Care Campus, Haifa, Israel
| | - Liel Rufizen
- Department of General Surgery, Rambam Health Care Campus, Haifa, Israel
| | - Hayim Gilshtein
- Department of General Surgery, Rambam Health Care Campus, Haifa, Israel
- Colorectal Unit, Rambam Health Care Campus, Haifa, Israel
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Cao D, Sun Y, Li Y, Su P, Pillai JJ, Qiao Y, Lu H, Van Zijl PC, Knutsson L, Hua J. Concurrent measurement of perfusion parameters related to small blood vessels and cerebrospinal fluid circulation in the human brain using dynamic dual-spin-echo perfusion MRI. NMR Biomed 2023; 36:e4984. [PMID: 37308297 PMCID: PMC10808973 DOI: 10.1002/nbm.4984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 04/25/2023] [Accepted: 05/12/2023] [Indexed: 06/14/2023]
Abstract
Accumulating evidence from recent studies has indicated the importance of studying the interaction between the microvascular and lymphatic systems in the brain. To date, most imaging methods can only measure blood or lymphatic vessels separately, such as dynamic susceptibility contrast (DSC) MRI for blood vessels and DSC MRI-in-the-cerebrospinal fluid (CSF) (cDSC MRI) for lymphatic vessels. An approach that can measure both blood and lymphatic vessels in a single scan offers advantages such as a halved scan time and contrast dosage. This study attempts to develop one such approach by optimizing a dual-echo turbo-spin-echo sequence, termed "dynamic dual-spin-echo perfusion (DDSEP) MRI". Bloch simulations were performed to optimize the dual-echo sequence for the measurement of gadolinium (Gd)-induced blood and CSF signal changes using a short and a long echo time, respectively. The proposed method furnishes a T1-dominant contrast in CSF and a T2-dominant contrast in blood. MRI experiments were performed in healthy subjects to evaluate the dual-echo approach by comparing it with existing separate methods. Based on simulations, the short and long echo time were chosen around the time when blood signals show maximum difference between post- and pre-Gd scans, and the time when blood signals are completely suppressed, respectively. The proposed method showed consistent results in human brains as previous studies using separate methods. Signal changes from small blood vessels occurred faster than from lymphatic vessels after intravenous Gd injection. In conclusion, Gd-induced signal changes in blood and CSF can be detected simultaneously in healthy subjects with the proposed sequence. The temporal difference in Gd-induced signal changes from small blood and lymphatic vessels after intravenous Gd injection was confirmed using the proposed approach in the same human subjects. Results from this proof-of-concept study will be used to further optimize DDSEP MRI in subsequent studies.
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Affiliation(s)
- Di Cao
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, United States
- Neurosection, Division of MRI Research, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland, United States
| | - Yuanqi Sun
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, United States
- Neurosection, Division of MRI Research, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland, United States
| | - Yinghao Li
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, United States
- Neurosection, Division of MRI Research, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland, United States
| | - Pan Su
- Neurosection, Division of MRI Research, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland, United States
| | - Jay J. Pillai
- Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
- Division of Neuroradiology, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, United States
| | - Ye Qiao
- Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
| | - Hanzhang Lu
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, United States
- Neurosection, Division of MRI Research, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland, United States
| | - Peter C.M. Van Zijl
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, United States
- Neurosection, Division of MRI Research, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
| | - Linda Knutsson
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, United States
- Neurosection, Division of MRI Research, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
- Department of Medical Radiation Physics, Lund University, Lund, Sweden
| | - Jun Hua
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, United States
- Neurosection, Division of MRI Research, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
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Robinson WH, Willardson HB, Nye NS. Bilateral lower extremity inflammatory lymphedema after an ultramarathon. JAAD Case Rep 2023; 40:145-147. [PMID: 37817887 PMCID: PMC10562084 DOI: 10.1016/j.jdcr.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/12/2023] Open
Affiliation(s)
| | - Hal B. Willardson
- Dermatology Clinic, 673rd Medical Group, Joint Base Elmendorf-Richardson, Anchorage, Alaska
| | - Nathaniel S. Nye
- Sports Medicine Clinic, Fort Belvoir Community Hospital, Fort Belvoir, Virginia
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Abstract
OBJECTIVE The objective of this review was to describe the immunological changes that take place in the dura mater in response to metastatic disease that seeds the CNS. The authors hypothesized that the dura's anatomy and resident immune cell population play a role in enabling metastasis to the brain and leptomeninges. METHODS An extensive literature search was conducted to identify evidence that supports the dura's participation in metastasis to the CNS. The authors' hypothesis was informed by a recent upsurge in studies that have investigated the dura's role in metastatic development, CNS infections, and autoimmunity. They reviewed this literature as well as the use of immunotherapy in treating brain metastases and how these therapies change the meningeal immune landscape to overcome and reverse tumor-promoting immunosuppression. RESULTS Evidence suggests that the unique architecture and immune cell profile of the dura, compared with other immune compartments within the CNS, facilitate entry of metastatic tumor cells into the brain. Once these tumor cells penetrate the dural barrier, they propagate an immunosuppressive tumor microenvironment. Therefore, immunotherapy may serve to overcome this immunosuppressive environment and liberate proinflammatory immune cells in an effort to combat metastatic disease. CONCLUSIONS Within the next few years, the authors expect the addition of several more scientific studies into the literature that further underscore the dura as a chief participant and neuroanatomical barrier in neuro-oncology.
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Affiliation(s)
- Francesca M Cozzi
- 1Department of Neurosurgery, Hackensack Meridian School of Medicine, Nutley, New Jersey
| | - Leonel Ampie
- 2Neurosurgical Oncology Unit, Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland; and
- 3Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia
| | - Maxwell T Laws
- 2Neurosurgical Oncology Unit, Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland; and
- 3Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia
| | - Desmond A Brown
- 2Neurosurgical Oncology Unit, Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland; and
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11
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Balfour A, Raffi J, Lee BA, Kraus CN. Red vulvar plaque with unilateral edema. JAAD Case Rep 2023; 38:117-119. [PMID: 37521193 PMCID: PMC10372043 DOI: 10.1016/j.jdcr.2023.06.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023] Open
Affiliation(s)
- Alex Balfour
- School of Medicine, University of California, Irvine, California
| | - Jodie Raffi
- Department of Dermatology, University of California, Irvine, Irvine, California
| | - Bonnie A. Lee
- Department of Dermatology, University of California, Irvine, Irvine, California
| | - Christina N. Kraus
- Department of Dermatology, University of California, Irvine, Irvine, California
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12
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Jannaway M, Iyer D, Mastrogiacomo DM, Li K, Sung DC, Yang Y, Kahn ML, Scallan JP. VEGFR3 is required for button junction formation in lymphatic vessels. Cell Rep 2023; 42:112777. [PMID: 37454290 PMCID: PMC10503778 DOI: 10.1016/j.celrep.2023.112777] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 06/01/2023] [Accepted: 06/25/2023] [Indexed: 07/18/2023] Open
Abstract
Lymphatic capillaries develop discontinuous cell-cell junctions that permit the absorption of large macromolecules, chylomicrons, and fluid from the interstitium. While excessive vascular endothelial growth factor 2 (VEGFR2) signaling can remodel and seal these junctions, whether and how VEGFR3 can alter lymphatic junctions remains incompletely understood. Here, we use lymphatic-specific Flt4 knockout mice to investigate VEGFR3 signaling in lymphatic junctions. We show that loss of Flt4 prevents specialized button junction formation in multiple tissues and impairs interstitial absorption. Knockdown of FLT4 in human lymphatic endothelial cells results in impaired NOTCH1 expression and activation, and overexpression of the NOTCH1 intracellular domain in Flt4 knockout vessels rescues the formation of button junctions and absorption of interstitial molecules. Together, our data reveal a requirement for VEGFR3 and NOTCH1 signaling in the development of button junctions during postnatal development and may hold clinical relevance to lymphatic diseases with impaired VEGFR3 signaling.
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Affiliation(s)
- Melanie Jannaway
- Department of Molecular Pharmacology and Physiology, Morsani College of Medicine, University of South Florida, Tampa, FL 33612, USA
| | - Drishya Iyer
- Department of Molecular Pharmacology and Physiology, Morsani College of Medicine, University of South Florida, Tampa, FL 33612, USA
| | - Diandra M Mastrogiacomo
- Department of Molecular Pharmacology and Physiology, Morsani College of Medicine, University of South Florida, Tampa, FL 33612, USA
| | - Kunyu Li
- Department of Molecular Pharmacology and Physiology, Morsani College of Medicine, University of South Florida, Tampa, FL 33612, USA
| | - Derek C Sung
- Cardiovascular Institute, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Ying Yang
- Department of Molecular Pharmacology and Physiology, Morsani College of Medicine, University of South Florida, Tampa, FL 33612, USA
| | - Mark L Kahn
- Cardiovascular Institute, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Joshua P Scallan
- Department of Molecular Pharmacology and Physiology, Morsani College of Medicine, University of South Florida, Tampa, FL 33612, USA.
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Nguyen D, Dionyssiou D, Zaitseva TS, Zhou AT, Sue G, Deptula P, Moroz MA, Tabada P, Rockson SG, Paukshto MV, Cheng MH, Huang NF. Development of a rat model of lymphedema and the implantation of a collagen-based medical device for therapeutic intervention. Front Cardiovasc Med 2023; 10:1214116. [PMID: 37469481 PMCID: PMC10353614 DOI: 10.3389/fcvm.2023.1214116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 06/12/2023] [Indexed: 07/21/2023] Open
Abstract
Secondary lymphedema is a common condition among cancer survivors, and treatment strategies to prevent or treat lymphedema are in high demand. The development of novel strategies to diagnose or treat lymphedema would benefit from a robust experimental animal model of secondary lymphedema. The purpose of this methods paper is to describe and summarize our experience in developing and characterizing a rat hindlimb model of lymphedema. Here we describe a protocol to induce secondary lymphedema that takes advantage of micro computed tomography imaging for limb volume measurements and visualization of lymph drainage with near infrared imaging. To demonstrate the utility of this preclinical model for studying the therapeutic benefit of novel devices, we apply this animal model to test the efficacy of a biomaterials-based implantable medical device.
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Affiliation(s)
- Dung Nguyen
- Department of Plastic and Reconstructive Surgery, Stanford University, Stanford, CA, United States
| | | | | | - Anna T. Zhou
- Department of Plastic and Reconstructive Surgery, Stanford University, Stanford, CA, United States
| | - Gloria Sue
- Division of Plastic and Reconstructive Surgery, University of California San Francisco, San Francisco, CA, United States
| | - Peter Deptula
- Department of Plastic and Reconstructive Surgery, Stanford University, Stanford, CA, United States
| | - Maxim A. Moroz
- Department of Radiology, Stanford University, Stanford, CA, United States
| | - Peter Tabada
- Fibralign Corp, Union City, Thessaloniki, CA, United States
| | - Stanley G. Rockson
- Division of Cardiovascular Medicine, Stanford University, Stanford, CA, United States
| | | | | | - Ngan F. Huang
- Department of Cardiothoracic Surgery, Stanford University, Stanford, CA, United States
- Stanford Cardiovascular Institute, Stanford University, Stanford, CA, United States
- Center for Tissue Regeneration, Repair and Restoration, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, United States
- Department of Chemical Engineering, Stanford University, Palo Alto, CA, United States, United States
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14
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Brown S, Nores GDG, Sarker A, Ly C, Li C, Park HJ, Hespe GE, Gardenier J, Kuonqui K, Campbell A, Shin J, Kataru RP, Aras O, Mehrara BJ. Topical captopril: a promising treatment for secondary lymphedema. Transl Res 2023; 257:43-53. [PMID: 36736951 PMCID: PMC10192126 DOI: 10.1016/j.trsl.2023.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 01/15/2023] [Accepted: 01/25/2023] [Indexed: 02/04/2023]
Abstract
Transforming growth factor-beta 1 (TGF-β1)-mediated tissue fibrosis is an important regulator of lymphatic dysfunction in secondary lymphedema. However, TGF-β1 targeting can cause toxicity and autoimmune complications, limiting clinical utility. Angiotensin II (Ang II) modulates intracellular TGF-β1 signaling, and inhibition of Ang II production using angiotensin-converting enzyme (ACE) inhibitors, such as captopril, has antifibrotic efficacy in some pathological settings. Therefore, we analyzed the expression of ACE and Ang II in clinical lymphedema biopsy specimens from patients with unilateral breast cancer-related lymphedema (BCRL) and mouse models, and found that cutaneous ACE expression is increased in lymphedematous tissues. Furthermore, topical captopril decreases fibrosis, activation of intracellular TGF-β1 signaling pathways, inflammation, and swelling in mouse models of lymphedema. Captopril treatment also improves lymphatic function and immune cell trafficking by increasing collecting lymphatic pumping. Our results show that the renin-angiotensin system in the skin plays an important role in the regulation of fibrosis in lymphedema, and inhibition of this signaling pathway may hold merit for treating lymphedema.
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Affiliation(s)
- Stav Brown
- Department of Surgery, Plastic and Reconstructive Surgery Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Gabriela D G Nores
- Department of Surgery, Plastic and Reconstructive Surgery Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Ananta Sarker
- Department of Surgery, Plastic and Reconstructive Surgery Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Catherine Ly
- Department of Surgery, Plastic and Reconstructive Surgery Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Claire Li
- Department of Surgery, Plastic and Reconstructive Surgery Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Hyeung Ju Park
- Department of Surgery, Plastic and Reconstructive Surgery Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Geoffrey E Hespe
- Department of Surgery, Plastic and Reconstructive Surgery Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jason Gardenier
- Department of Surgery, Plastic and Reconstructive Surgery Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Kevin Kuonqui
- Department of Surgery, Plastic and Reconstructive Surgery Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Adana Campbell
- Department of Surgery, Plastic and Reconstructive Surgery Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jinyeon Shin
- Department of Surgery, Plastic and Reconstructive Surgery Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Raghu P Kataru
- Department of Surgery, Plastic and Reconstructive Surgery Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Omer Aras
- Department of Surgery, Plastic and Reconstructive Surgery Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Babak J Mehrara
- Department of Surgery, Plastic and Reconstructive Surgery Service, Memorial Sloan Kettering Cancer Center, New York, New York.
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15
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Alshaakh Moh'D Mari A, Varshney A, Recker K, Parikh J, Zayat V. Polypoid Lymphangiectasia in the Sigmoid Colon: A Case Report of a Rare Entity. Cureus 2023; 15:e40632. [PMID: 37476133 PMCID: PMC10355166 DOI: 10.7759/cureus.40632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 06/19/2023] [Indexed: 07/22/2023] Open
Abstract
Intestinal polypoid lymphangiectasia is an uncommon disorder involving an improperly formed enteric lymphatic system. It is characterized by lymphatic vessel dilatation with impaired drainage or obstruction of the lymph from the intestine. In this report, we present a case of a 73-year-old male patient with chronic intermittent left lower quadrant abdominal pain for one year who was found to have a sigmoid colon polyp on a colonoscopy. Upon microscopic examination, the polyp revealed dilated lymphatic vessels staining strongly for D2-40 (lymphatic vessel marker), supporting the diagnosis of polypoid lymphangiectasia. Intestinal lymphangiectasia has a broad differential diagnosis, warranting histopathological examination for a definitive diagnosis.--------------.
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Affiliation(s)
| | - Aarushi Varshney
- Internal Medicine, University of Central Florida HCA Healthcare GME, Orlando, USA
| | - Kristin Recker
- Pathology, University of Central Florida College of Medicine, Orlando, USA
| | - Jignesh Parikh
- Pathology, Orlando Veterans Affairs Medical Center, Orlando, USA
| | - Vania Zayat
- Pathology, Orlando Veterans Affairs Medical Center, Orlando, USA
- Pathology, University of Central Florida College of Medicine, Orlando, USA
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16
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Lin X, Bell RD, Catheline SE, Takano T, McDavid A, Jonason JH, Schwarz EM, Xing L. Targeting Synovial Lymphatic Function as a Novel Therapeutic Intervention for Age-Related Osteoarthritis in Mice. Arthritis Rheumatol 2023; 75:923-936. [PMID: 36625730 PMCID: PMC10238595 DOI: 10.1002/art.42441] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 12/16/2022] [Accepted: 01/05/2023] [Indexed: 01/11/2023]
Abstract
OBJECTIVE The synovial lymphatic system (SLS) removes catabolic factors from the joint. Vascular endothelial growth factor C (VEGF-C) and its receptor, VEGFR-3, are crucial for lymphangiogenesis. However, their involvement in age-related osteoarthritis (OA) is unknown. This study was undertaken to determine whether the SLS and the VEGF-C/VEGFR-3 pathway contribute to the development and progression of age-related OA, using a murine model of naturally occurring joint disease. METHODS SLS function was assessed in the knees of young (3-month-old) and aged (19-24-month-old) male and female C57BL/6J mice via a newly established in vivo IVIS-dextran imaging approach, which, in addition to histology, was used to assess the effects of VEGF-C treatment on SLS function and OA pathology in aged mice. RNA-sequencing of synovial tissue was performed to explore molecular mechanisms of the disease in the mouse knee joints. RESULTS Results showed that aged mice had impaired SLS function, including decreases in joint clearance (mean T1/2 of signal intensity clearance, 2.8 hours in aged mice versus 0.5 hours in young mice; P < 0.0001), synovial influx (mean ± SD 1.7 ± 0.8% in aged mice versus 4.1 ± 1.9% in young mice; P = 0.0004), and lymph node draining capacity (mean ± SD epifluorescence total radiant intensity ([photons/second]/[μW/cm2 ]) 1.4 ± 0.8 in aged mice versus 3.7 ± 1.2 in young mice; P < 0.0001). RNA-sequencing of the synovial tissue showed that Vegf-c and Vegfr3 signaling genes were decreased in the synovium of aged mice. VEGF-C treatment resulted in improvements in SLS function in aged mice, including increased percentage of signal intensity joint clearance (mean ± SD 63 ± 9% in VEGF-C-treated aged mice versus 52 ± 15% in vehicle-treated aged mice; P = 0.012), increased total articular cartilage cross-sectional area (mean ± SD 0.38 ± 0.07 mm2 in VEGF-C-treated aged mice versus 0.26 ± 0.07 mm2 in vehicle-treated aged mice; P < 0.0001), and decreased percentage of matrix metallopeptidase 13-positive staining area within total synovial area in 22-month-old VEGF-C-treated mice versus 22-month-old vehicle-treated mice (mean ± SD decrease 7 ± 2% versus 4 ± 1%; P = 0.0004). CONCLUSION SLS function is reduced in the knee joints of aged mice due to decreased VEGF-C/VEGFR-3 signaling. VEGF-C treatment attenuates OA joint damage and improves synovial lymphatic drainage in aged mice. The SLS and VEGF-C/VEGFR-3 signaling represent novel physiopathologic mechanisms that could potentially be used as therapeutic targets for age-related OA.
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Affiliation(s)
- Xi Lin
- Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Richard D. Bell
- Center for Musculoskeletal Research, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Sarah E. Catheline
- Center for Musculoskeletal Research, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Takahiro Takano
- Department of Pharmacology and Physiology, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Andrew McDavid
- Department of Biostatistics and computational biology, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Jennifer H. Jonason
- Center for Musculoskeletal Research, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Edward M. Schwarz
- Center for Musculoskeletal Research, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Lianping Xing
- Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, NY 14642, USA
- Center for Musculoskeletal Research, University of Rochester Medical Center, Rochester, NY 14642, USA
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17
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Moussa AM, Aly AK, Maybody M, Camacho JC, Ridouani F, Gonzalez-Aguirre AJ, Santos E. A comparison of lymphatic embolization and sclerotherapy in the management of iatrogenic abdominopelvic lymphoceles following oncological surgery. Diagn Interv Radiol 2023; 29:542-547. [PMID: 37171042 PMCID: PMC10679622 DOI: 10.4274/dir.2023.232135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 04/10/2023] [Indexed: 05/13/2023]
Abstract
PURPOSE To compare the safety and efficacy of sclerotherapy and lymphatic embolization (LE) in the treatment of symptomatic iatrogenic lymphoceles following the placement of a percutaneous drainage catheter. METHODS This is a retrospective study of 46 patients who underwent sclerotherapy (17 patients) or LE (29 patients) for the management of symptomatic iatrogenic lymphoceles following percutaneous drain placement between January 2017 and December 2021. The demographic characteristics, time between surgery and lymphatic intervention, clinical presentation, number of procedures, drain output pre- and post-intervention, time from intervention to drain removal, and adverse events were collected and compared for both groups. The clinical success rate, defined as the successful removal of the drain after one procedure, was calculated. Adverse events were reported according to the Society of Interventional Radiology classification. A statistical analysis was conducted using SPSS, and the P value for statistical significance was set at 0.05. The Mann-Whitney U test was used to compare differences in the scale variables, and Fisher's exact test was used to compare the categorical and ordinal variables between both groups. RESULTS A total of 46 patients with 49 lymphoceles met the inclusion criteria of the study. Of these patients, 17 patients (19 lymphoceles) underwent sclerotherapy, and 29 patients (30 lymphoceles) underwent LE as their initial procedures. The clinical success after one procedure was significantly higher (83% vs. 47%, P = 0.011), and the median time between the first intervention and drain removal was significantly shorter in the LE group (median duration of 6 vs. 13 days, P = 0.018) compared with the sclerotherapy group. No statistically significant difference in adverse events was noted between both groups (0.26 vs. 0.10, P = 0.11). CONCLUSION This study found that LE had a higher clinical success rate after the first procedure and a shorter time to drain removal compared with sclerotherapy. There was no difference in the rate of adverse events between both groups. Although LE is a safe and promising technique, a prospective study is needed to further compare the efficacy of both treatment modalities.
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Affiliation(s)
- Amgad M. Moussa
- Department of Radiology, Division of Interventional Radiology,Memorial Sloan Kettering Cancer Center, New York, United States
| | - Ahmed K. Aly
- Department of Radiology, Division of Interventional Radiology,Memorial Sloan Kettering Cancer Center, New York, United States
| | - Majid Maybody
- Department of Radiology, Division of Interventional Radiology,Memorial Sloan Kettering Cancer Center, New York, United States
| | - Juan C. Camacho
- Department of Radiology, Division of Interventional Radiology, Florida Atlantic University, Florida, United States
| | - Fourat Ridouani
- Department of Radiology, Division of Interventional Radiology,Memorial Sloan Kettering Cancer Center, New York, United States
| | - Adrian J. Gonzalez-Aguirre
- Department of Radiology, Division of Interventional Radiology,Memorial Sloan Kettering Cancer Center, New York, United States
| | - Ernesto Santos
- Department of Radiology, Division of Interventional Radiology,Memorial Sloan Kettering Cancer Center, New York, United States
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18
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Abstract
Kidney disease is associated with adverse consequences in many organs beyond the kidney, including the heart, lungs, brain, and intestines. The kidney-intestinal cross talk involves intestinal epithelial damage, dysbiosis, and generation of uremic toxins. Recent studies reveal that kidney injury expands the intestinal lymphatics, increases lymphatic flow, and alters the composition of mesenteric lymph. The intestinal lymphatics, like blood vessels, are a route for transporting potentially harmful substances generated by the intestines. The lymphatic architecture and actions are uniquely suited to take up and transport large macromolecules, functions that differentiate them from blood vessels, allowing them to play a distinct role in a variety of physiological and pathological processes. Here, we focus on the mechanisms by which kidney diseases result in deleterious changes in intestinal lymphatics and consider a novel paradigm of a vicious cycle of detrimental organ cross talk. This concept involves kidney injury-induced modulation of intestinal lymphatics that promotes production and distribution of harmful factors, which in turn contributes to disease progression in distant organ systems.
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Affiliation(s)
- Jianyong Zhong
- Department of Pediatrics (J.Z., H.-C.Y., A.B.F., E.L.S., V.K.), Vanderbilt University Medical Center, Nashville, TN
- Department of Pathology, Microbiology and Immunology (J.Z., H.-C.Y., A.B.F.), Vanderbilt University Medical Center, Nashville, TN
| | - Annet Kirabo
- Department of Molecular Physiology and Biophysics (A.K.), Vanderbilt University Medical Center, Nashville, TN
- Division of Clinical Pharmacology, Vanderbilt University, Nashville, TN (A.K.)
| | - Hai-Chun Yang
- Department of Pediatrics (J.Z., H.-C.Y., A.B.F., E.L.S., V.K.), Vanderbilt University Medical Center, Nashville, TN
- Department of Pathology, Microbiology and Immunology (J.Z., H.-C.Y., A.B.F.), Vanderbilt University Medical Center, Nashville, TN
| | - Agnes B Fogo
- Department of Pediatrics (J.Z., H.-C.Y., A.B.F., E.L.S., V.K.), Vanderbilt University Medical Center, Nashville, TN
- Department of Pathology, Microbiology and Immunology (J.Z., H.-C.Y., A.B.F.), Vanderbilt University Medical Center, Nashville, TN
- Department of Medicine (A.B.F.), Vanderbilt University Medical Center, Nashville, TN
| | - Elaine L Shelton
- Department of Pediatrics (J.Z., H.-C.Y., A.B.F., E.L.S., V.K.), Vanderbilt University Medical Center, Nashville, TN
| | - Valentina Kon
- Department of Pediatrics (J.Z., H.-C.Y., A.B.F., E.L.S., V.K.), Vanderbilt University Medical Center, Nashville, TN
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19
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Bourgeois P, Roman MM, Schweicher J, Lavoisier P, Maquet P, Karler C, Lizewski M, Fouarge A, Cuylits N, del Marmol V, Leduc O. Lymphatic Alterations Under Tattoos: Preliminary Reports of One Observational Study. Clin Cosmet Investig Dermatol 2023; 16:257-265. [PMID: 36733347 PMCID: PMC9888301 DOI: 10.2147/ccid.s393038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 12/22/2022] [Indexed: 01/28/2023]
Abstract
Background The number of people within the European population having at least one tattoo has increased notably and with it the number of tattoo-associated clinical complications. The injected inks are known to be removed by the lymphatic vessels and can be found in the draining lymph nodes. Aim of the Study To report our observations on the lymphatic drainages seen under tattoos using near infrared fluorescence imaging of these lymphatic vessels after the injection of indocyanine green. Material and Methods Indocyanine green was injected intradermally at the basis of the 20 tattooed area(s) in 19 subjects (nine women and ten men; mean age = 28.6). Ten subjects had only black tattoos (six upper limbs and four lower limbs), five (two upper limbs and three lower limbs) black and white tattoos and five multi-colored tattooed limbs (four lower limbs and one upper limb). Results The imaging exams revealed alterations in eight individuals, seven of whom had tattoos on their lower limbs. Furthermore, the imaging results showed that the abnormalities might be related to the tattooed limb, the tattoo extent and colour. Conclusion Alterations of the cutaneous lymphatic channels are frequently observed under tattooed territories. Their causal factors should be more precisely studied in future works and these lymphatic alterations should be considered in tattooed patients when using similar imaging techniques for therapeutic and surgical assessments.
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Affiliation(s)
- Pierre Bourgeois
- Service of Dermatology, Hospital Erasme, Université Libre de Bruxelles, Brussels, Belgium,Services of Nuclear Medicine, HIS-IZZ Hospitals, Université Libre de Bruxelles, Brussels, Belgium,Multi-Disciplinary Clinic of Lymphology, Institute Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium,Service of Vascular Surgery, HIS-IZZ Hospitals, Université Libre de Bruxelles, Brussels, Belgium,Correspondence: Pierre Bourgeois, Department of Dermatology, University Hospital Erasme, Université Libre de Bruxelles, 808, route de Lennik, Brussels, 1070, Belgium, Tel +32495201906, Email
| | - Mirela Mariana Roman
- Department of Mammo-Pelvic Surgery, Institute Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Justine Schweicher
- Unité de lympho-phlébologie, Haute Ecole Bruxelles-Brabant, Haute Ecole Robert Schuman, Brussels, Belgium
| | - Pauline Lavoisier
- Unité de lympho-phlébologie, Haute Ecole Bruxelles-Brabant, Haute Ecole Robert Schuman, Brussels, Belgium
| | - Philippe Maquet
- Unité de lympho-phlébologie, Haute Ecole Bruxelles-Brabant, Haute Ecole Robert Schuman, Brussels, Belgium
| | - Clarence Karler
- Department of Anesthesia-Algologia, Hospital Moliere, Université Libre de Bruxelles, Brussels, Belgium
| | - Mateusz Lizewski
- Service of Plastic, Reconstructive and Aesthetic Surgery, Hospital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Alessandro Fouarge
- Service of Plastic, Reconstructive and Aesthetic Surgery, Hospital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Nicolas Cuylits
- Service of Plastic, Reconstructive and Aesthetic Surgery, Hospital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Véronique del Marmol
- Service of Dermatology, Hospital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Olivier Leduc
- Unité de lympho-phlébologie, Haute Ecole Bruxelles-Brabant, Haute Ecole Robert Schuman, Brussels, Belgium
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20
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Chiu A, Jia W, Sun Y, Goldman J, Zhao F. Fibroblast-Generated Extracellular Matrix Guides Anastomosis during Wound Healing in an Engineered Lymphatic Skin Flap. Bioengineering (Basel) 2023; 10:bioengineering10020149. [PMID: 36829643 PMCID: PMC9952048 DOI: 10.3390/bioengineering10020149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 01/04/2023] [Accepted: 01/17/2023] [Indexed: 01/25/2023] Open
Abstract
A healthy lymphatic system is required to return excess interstitial fluid back to the venous circulation. However, up to 49% of breast cancer survivors eventually develop breast cancer-related lymphedema due to lymphatic injuries from lymph node dissections or biopsies performed to treat cancer. While early-stage lymphedema can be ameliorated by manual lymph drainage, no cure exists for late-stage lymphedema when lymph vessels become completely dysfunctional. A viable late-stage treatment is the autotransplantation of functional lymphatic vessels. Here we report on a novel engineered lymphatic flap that may eventually replace the skin flaps used in vascularized lymph vessel transfers. The engineered flap mimics the lymphatic and dermal compartments of the skin by guiding multi-layered tissue organization of mesenchymal stem cells and lymphatic endothelial cells with an aligned decellularized fibroblast matrix. The construct was tested in a novel bilayered wound healing model and implanted into athymic nude rats. The in vitro model demonstrated capillary invasion into the wound gaps and deposition of extracellular matrix fibers, which may guide anastomosis and vascular integration of the graft during wound healing. The construct successfully anastomosed in vivo, forming chimeric vessels of human and rat cells. Overall, our flap replacement has high potential for treating lymphedema.
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Affiliation(s)
- Alvis Chiu
- Stem Cell and Tissue Engineering Lab, Department of Biomedical Engineering, College of Engineering, Texas A&M University, College Station, TX 77843, USA
| | - Wenkai Jia
- Stem Cell and Tissue Engineering Lab, Department of Biomedical Engineering, College of Engineering, Texas A&M University, College Station, TX 77843, USA
| | - Yumeng Sun
- Stem Cell and Tissue Engineering Lab, Department of Biomedical Engineering, College of Engineering, Texas A&M University, College Station, TX 77843, USA
| | - Jeremy Goldman
- Vascular Materials Lab, Department of Biomedical Engineering, College of Engineering, Michigan Technological University, Houghton, MI 49931, USA
| | - Feng Zhao
- Stem Cell and Tissue Engineering Lab, Department of Biomedical Engineering, College of Engineering, Texas A&M University, College Station, TX 77843, USA
- Correspondence:
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21
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Asiyabi MM, Vahidi B. In silico analysis of a hierarchical microfluidic vascular network: Detecting the location of angiogenic sprouting. Int J Numer Method Biomed Eng 2023; 39:e3654. [PMID: 36209469 DOI: 10.1002/cnm.3654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 06/30/2022] [Accepted: 09/24/2022] [Indexed: 06/16/2023]
Abstract
Lack of oxygen is one of the leading causes of failure in engineered tissue. Therefore, angiogenesis will be necessary for the survival of larger tissues in vivo. In addition, a proper lymphatic system that plays an essential role in relieving inflammation and maintaining tissue homeostasis is of great importance for tissue regeneration and repair. Many biomechanical parameters are involved in controlling angiogenesis and capillary network generation, which are challenging to study and control in experimental studies or in vitro. In the present study, using numerical modeling, the effect of various geometric and biomechanical parameters in creating suitable conditions for angiogenesis was investigated. Furthermore, sprouting points were predicted using flow dynamics. For this purpose, a porous scaffold, flow channels with parametric geometry that followed Murray's law, and a drainage channel were considered. Results suggested that the geometry of the microfluidic channels and the characteristics of the vessel wall and scaffold plays a complementary role in determining the transmural pressure. It was found that a twofold increase in the vascular hydraulic conductivity can reduce the minimum transmural pressure by up to 28% and increase the drainage flow rate by 44%. In addition, the minimum magnitude of transmural pressure tends to zero for scaffold's hydraulic conductivity values smaller than 10-11 m3 s kg-1 . The results of this study can be used in optimizing the design of the relevant microfluidic systems to induce angiogenesis and avoid leakage in the constructed implantable tissue.
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Affiliation(s)
- Milad Mahdinezhad Asiyabi
- Division of Biomedical Engineering, Department of Life Science Engineering, Faculty of New Sciences and Technologies, University of Tehran, Tehran, Iran
| | - Bahman Vahidi
- Division of Biomedical Engineering, Department of Life Science Engineering, Faculty of New Sciences and Technologies, University of Tehran, Tehran, Iran
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22
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Lampejo AO, Ghavimi SAA, Hägerling R, Agarwal S, Murfee WL. Lymphatic/blood vessel plasticity: motivation for a future research area based on present and past observations. Am J Physiol Heart Circ Physiol 2023; 324:H109-H121. [PMID: 36459445 PMCID: PMC9829479 DOI: 10.1152/ajpheart.00612.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 11/23/2022] [Accepted: 11/23/2022] [Indexed: 12/04/2022]
Abstract
The lymphatic system plays a significant role in homeostasis and drainage of excess fluid back into venous circulation. Lymphatics are also associated with a number of diseases including lymphedema, tumor metastasis, and various lymphatic malformations. Emerging evidence suggests that lymphatics might have a bigger connection to the blood vascular system than originally presumed. As these two systems are often studied in isolation, several knowledge gaps exist surrounding what constitutes lymphatic vascular plasticity, under what conditions it arises, and where structures characteristic of plasticity can form. The objective of this review is to overview current structural, cell lineage-based, and cell identity-based evidence for lymphatic plasticity. These examples of plasticity will then be considered in the context of potential clinical and surgical implications of this evolving research area. This review details our current understanding of lymphatic plasticity, highlights key unanswered questions in the field, and motivates future research aimed at clarifying the role and therapeutic potential of lymphatic plasticity in disease.
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Affiliation(s)
- Arinola O Lampejo
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, Florida
| | | | - René Hägerling
- Institute of Medical and Human Genetics, Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Berlin Institute of Health Center for Regenerative Therapies, Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Berlin, Germany
- Clinician Scientist Program, Berlin Institute of Health Academy, Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Shailesh Agarwal
- Division of Plastic and Reconstructive Surgery, Brigham and Women's Hospital, Boston, Massachusetts
| | - Walter L Murfee
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, Florida
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Sung DC, Chen M, Dominguez MH, Mahadevan A, Chen X, Yang J, Gao S, Ren AA, Tang AT, Mericko P, Patton R, Lee M, Jannaway M, Nottebaum A, Vestweber D, Scallan JP, Kahn ML. Sinusoidal and lymphatic vessel growth is controlled by reciprocal VEGF-C-CDH5 inhibition. Nat Cardiovasc Res 2022; 1:1006-1021. [PMID: 36910472 PMCID: PMC9997205 DOI: 10.1038/s44161-022-00147-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 09/14/2022] [Indexed: 11/12/2022]
Abstract
Sinusoids are specialized, low pressure blood vessels in the liver, bone marrow, and spleen required for definitive hematopoiesis. Unlike other blood endothelial cells (ECs), sinusoidal ECs express high levels of VEGFR3. VEGFR3 and its ligand VEGF-C are known to support lymphatic growth, but their function in sinusoidal vessels is unknown. In this study, we define a reciprocal VEGF-C/VEGFR3-CDH5 (VE-cadherin) signaling axis that controls growth of both sinusoidal and lymphatic vessels. Loss of VEGF-C or VEGFR3 resulted in cutaneous edema, reduced fetal liver size, and bloodless bone marrow due to impaired lymphatic and sinusoidal vessel growth. Mice with membrane-retained VE-cadherin conferred identical lymphatic and sinusoidal defects, suggesting that VE-cadherin opposes VEGF-C/VEGFR3 signaling. In developing mice, loss of VE-cadherin rescued defects in sinusoidal and lymphatic growth caused by loss of VEGFR3 but not loss of VEGF-C, findings explained by potentiated VEGF-C/VEGFR2 signaling in VEGFR3-deficient lymphatic ECs. Mechanistically, VEGF-C/VEGFR3 signaling induces VE-cadherin endocytosis and loss of function via SRC-mediated phosphorylation, while VE-cadherin prevents VEGFR3 endocytosis required for optimal receptor signaling. These findings establish an essential role for VEGF-C/VEGFR3 signaling during sinusoidal vascular growth, identify VE-cadherin as a powerful negative regulator of VEGF-C signaling that acts through both VEGFR3 and VEGFR2 receptors, and suggest that negative regulation of VE-cadherin is required for effective VEGF-C/VEGFR3 signaling during growth of sinusoidal and lymphatic vessels. Manipulation of this reciprocal negative regulatory mechanism, e.g. by reducing VE-cadherin function, may be used to stimulate therapeutic sinusoidal or lymphatic vessel growth.
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Affiliation(s)
- Derek C. Sung
- Cardiovascular Institute, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Mei Chen
- Cardiovascular Institute, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Martin H. Dominguez
- Cardiovascular Institute, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Aparna Mahadevan
- Cardiovascular Institute, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Xiaowen Chen
- Cardiovascular Institute, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jisheng Yang
- Cardiovascular Institute, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Siqi Gao
- Cardiovascular Institute, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Aileen A. Ren
- Cardiovascular Institute, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Alan T. Tang
- Cardiovascular Institute, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Patricia Mericko
- Cardiovascular Institute, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Raiyah Patton
- Cardiovascular Institute, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Michelle Lee
- University Laboratory Animal Resources, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Melanie Jannaway
- Department of Molecular Pharmacology and Physiology, University of South Florida, Tampa, Florida
| | - Astrid Nottebaum
- Max Planck Institute for Molecular Biomedicine, Münster, Germany
| | | | - Joshua P. Scallan
- Department of Molecular Pharmacology and Physiology, University of South Florida, Tampa, Florida
| | - Mark L. Kahn
- Cardiovascular Institute, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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24
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Fedrigo R, Segars WP, Martineau P, Gowdy C, Bloise I, Uribe CF, Rahmim A. Development of scalable lymphatic system in the 4D XCAT phantom: Application to quantitative evaluation of lymphoma PET segmentations. Med Phys 2022; 49:6871-6884. [PMID: 36053829 PMCID: PMC9742182 DOI: 10.1002/mp.15963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 08/01/2022] [Accepted: 08/16/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Digital anthropomorphic phantoms, such as the 4D extended cardiac-torso (XCAT) phantom, are actively used to develop, optimize, and evaluate a variety of imaging applications, allowing for realistic patient modeling and knowledge of ground truth. The XCAT phantom defines the activity and attenuation for a simulated patient, which includes a complete set of organs, muscle, bone, and soft tissue, while also accounting for cardiac and respiratory motion. However, the XCAT phantom does not currently include the lymphatic system, critical for evaluating medical imaging tasks such as sentinel node detection, node density measurement, and radiation dosimetry. PURPOSE In this study, we aimed to develop a scalable lymphatic system in the XCAT phantom, to facilitate improved research of the lymphatic system in medical imaging. Using this scalable lymphatic system, we modeled the lymph node conglomerate pathology that is characteristically observed in primary mediastinal B-cell lymphoma (PMBCL). As an extended application, we evaluated positron emission tomography (PET) image quantification of metabolic tumor volume (MTV) and total lesion glycolysis (TLG) of these simulated lymphomas, though the phantoms may be applied to other imaging modalities and study design paradigms (e.g., image quality, detection). METHODS A template model for the lymphatic system was developed based on anatomical data from the Visible Human Project of the National Library of Medicine. The segmented nodes and vessels were fit with non-uniform rational basis spline surfaces, and multichannel large deformation diffeomorphic metric mapping was used to propagate the template to different XCAT anatomies. To model conglomerates observed in PMBCL, lymph nodes were enlarged, converged within the mediastinum, and tracer concentration was increased. We used the phantoms as inputs to a PET simulation tool, which generated images using ordered subsets expectation maximization reconstruction with 2-8 mm Gaussian filters. Fixed thresholding (FT) and gradient segmentation were used to determine MTV and TLG. Percent bias (%Bias) and coefficient of variation (COV) were computed as measures of accuracy and precision, respectively, for each MTV and TLG measurement. RESULTS Using the methodology described above, we introduced a scalable lymphatic system in the XCAT phantom, which allows for the radioactivity and attenuation ground truth to be generated in 116 ± 2.5 s using a 2.3 GHz processor. Within the Rhinoceros interface, lymph node anatomy and function were modified to create a cohort of 10 phantoms with lymph node conglomerates. Using the lymphoma phantoms to evaluate PET quantification of MTV, mean %Bias values were -9.3%, -41.3%, and 20.9%, while COV values were 4.08%, 7.6%, and 3.4% using 25% FT, 40% FT, and gradient segmentations, respectively. Comparatively for TLG, mean %Bias values were -27.4%, -45.8%, and -16.0%, while COV values were 1.9%, 5.7%, and 1.4%, for the 25% FT, 40% FT, and gradient segmentations, respectively. CONCLUSIONS In this work, we upgraded the XCAT phantom to include a lymphatic system, comprised of a network of 276 scalable lymph nodes and corresponding vessels. As an application, we created a cohort of phantoms with lymph node conglomerates to evaluate lymphoma quantification in PET imaging, which highlights an important application of this work.
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Affiliation(s)
- Roberto Fedrigo
- Department of Integrative Oncology, BC Cancer Research Institute, Vancouver, BC V5Z 1L3, Canada
- Department of Physics & Astronomy, University of British Columbia, Vancouver, BC V6T 1Z1, Canada
| | | | | | - Claire Gowdy
- Department of Radiology, BC Children’s Hospital, Vancouver, BC V6H 0B3, Canada
| | - Ingrid Bloise
- Department of Integrative Oncology, BC Cancer Research Institute, Vancouver, BC V5Z 1L3, Canada
| | - Carlos F. Uribe
- Functional Imaging, BC Cancer, Vancouver, BC V5Z 4E6, Canada
- Department of Radiology, University of British Columbia, Vancouver, BC V6T 2B5, Canada
| | - Arman Rahmim
- Department of Integrative Oncology, BC Cancer Research Institute, Vancouver, BC V5Z 1L3, Canada
- Department of Physics & Astronomy, University of British Columbia, Vancouver, BC V6T 1Z1, Canada
- Department of Radiology, University of British Columbia, Vancouver, BC V6T 2B5, Canada
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25
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Russell PS, Hucklesby JJW, Hong J, Cao E, Trevaskis NL, Angel CE, Windsor JA, Phillips ARJ. Vmeasur: A software package for experimental and clinical measurement of mesenteric lymphatic contractile function over an extended vessel length. Microcirculation 2022; 29:e12748. [PMID: 35092129 PMCID: PMC9787391 DOI: 10.1111/micc.12748] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 01/16/2022] [Accepted: 01/21/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Conventionally, in vivo mesenteric lymphatic contractile function is measured using a high magnification transmission microscope (field of view 0.3-1.5 mm), which precludes visualization of extended lengths of vessels embedded in mesenteric fat. Existing software is not optimized for imaging at a low magnification using a contrast agent. We aimed to develop a simple and clinically transferable method for in situ visualization, image analysis, and quantitative assessment of mesenteric lymphatic contractile function over an extended area. METHODS Subserosal injection of various blue dyes was taken up by mesenteric lymphatics and visualized under a stereomicroscope (25×), allowing for video recording of 1.4 × 1.1 cm of intact mesentery. A new R package ("vmeasur") that combines multiple high-performance image analyses into a single workflow was developed. The edges of each vessel were determined by applying an automated threshold to each frame (with real-time manual verification). The vessel width at every point in each frame was plotted to provide contractile parameters over time and along the lymphatic vessel length. RESULTS Contractile parameters and their differences along the length of the vessel were accurately calculated in a rodent model. In a human mesenteric lymphatic, the algorithm was also able to measure changes in diameter over length. CONCLUSION This software offers a low cost, rapid, and accessible method to measure lymphatic contractile function over a wide area, showing differences in contractility along the length of a vessel. Because the presence of mesenteric fat has less of an impact on imaging, due to the use of an exogenous contrast agent, there is potential for clinical application.
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Affiliation(s)
- Peter S. Russell
- Applied Surgery and Metabolism LaboratorySchool of Biological SciencesUniversity of AucklandAucklandNew Zealand,Department of SurgeryFaculty of Medical and Health SciencesSurgical and Translational Research CentreUniversity of AucklandAucklandNew Zealand
| | - James J. W. Hucklesby
- Human Cellular Immunology GroupSchool of Biological SciencesUniversity of AucklandAucklandNew Zealand,Department of Molecular Medicine and PathologyFaculty of Medical and Health SciencesUniversity of AucklandAucklandNew Zealand
| | - Jiwon Hong
- Applied Surgery and Metabolism LaboratorySchool of Biological SciencesUniversity of AucklandAucklandNew Zealand,Department of SurgeryFaculty of Medical and Health SciencesSurgical and Translational Research CentreUniversity of AucklandAucklandNew Zealand
| | - Enyuan Cao
- Drug Delivery, Disposition and DynamicsMonash Institute of Pharmaceutical SciencesMonash UniversityParkvilleVic.Australia
| | - Natalie L. Trevaskis
- Drug Delivery, Disposition and DynamicsMonash Institute of Pharmaceutical SciencesMonash UniversityParkvilleVic.Australia
| | - Catherine E. Angel
- Human Cellular Immunology GroupSchool of Biological SciencesUniversity of AucklandAucklandNew Zealand
| | - John A. Windsor
- Department of SurgeryFaculty of Medical and Health SciencesSurgical and Translational Research CentreUniversity of AucklandAucklandNew Zealand
| | - Anthony R. J. Phillips
- Applied Surgery and Metabolism LaboratorySchool of Biological SciencesUniversity of AucklandAucklandNew Zealand,Department of SurgeryFaculty of Medical and Health SciencesSurgical and Translational Research CentreUniversity of AucklandAucklandNew Zealand
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Abstract
The central nervous system (CNS) has been viewed as an immunologically privileged site, but emerging works are uncovering a large array of neuroimmune interactions primarily occurring at its borders. CNS barriers sites host diverse population of both innate and adaptive immune cells capable of, directly and indirectly, influence the function of the residing cells of the brain parenchyma. These structures are only starting to reveal their role in controlling brain function under normal and pathological conditions and represent an underexplored therapeutic target for the treatment of brain disorders. This review will highlight the development of the CNS barriers to host neuro-immune interactions and emphasize their newly described roles in neurodevelopmental, neurological, and neurodegenerative disorders, particularly for the meninges.
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Affiliation(s)
- Natalie M Frederick
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Gabriel A Tavares
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Antoine Louveau
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA.,Department of Molecular Medicine, Cleveland Clinic College of Medicine, Case Western Reserve University, Cleveland, Ohio, USA.,Kent University, Neurosciences, School of Biomedical Sciences, Cleveland, Ohio, USA
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27
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Dai L, Uehara M, Li X, LaBarre BA, Banouni N, Ichimura T, Lee-Sundlov MM, Kasinath V, Sullivan JA, Ni H, Barone F, Giannini S, Bahmani B, Sage PT, Patsopoulos NA, Tsokos GC, Bromberg JS, Hoffmeister K, Jiang L, Abdi R. Characterization of CD41 + cells in the lymph node. Front Immunol 2022; 13:801945. [PMID: 36032128 PMCID: PMC9405417 DOI: 10.3389/fimmu.2022.801945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 07/18/2022] [Indexed: 11/23/2022] Open
Abstract
Lymph nodes (LNs) are the critical sites of immunity, and the stromal cells of LNs are crucial to their function. Our understanding of the stromal compartment of the LN has deepened recently with the characterization of nontraditional stromal cells. CD41 (integrin αIIb) is known to be expressed by platelets and hematolymphoid cells. We identified two distinct populations of CD41+Lyve1+ and CD41+Lyve1- cells in the LNs. CD41+Lyve1- cells appear in the LN mostly at the later stages of the lives of mice. We identified CD41+ cells in human LNs as well. We demonstrated that murine CD41+ cells express mesodermal markers, such as Sca-1, CD105 and CD29, but lack platelet markers. We did not observe the presence of platelets around the HEVs or within proximity to fibroblastic reticular cells of the LN. Examination of thoracic duct lymph fluid showed the presence of CD41+Lyve1- cells, suggesting that these cells recirculate throughout the body. FTY720 reduced their trafficking to lymph fluid, suggesting that their egress is controlled by the S1P1 pathway. CD41+Lyve1- cells of the LNs were sensitive to radiation, suggestive of their replicative nature. Single cell RNA sequencing data showed that the CD41+ cell population in naïve mouse LNs expressed largely stromal cell markers. Further studies are required to examine more deeply the role of CD41+ cells in the function of LNs.
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Affiliation(s)
- Li Dai
- Transplantation Research Center, Renal Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States,China Pharmaceutical University, Nanjing, China
| | - Mayuko Uehara
- Transplantation Research Center, Renal Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
| | - Xiaofei Li
- Transplantation Research Center, Renal Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
| | - Brenna A. LaBarre
- Systems Biology and Computer Science Program, Ann Romney Center for Neurological Diseases, Department of Neurology, Brigham & Women’s Hospital, Boston, MA, United States
| | - Naima Banouni
- Transplantation Research Center, Renal Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
| | - Takaharu Ichimura
- Renal Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
| | - Melissa M. Lee-Sundlov
- Division of Hematology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States,BloodCenter of Wisconsin, Blood Research Institute, Milwaukee, WI, United States
| | - Vivek Kasinath
- Transplantation Research Center, Renal Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
| | - Jade A. Sullivan
- Department of Laboratory Medicine and Pathobiology, and Toronto Platelet Immunobiology Group, St. Michael’s Hospital, University of Toronto, Toronto, ON, Canada
| | - Heyu Ni
- Department of Laboratory Medicine and Pathobiology, and Toronto Platelet Immunobiology Group, St. Michael’s Hospital, University of Toronto, Toronto, ON, Canada,Canadian Blood Services Centre for Innovation, Toronto, ON, Canada
| | - Francesca Barone
- Centre for Translational Inflammation Research, University of Birmingham, Birmingham, United Kingdom
| | - Silvia Giannini
- Division of Hematology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
| | - Baharak Bahmani
- Transplantation Research Center, Renal Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
| | - Peter T. Sage
- Transplantation Research Center, Renal Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
| | - Nikolaos A. Patsopoulos
- Systems Biology and Computer Science Program, Ann Romney Center for Neurological Diseases, Department of Neurology, Brigham & Women’s Hospital, Boston, MA, United States,Broad Institute of Harvard and Massachusetts Institute of Technology, Cambridge, MA, United States
| | - George C. Tsokos
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Jonathan S. Bromberg
- Departments of Surgery and Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Karin Hoffmeister
- Division of Hematology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States,BloodCenter of Wisconsin, Blood Research Institute, Milwaukee, WI, United States
| | - Liwei Jiang
- Institute of Health and Medical Technology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, China,*Correspondence: Reza Abdi, ; Liwei Jiang,
| | - Reza Abdi
- Transplantation Research Center, Renal Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States,*Correspondence: Reza Abdi, ; Liwei Jiang,
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Solorzano E, Alejo AL, Ball HC, Magoline J, Khalil Y, Kelly M, Safadi FF. Osteopathy in Complex Lymphatic Anomalies. Int J Mol Sci 2022; 23:ijms23158258. [PMID: 35897834 PMCID: PMC9332568 DOI: 10.3390/ijms23158258] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 07/07/2022] [Accepted: 07/16/2022] [Indexed: 11/16/2022] Open
Abstract
Complex Lymphatic Anomalies (CLA) are lymphatic malformations with idiopathic bone and soft tissue involvement. The extent of the abnormal lymphatic presentation and boney invasion varies between subtypes of CLA. The etiology of these diseases has proven to be extremely elusive due to their rarity and irregular progression. In this review, we compiled literature on each of the four primary CLA subtypes and discuss their clinical presentation, lymphatic invasion, osseous profile, and regulatory pathways associated with abnormal bone loss caused by the lymphatic invasion. We highlight key proliferation and differentiation pathways shared between lymphatics and bone and how these systems may interact with each other to stimulate lymphangiogenesis and cause bone loss.
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Affiliation(s)
- Ernesto Solorzano
- Department of Anatomy and Neurobiology, Northeast Ohio Medical University (NEOMED), Rootstown, OH 44272, USA; (E.S.); (A.L.A.); (H.C.B.); (J.M.); (Y.K.); (M.K.)
- Musculoskeletal Research Group, Northeast Ohio Medical University (NEOMED), Rootstown, OH 44272, USA
| | - Andrew L. Alejo
- Department of Anatomy and Neurobiology, Northeast Ohio Medical University (NEOMED), Rootstown, OH 44272, USA; (E.S.); (A.L.A.); (H.C.B.); (J.M.); (Y.K.); (M.K.)
- Musculoskeletal Research Group, Northeast Ohio Medical University (NEOMED), Rootstown, OH 44272, USA
| | - Hope C. Ball
- Department of Anatomy and Neurobiology, Northeast Ohio Medical University (NEOMED), Rootstown, OH 44272, USA; (E.S.); (A.L.A.); (H.C.B.); (J.M.); (Y.K.); (M.K.)
- Musculoskeletal Research Group, Northeast Ohio Medical University (NEOMED), Rootstown, OH 44272, USA
| | - Joseph Magoline
- Department of Anatomy and Neurobiology, Northeast Ohio Medical University (NEOMED), Rootstown, OH 44272, USA; (E.S.); (A.L.A.); (H.C.B.); (J.M.); (Y.K.); (M.K.)
- Musculoskeletal Research Group, Northeast Ohio Medical University (NEOMED), Rootstown, OH 44272, USA
| | - Yusuf Khalil
- Department of Anatomy and Neurobiology, Northeast Ohio Medical University (NEOMED), Rootstown, OH 44272, USA; (E.S.); (A.L.A.); (H.C.B.); (J.M.); (Y.K.); (M.K.)
- Musculoskeletal Research Group, Northeast Ohio Medical University (NEOMED), Rootstown, OH 44272, USA
| | - Michael Kelly
- Department of Anatomy and Neurobiology, Northeast Ohio Medical University (NEOMED), Rootstown, OH 44272, USA; (E.S.); (A.L.A.); (H.C.B.); (J.M.); (Y.K.); (M.K.)
- Department of Pediatric Hematology Oncology and Blood, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Fayez F. Safadi
- Department of Anatomy and Neurobiology, Northeast Ohio Medical University (NEOMED), Rootstown, OH 44272, USA; (E.S.); (A.L.A.); (H.C.B.); (J.M.); (Y.K.); (M.K.)
- Musculoskeletal Research Group, Northeast Ohio Medical University (NEOMED), Rootstown, OH 44272, USA
- Rebecca D. Considine Research Institute, Akron Children’s Hospital, Akron, OH 44308, USA
- School of Biomedical Sciences, Kent State University, Kent, OH 44243, USA
- Correspondence: ; Tel.: +1-330-325-6619
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29
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Russell PS, Velivolu R, Maldonado Zimbrón VE, Hong J, Kavianinia I, Hickey AJR, Windsor JA, Phillips ARJ. Fluorescent Tracers for In Vivo Imaging of Lymphatic Targets. Front Pharmacol 2022; 13:952581. [PMID: 35935839 PMCID: PMC9355481 DOI: 10.3389/fphar.2022.952581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 06/16/2022] [Indexed: 11/13/2022] Open
Abstract
The lymphatic system continues to gain importance in a range of conditions, and therefore, imaging of lymphatic vessels is becoming more widespread for research, diagnosis, and treatment. Fluorescent lymphatic imaging offers advantages over other methods in that it is affordable, has higher resolution, and does not require radiation exposure. However, because the lymphatic system is a one-way drainage system, the successful delivery of fluorescent tracers to lymphatic vessels represents a unique challenge. Each fluorescent tracer used for lymphatic imaging has distinct characteristics, including size, shape, charge, weight, conjugates, excitation/emission wavelength, stability, and quantum yield. These characteristics in combination with the properties of the target tissue affect the uptake of the dye into lymphatic vessels and the fluorescence quality. Here, we review the characteristics of visible wavelength and near-infrared fluorescent tracers used for in vivo lymphatic imaging and describe the various techniques used to specifically target them to lymphatic vessels for high-quality lymphatic imaging in both clinical and pre-clinical applications. We also discuss potential areas of future research to improve the lymphatic fluorescent tracer design.
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Affiliation(s)
- P. S. Russell
- Applied Surgery and Metabolism Laboratory, School of Biological Sciences, Faculty of Science, University of Auckland, Auckland, New Zealand
- Surgical and Translational Research Centre, Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - R. Velivolu
- Applied Surgery and Metabolism Laboratory, School of Biological Sciences, Faculty of Science, University of Auckland, Auckland, New Zealand
- Surgical and Translational Research Centre, Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - V. E. Maldonado Zimbrón
- Applied Surgery and Metabolism Laboratory, School of Biological Sciences, Faculty of Science, University of Auckland, Auckland, New Zealand
- Surgical and Translational Research Centre, Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - J. Hong
- Applied Surgery and Metabolism Laboratory, School of Biological Sciences, Faculty of Science, University of Auckland, Auckland, New Zealand
- Surgical and Translational Research Centre, Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- Maurice Wilkins Centre for Molecular Biodiscovery, School of Biological Sciences, Faculty of Science, The University of Auckland, Auckland, New Zealand
| | - I. Kavianinia
- Maurice Wilkins Centre for Molecular Biodiscovery, School of Biological Sciences, Faculty of Science, The University of Auckland, Auckland, New Zealand
- School of Chemical Sciences, Faculty of Science, The University of Auckland, Auckland, New Zealand
| | - A. J. R. Hickey
- Applied Surgery and Metabolism Laboratory, School of Biological Sciences, Faculty of Science, University of Auckland, Auckland, New Zealand
- Maurice Wilkins Centre for Molecular Biodiscovery, School of Biological Sciences, Faculty of Science, The University of Auckland, Auckland, New Zealand
| | - J. A. Windsor
- Surgical and Translational Research Centre, Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- Maurice Wilkins Centre for Molecular Biodiscovery, School of Biological Sciences, Faculty of Science, The University of Auckland, Auckland, New Zealand
| | - A. R. J. Phillips
- Applied Surgery and Metabolism Laboratory, School of Biological Sciences, Faculty of Science, University of Auckland, Auckland, New Zealand
- Surgical and Translational Research Centre, Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- Maurice Wilkins Centre for Molecular Biodiscovery, School of Biological Sciences, Faculty of Science, The University of Auckland, Auckland, New Zealand
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30
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Si H, Yin C, Wang W, Davies P, Sanchez E, Suntravat M, Zawieja D, Cromer W. Effect of the snake venom component crotamine on lymphatic endothelial cell responses and lymph transport. Microcirculation 2022; 30:e12775. [PMID: 35689804 PMCID: PMC9850291 DOI: 10.1111/micc.12775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/16/2022] [Accepted: 06/06/2022] [Indexed: 01/21/2023]
Abstract
OBJECTIVE The pathology of snake envenomation is closely tied to the severity of edema in the tissue surrounding the area of the bite. Elucidating the mechanisms that promote the development of such severe edema is critical to a better understanding of how to treat this life-threatening injury. We focused on one of the most abundant venom components in North American viper venom, crotamine, and the effects it has on the cells and function of the lymphatic system. METHODS We used RT-PCR to identify the location and relative abundance of crotamine's cellular targets (Kvα channels) within the tissues and cells of the lymphatic system. We used calcium flux, nitrate production, and cell morphometry to determine the effects of crotamine on lymphatic endothelial cells. We used tracer transport, node morphometry, and node deposition to determine the effects of crotamine on lymph transport in vivo. RESULTS We found that genes that encode targets of crotamine are highly present in lymphatic tissues and cells and that there is a differential distribution of those genes that correlates with phasic contractile activity. We found that crotamine potentiates calcium flux in human dermal lymphatic endothelial cells in response to stimulation with histamine and sheer stress (but not alone) and that it alters the production of nitric oxide in response to shear as well as changes the level of F-actin polymerization of those same cells. Crotamine alters lymphatic transport of large molecular weight tracers to local lymph nodes and is deposited within the node mostly in the immediate subcapsular region. CONCLUSION This evidence suggests that snake venom components may have an impact on the function of the lymphatic system. This needs to be studied in greater detail as there are numerous venom components that may have effects on aspects of the lymphatic system. This would not only provide basic information on the pathobiology of snakebite but also provide targets for improved therapeutics to treat snakebite.
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Affiliation(s)
- Hongjiang Si
- Department of Medical Physiology, Texas A&M University Health Science Center
| | - Chunhiu Yin
- Center for Translational Cancer Research, Texas A&M Institute of Biosciences and Technology
| | - Wei Wang
- Department of Medical Physiology, Texas A&M University Health Science Center
| | - Peter Davies
- Center for Translational Cancer Research, Texas A&M Institute of Biosciences and Technology
| | - Elda Sanchez
- National Natural Toxins Research Center, Texas A&M Kingsville
| | | | - David Zawieja
- Department of Medical Physiology, Texas A&M University Health Science Center
| | - Walter Cromer
- Department of Medical Physiology, Texas A&M University Health Science Center
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31
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Xu W, Nelson-Maney NP, Bálint L, Kwon HB, Davis RB, Dy DCM, Dunleavey JM, St. Croix B, Caron KM. Orphan G-Protein Coupled Receptor GPRC5B Is Critical for Lymphatic Development. Int J Mol Sci 2022; 23:ijms23105712. [PMID: 35628521 PMCID: PMC9146384 DOI: 10.3390/ijms23105712] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 05/18/2022] [Accepted: 05/19/2022] [Indexed: 12/22/2022] Open
Abstract
Numerous studies have focused on the molecular signaling pathways that govern the development and growth of lymphatics in the hopes of elucidating promising druggable targets. G protein-coupled receptors (GPCRs) are currently the largest family of membrane receptors targeted by FDA-approved drugs, but there remain many unexplored receptors, including orphan GPCRs with no known biological ligand or physiological function. Thus, we sought to illuminate the cadre of GPCRs expressed at high levels in lymphatic endothelial cells and identified four orphan receptors: GPRC5B, AGDRF5/GPR116, FZD8 and GPR61. Compared to blood endothelial cells, GPRC5B is the most abundant GPCR expressed in cultured human lymphatic endothelial cells (LECs), and in situ RNAscope shows high mRNA levels in lymphatics of mice. Using genetic engineering approaches in both zebrafish and mice, we characterized the function of GPRC5B in lymphatic development. Morphant gprc5b zebrafish exhibited failure of thoracic duct formation, and Gprc5b-/- mice suffered from embryonic hydrops fetalis and hemorrhage associated with subcutaneous edema and blood-filled lymphatic vessels. Compared to Gprc5+/+ littermate controls, Gprc5b-/- embryos exhibited attenuated developmental lymphangiogenesis. During the postnatal period, ~30% of Gprc5b-/- mice were growth-restricted or died prior to weaning, with associated attenuation of postnatal cardiac lymphatic growth. In cultured human primary LECs, expression of GPRC5B is required to maintain cell proliferation and viability. Collectively, we identify a novel role for the lymphatic-enriched orphan GPRC5B receptor in lymphangiogenesis of fish, mice and human cells. Elucidating the roles of orphan GPCRs in lymphatics provides new avenues for discovery of druggable targets to treat lymphatic-related conditions such as lymphedema and cancer.
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Affiliation(s)
- Wenjing Xu
- Department of Cell Biology and Physiology, The University of North Carolina, Chapel Hill, NC 27599, USA; (W.X.); (N.P.N.-M.); (L.B.); (H.-B.K.); (R.B.D.); (D.C.M.D.)
| | - Nathan P. Nelson-Maney
- Department of Cell Biology and Physiology, The University of North Carolina, Chapel Hill, NC 27599, USA; (W.X.); (N.P.N.-M.); (L.B.); (H.-B.K.); (R.B.D.); (D.C.M.D.)
| | - László Bálint
- Department of Cell Biology and Physiology, The University of North Carolina, Chapel Hill, NC 27599, USA; (W.X.); (N.P.N.-M.); (L.B.); (H.-B.K.); (R.B.D.); (D.C.M.D.)
| | - Hyouk-Bum Kwon
- Department of Cell Biology and Physiology, The University of North Carolina, Chapel Hill, NC 27599, USA; (W.X.); (N.P.N.-M.); (L.B.); (H.-B.K.); (R.B.D.); (D.C.M.D.)
| | - Reema B. Davis
- Department of Cell Biology and Physiology, The University of North Carolina, Chapel Hill, NC 27599, USA; (W.X.); (N.P.N.-M.); (L.B.); (H.-B.K.); (R.B.D.); (D.C.M.D.)
| | - Danielle C. M. Dy
- Department of Cell Biology and Physiology, The University of North Carolina, Chapel Hill, NC 27599, USA; (W.X.); (N.P.N.-M.); (L.B.); (H.-B.K.); (R.B.D.); (D.C.M.D.)
| | - James M. Dunleavey
- Tumor Angiogenesis Unit, Mouse Cancer Genetics Program, National Cancer Institute–Frederick, NIH, Frederick, MD 21702, USA; (J.M.D.); (B.S.C.)
| | - Brad St. Croix
- Tumor Angiogenesis Unit, Mouse Cancer Genetics Program, National Cancer Institute–Frederick, NIH, Frederick, MD 21702, USA; (J.M.D.); (B.S.C.)
| | - Kathleen M. Caron
- Department of Cell Biology and Physiology, The University of North Carolina, Chapel Hill, NC 27599, USA; (W.X.); (N.P.N.-M.); (L.B.); (H.-B.K.); (R.B.D.); (D.C.M.D.)
- Correspondence:
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32
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Freytag JM, Ryan TD, Bange JE, Bonarrigo KC, Chouteau WA, Wittekind SG, Tian C, Gao Z, Villa CR. Obesity and loss of ambulation are associated with lower extremity oedema in Duchenne muscular dystrophy. Cardiol Young 2022;:1-6. [PMID: 35549789 DOI: 10.1017/S1047951122001342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Patients with Duchenne muscular dystrophy have multiple risk factors for lower extremity oedema. This study sought to define the frequency and predictors of oedema. Patients aged 15 years and older were screened by patient questionnaire, and the presence of oedema was confirmed by subsequent physical exam. Twenty-four of 52 patients (46%) had oedema, 12 of whom had swelling extending above the foot and two with sores/skin breakdown. There was no significant difference in age, frequency, or duration of glucocorticoid use, non-invasive respiratory support use, forced vital capacity, cardiac medication use, or ejection fraction between patients with and without oedema (all p > 0.2). Those with oedema had a greater time since the loss of ambulation (8.4 years versus 3.5 years; p = 0.004), higher body mass index (28.3 versus 24.8; p = 0.014), and lower frequency of deflazacort use (67% versus 89%; p = 0.008). Multivariate analysis revealed a longer duration of loss of ambulation (p = 0.02) and higher body mass index (p = 0.009) as predictors of oedema. Lower extremity oedema is common in Duchenne muscular dystrophy but independent of cardiac function. Interventions focused on minimising body mass index increases over time may be a therapeutic target.
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Peil J, Bock F, Kiefer F, Schmidt R, Heindl LM, Cursiefen C, Schlereth SL. New Therapeutic Approaches for Conjunctival Melanoma-What We Know So Far and Where Therapy Is Potentially Heading: Focus on Lymphatic Vessels and Dendritic Cells. Int J Mol Sci 2022; 23:1478. [PMID: 35163401 PMCID: PMC8835854 DOI: 10.3390/ijms23031478] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 01/21/2022] [Accepted: 01/24/2022] [Indexed: 11/25/2022] Open
Abstract
Conjunctival melanoma (CM) accounts for 5% of all ocular melanomas and arises from malignantly transformed melanocytes in the conjunctival epithelium. Current therapies using surgical excision in combination with chemo- or cryotherapy still have high rates for recurrences and metastatic disease. Lately, novel signal transduction-targeted and immune checkpoint inhibitors like cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) inhibitors, programmed cell death protein-1 (PD-1) receptor inhibitors, BRAF- or MEK-inhibitors for systemic treatment of melanoma have improved the outcome even for unresectable cutaneous melanoma, improving patient survival dramatically. The use of these therapies is now also recommended for CM; however, the immunological background of CM is barely known, underlining the need for research to better understand the immunological basics when treating CM patients with immunomodulatory therapies. Immune checkpoint inhibitors activate tumor defense by interrupting inhibitory interactions between tumor cells and T lymphocytes at the so-called checkpoints. The tumor cells exploit these inhibitory targets on T-cells that are usually used by dendritic cells (DCs). DCs are antigen-presenting cells at the forefront of immune response induction. They contribute to immune tolerance and immune defense but in the case of tumor development, immune tolerance is often prevalent. Enhancing the immune response via DCs, interfering with the lymphatic pathways during immune cell migration and tumor development and specifically targeting tumor cells is a major therapeutic opportunity for many tumor entities including CM. This review summarizes the current knowledge on the function of lymphatic vessels in tumor growth and immune cell transport and continues to compare DC subsets in CM with related melanomas, such as cutaneous melanoma and mucosal melanoma.
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Affiliation(s)
- Jennifer Peil
- Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany; (J.P.); (F.B.); (L.M.H.); (C.C.)
| | - Felix Bock
- Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany; (J.P.); (F.B.); (L.M.H.); (C.C.)
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, 50937 Cologne, Germany
| | - Friedemann Kiefer
- European Institute for Molecular Imaging (EIMI), University of Münster, 48149 Münster, Germany;
| | - Rebecca Schmidt
- Department of Oral, Maxillofacial and Plastic Facial Surgery, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University, 40225 Düsseldorf, Germany;
| | - Ludwig M. Heindl
- Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany; (J.P.); (F.B.); (L.M.H.); (C.C.)
| | - Claus Cursiefen
- Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany; (J.P.); (F.B.); (L.M.H.); (C.C.)
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, 50937 Cologne, Germany
| | - Simona L. Schlereth
- Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany; (J.P.); (F.B.); (L.M.H.); (C.C.)
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, 50937 Cologne, Germany
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Fu MR, McTernan ML, Qiu JM, Miaskowski C, Conley YP, Ko E, Axelrod D, Guth A, Somers TJ, Wood LJ, Wang Y. Co-occurring Fatigue and Lymphatic Pain Incrementally Aggravate Their Negative Effects on Activities of Daily Living, Emotional Distress, and Overall Health of Breast Cancer Patients. Integr Cancer Ther 2022; 21:15347354221089605. [PMID: 35446180 PMCID: PMC9047803 DOI: 10.1177/15347354221089605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 02/16/2022] [Accepted: 03/08/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Fatigue and lymphatic pain are the most common and debilitating long-term adverse effects of breast cancer treatment. Fatigue and pain independently have negative effects on quality of life, physical functions, and cancer recurrence-free survival. The interactions between fatigue and pain may aggravate their negative effects. OBJECTIVES Examine the effects of co-occurring fatigue and lymphatic pain on activities of daily living (ADLs), emotional distress, and overall health of breast cancer patients. METHODS A cross-sectional and observational design was used to enroll 354 breast cancer patients. Valid and reliable instruments were used to assess fatigue, lymphatic pain, ADLs, emotional distress, and overall health. Descriptive statistics and multivariable regression models were used for data analysis. RESULTS After controlling for demographic and clinical factors, patients with co-occurring fatigue and lymphatic pain had higher odds of having impaired ADLs (OR = 24.43, CI = [5.44-109.67], P < .001) and emotional distress (OR = 26.52, CI = [9.64-72.90], P < .001) compared to patients with only fatigue and only lymphatic pain. Patients with co-occurring fatigue and lymphatic pain had 179% increase in impaired ADL scores (B = 8.06, CI = [5.54-10.59]) and 211% increase in emotional distress scores (B = 9.17, CI = [5.52-12.83]) compared to those without co-occurring fatigue and lymphatic pain. Patients with co-occurring fatigue and lymphatic pain had a 34% decrease (B = -26.29, CI = [-31.90 to -20.69]) and patients with only fatigue had a 33% decrease in overall health scores (B = -25.74, 95% CI = [-34.14 to -17.33]), indicating poor overall health. CONCLUSIONS Fatigue and lymphatic pain affected 66.4% of breast cancer patients. Findings from this study suggest that co-occurring fatigue and lymphatic pain have negative effects on breast cancer patients' ADLs, emotional distress, and overall health. The synergistic interactions between fatigue and lymphatic pain incrementally aggravated their negative effects on ADLs and emotional distress. Findings of the study highlight the need to evaluate the underlying mechanisms for co-occurring fatigue and lymphatic pain and develop interventions that target both fatigue and lymphatic pain to improve breast cancer patients' the quality of life.
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Affiliation(s)
| | | | | | | | | | - Eunjung Ko
- The Ohio State University, Columbus,
OH, USA
| | | | - Amber Guth
- New York University School of Medicine,
New York, NY, USA
| | | | | | - Yao Wang
- New York University Tandon School of
Engineering, Brooklyn, NY, USA
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35
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Bernard FC, Kaiser J, Raval SK, Nepiyushchikh ZV, Doan TN, Willett NJ, Dixon JB. Multichromatic near-infrared imaging to assess interstitial lymphatic and venous uptake in vivo. J Biomed Opt 2021; 26:JBO-210078R. [PMID: 34881527 PMCID: PMC8654485 DOI: 10.1117/1.jbo.26.12.126001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 10/21/2021] [Indexed: 05/12/2023]
Abstract
SIGNIFICANCE Changes in interstitial fluid clearance are implicated in many diseases. Using near-infrared (NIR) imaging with properly sized tracers could enhance our understanding of how venous and lymphatic drainage are involved in disease progression or enhance drug delivery strategies. AIM We investigated multichromatic NIR imaging with multiple tracers to assess in vivo microvascular clearance kinetics and pathways in different tissue spaces. APPROACH We used a chemically inert IR Dye 800CW (D800) to target venous capillaries and a purified conjugate of IR dye 680RD with 40 kDa PEG (P40D680) to target lymphatic capillaries in vivo. Optical imaging settings were validated and tuned in vitro using tissue phantoms. We investigated multichromatic NIR imaging's utility in two in vivo tissue beds: the mouse tail and rat knee joint. We then tested the ability of the approach to detect interstitial fluid perturbations due to exercise. RESULTS In an in vitro simulated tissue environment, free dye and PEG mixture allowed for simultaneous detection without interference. In the mouse tail, co-injected NIR tracers cleared from the interstitial space via distinct routes, suggestive of lymphatic and venous uptake mechanisms. In the rat knee, we determined that exercise after injection transiently increased lymphatic drainage as measured by lower normalized intensity immediately after exercise, whereas exercise pre-injection exhibited a transient delay in clearance from the joint. CONCLUSIONS NIR imaging enables simultaneous imaging of lymphatic and venous-mediated fluid clearance with great sensitivity and can be used to measure temporal changes in clearance rates and pathways.
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Affiliation(s)
- Fabrice C. Bernard
- Georgia Institute of Technology and Emory University, Wallace H. Coulter Department of Biomedical Engineering, Atlanta, Georgia, United States
| | - Jarred Kaiser
- Emory University, Department of Orthopaedics, Atlanta, Georgia, United States
| | - Sarvgna K. Raval
- Emory University, Department of Orthopaedics, Atlanta, Georgia, United States
| | - Zhanna V. Nepiyushchikh
- Georgia Institute of Technology, George W. Woodruff School of Mechanical Engineering, Atlanta, Georgia, United States
| | - Thanh N. Doan
- Emory University, Department of Orthopaedics, Atlanta, Georgia, United States
| | - Nick J. Willett
- Georgia Institute of Technology and Emory University, Wallace H. Coulter Department of Biomedical Engineering, Atlanta, Georgia, United States
- Emory University, Department of Orthopaedics, Atlanta, Georgia, United States
- Atlanta Veteran’s Affairs Medical Center, Department of Orthopaedics, Atlanta, Georgia, United States
- Georgia Institute of Technology, Parker H. Petit Institute for Bioengineering and Bioscience, Atlanta, Georgia, United States
| | - J. Brandon Dixon
- Georgia Institute of Technology and Emory University, Wallace H. Coulter Department of Biomedical Engineering, Atlanta, Georgia, United States
- Georgia Institute of Technology, George W. Woodruff School of Mechanical Engineering, Atlanta, Georgia, United States
- Georgia Institute of Technology, Parker H. Petit Institute for Bioengineering and Bioscience, Atlanta, Georgia, United States
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McCorkell KA, Jayachandran N, Cully MD, Freund-Brown J, Weinkopff T, Monslow J, Hu Y, Puré E, Freedman BD, Alvarez JI, Cancro MP, May MJ. Lymph node formation and B cell homeostasis require IKK-α in distinct endothelial cell-derived compartments. Proc Natl Acad Sci U S A 2021; 118:e2100195118. [PMID: 34810256 DOI: 10.1073/pnas.2100195118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2021] [Indexed: 11/18/2022] Open
Abstract
Global inactivation of IκB kinase (IKK)-α results in defective lymph node (LN) formation and B cell maturation, and loss of IKK-α-dependent noncanonical NF-κB signaling in stromal organizer and hematopoietic cells is thought to underlie these distinct defects. We previously demonstrated that this pathway is also activated in vascular endothelial cells (ECs). To determine the physiologic function of EC-intrinsic IKK-α, we crossed IkkαF/F mice with Tie2-cre or Cdh5-cre mice to ablate IKK-α in ECs. Notably, the compound defects of global IKK-α inactivation were recapitulated in IkkαTie2 and IkkαCdh5 mice, as both lacked all LNs and mature follicular and marginal zone B cell numbers were markedly reduced. However, as Tie2-cre and Cdh5-cre are expressed in all ECs, including blood forming hemogenic ECs, IKK-α was also absent in hematopoietic cells (HC). To determine if loss of HC-intrinsic IKK-α affected LN development, we generated IkkαVav mice lacking IKK-α in only the hematopoietic compartment. While mature B cell numbers were significantly reduced in IkkαVav mice, LN formation was intact. As lymphatic vessels also arise during development from blood ECs, we generated IkkαLyve1 mice lacking IKK-α in lymphatic ECs (LECs) to determine if IKK-α in lymphatic vessels impacts LN development. Strikingly, while mature B cell numbers were normal, LNs were completely absent in IkkαLyve1 mice. Thus, our findings reveal that IKK-α in distinct EC-derived compartments is uniquely required to promote B cell homeostasis and LN development, and we establish that LEC-intrinsic IKK-α is absolutely essential for LN formation.
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Wang T, Wang Z, de Fabritus L, Tao J, Saied EM, Lee HJ, Ramazanov BR, Jackson B, Burkhardt D, Parker M, Gleinich AS, Wang Z, Seo DE, Zhou T, Xu S, Alecu I, Azadi P, Arenz C, Hornemann T, Krishnaswamy S, van de Pavert SA, Kaech SM, Ivanova NB, Santori FR. 1-deoxysphingolipids bind to COUP-TF to modulate lymphatic and cardiac cell development. Dev Cell 2021; 56:3128-3145.e15. [PMID: 34762852 PMCID: PMC8628544 DOI: 10.1016/j.devcel.2021.10.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 08/30/2021] [Accepted: 10/19/2021] [Indexed: 12/12/2022]
Abstract
Identification of physiological modulators of nuclear hormone receptor (NHR) activity is paramount for understanding the link between metabolism and transcriptional networks that orchestrate development and cellular physiology. Using libraries of metabolic enzymes alongside their substrates and products, we identify 1-deoxysphingosines as modulators of the activity of NR2F1 and 2 (COUP-TFs), which are orphan NHRs that are critical for development of the nervous system, heart, veins, and lymphatic vessels. We show that these non-canonical alanine-based sphingolipids bind to the NR2F1/2 ligand-binding domains (LBDs) and modulate their transcriptional activity in cell-based assays at physiological concentrations. Furthermore, inhibition of sphingolipid biosynthesis phenocopies NR2F1/2 deficiency in endothelium and cardiomyocytes, and increases in 1-deoxysphingosine levels activate NR2F1/2-dependent differentiation programs. Our findings suggest that 1-deoxysphingosines are physiological regulators of NR2F1/2-mediated transcription.
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Affiliation(s)
- Ting Wang
- Department of Immunobiology, Yale University, New Haven, CT 06520, USA; Department of Hematology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Zheng Wang
- Department of Genetics and Cell Biology, Basic Medical College, Qingdao University, Qingdao, Shandong 266071, China; Department of Reproductive Medicine, the Affiliated Hospital of Qingdao University, Qingdao, Shandong 266000, China
| | - Lauriane de Fabritus
- Aix-Marseille Universite, CNRS, INSERM, Centre d'Immunologie de Marseille-Luminy (CIML), 13288 Marseille Cedex 9, France
| | - Jinglian Tao
- Department of Hematology, Tianjin Medical University General Hospital, Tianjin 300052, China; Center for Molecular Medicine, Department of Genetics, University of Georgia, Athens, GA 30602, USA
| | - Essa M Saied
- Institut für Chemie, Humboldt Universität zu Berlin, Berlin 12489, Germany; Chemistry Department, Faculty of Science, Suez Canal University, Ismailia 41522, Egypt
| | - Ho-Joon Lee
- Department of Genetics, Yale University, New Haven, CT 06520, USA; Center for Genome Analysis, Yale University, New Haven, CT 06510, USA
| | - Bulat R Ramazanov
- Department of Cell Biology, Yale University, New Haven, CT 06520, USA
| | - Benjamin Jackson
- Center for Molecular Medicine, Department of Genetics, University of Georgia, Athens, GA 30602, USA
| | - Daniel Burkhardt
- Department of Genetics, Yale University, New Haven, CT 06520, USA
| | - Mikhail Parker
- Center for Molecular Medicine, Department of Genetics, University of Georgia, Athens, GA 30602, USA
| | - Anne S Gleinich
- Complex Carbohydrate Research Center, University of Georgia, Athens, GA 30602, USA
| | - Zhirui Wang
- Complex Carbohydrate Research Center, University of Georgia, Athens, GA 30602, USA
| | - Dong Eun Seo
- Center for Molecular Medicine, Department of Genetics, University of Georgia, Athens, GA 30602, USA
| | - Ting Zhou
- Department of Immunobiology, Yale University, New Haven, CT 06520, USA
| | - Shihao Xu
- NOMIS Center for Immunobiology and Microbial Pathogenesis, the Salk Institute for Biological Studies, La Jolla, CA 92037, USA
| | - Irina Alecu
- Neural Regeneration Laboratory, Department of Biochemistry, Microbiology, and Immunology, University of Ottawa, Ottawa K1H 8M5, Canada
| | - Parastoo Azadi
- Complex Carbohydrate Research Center, University of Georgia, Athens, GA 30602, USA
| | - Christoph Arenz
- Institut für Chemie, Humboldt Universität zu Berlin, Berlin 12489, Germany
| | - Thorsten Hornemann
- Institute of Clinical Chemistry, University and University Hospital of Zurich, Zurich 8091, Switzerland
| | | | - Serge A van de Pavert
- Aix-Marseille Universite, CNRS, INSERM, Centre d'Immunologie de Marseille-Luminy (CIML), 13288 Marseille Cedex 9, France
| | - Susan M Kaech
- NOMIS Center for Immunobiology and Microbial Pathogenesis, the Salk Institute for Biological Studies, La Jolla, CA 92037, USA.
| | - Natalia B Ivanova
- Center for Molecular Medicine, Department of Genetics, University of Georgia, Athens, GA 30602, USA.
| | - Fabio R Santori
- Department of Immunobiology, Yale University, New Haven, CT 06520, USA.
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Tabrizi ZB, Ahmed NS, Horder JL, Storr SJ, Benest AV. Transcription Factor Control of Lymphatic Quiescence and Maturation of Lymphatic Neovessels in Development and Physiology. Front Physiol 2021; 12:672987. [PMID: 34795596 PMCID: PMC8593113 DOI: 10.3389/fphys.2021.672987] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 09/30/2021] [Indexed: 11/25/2022] Open
Abstract
The lymphatic system is a vascular system comprising modified lymphatic endothelial cells, lymph nodes and other lymphoid organs. The system has diverse, but critical functions in both physiology and pathology, and forms an interface between the blood vascular and immune system. It is increasingly evident that remodelling of the lymphatic system occurs alongside remodelling of the blood microvascular system, which is now considered a hallmark of most pathological conditions as well as being critical for normal development. Much attention has focussed on how the blood endothelium undergoes phenotypic switching in development and disease, resulting in over two decades of research to probe the mechanisms underlying the resulting heterogeneity. The lymphatic system has received less attention, and consequently there are fewer descriptions of functional and molecular heterogeneity, but differential transcription factor activity is likely an important control mechanism. Here we introduce and discuss significant transcription factors of relevance to coordinating cellular responses during lymphatic remodelling as the lymphatic endothelium dynamically changes from quiescence to actively remodelling.
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Affiliation(s)
- Zarah B Tabrizi
- Endothelial Quiescence Group, University of Nottingham, Nottingham, United Kingdom
| | - Nada S Ahmed
- Endothelial Quiescence Group, University of Nottingham, Nottingham, United Kingdom
| | - Joseph L Horder
- Endothelial Quiescence Group, University of Nottingham, Nottingham, United Kingdom
| | - Sarah J Storr
- Nottingham Breast Cancer Research Centre, Centre for Cancer Sciences School of Medicine, Biodiscovery Institute, University of Nottingham, Nottingham, United Kingdom
| | - Andrew V Benest
- Endothelial Quiescence Group, University of Nottingham, Nottingham, United Kingdom
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39
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Abraham WT, Jonas M, Dongaonkar RM, Geist B, Ueyama Y, Render K, Youngblood B, Muir W, Hamlin R, del Rio CL. Direct Interstitial Decongestion in an Animal Model of Acute-on-Chronic Ischemic Heart Failure. JACC Basic Transl Sci 2021; 6:872-881. [PMID: 34869951 PMCID: PMC8617571 DOI: 10.1016/j.jacbts.2021.09.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 09/30/2021] [Accepted: 09/30/2021] [Indexed: 11/19/2022]
Abstract
In ADHF, elevated CVP opposes thoracic duct lymph flow and impairs decongestion of the interstitial space. The use of a novel device for reducing CVP at the outflow of the thoracic duct was shown to be safe, well-tolerated, and effectively reduced EVLW, in an animal model of acute-on-chronic ischemic HF. Similar results were observed when translating this therapy to a human case study. Additional human studies to confirm these findings may establish device-based direct interstitial decongestion as a new treatment for ADHF.
Removal of excess fluid in acute decompensated heart failure (ADHF) targets the intravascular space, whereas most fluid resides in the interstitial space. The authors evaluated an approach to interstitial decongestion using a device to enhance lymph flow. The device was deployed in sheep with induced heart failure (HF) and acute volume overload to create a low-pressure zone at the thoracic duct outlet. Treatment decreased extravascular lung water (EVLW) volume (mL/kg) (-32% ± 9%, P = 0.029) compared to controls (+46% ± 9%, P = 0.003). Device-mediated thoracic duct decompression effectively reduced EVLW. Human studies may establish device-based interstitial decongestion as a new ADHF treatment.
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Affiliation(s)
- William T. Abraham
- Division of Cardiovascular Medicine, The Ohio State University, Columbus, Ohio, USA
- Address for correspondence: Dr William T. Abraham, Division of Cardiovascular Medicine, The Ohio State University, 473 West 12th Avenue, Columbus, Ohio 43210, USA.
| | - Michael Jonas
- Department of Cardiology, Kaplan Medical Center, Hebrew University School of Medicine, Rehovot, Israel
| | - Ranjeet M. Dongaonkar
- Department of Veterinary Physiology & Pharmacology, Michael E. DeBakey Institute for Comparative Cardiovascular Science and Biomedical Devices, Texas A&M University, College Station, Texas, USA
| | | | | | | | | | | | - Robert Hamlin
- Division of Cardiovascular Medicine, The Ohio State University, Columbus, Ohio, USA
- QTest Labs, Columbus, Ohio, USA
| | - Carlos L. del Rio
- QTest Labs, Columbus, Ohio, USA
- Cardiac Consulting, San Mateo, California, USA
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Abstract
Chylothorax, a lymphatic flow disorder characterized by an abnormal circulation of lymph fluid into the pleural cavity, is the most common cause of pleural effusions during the neonatal period. This condition affects 1/15,000 neonates every year. Affected neonates often manifest with respiratory distress, electrolyte imbalances, sepsis, and even immunodeficiencies. Mortality risk is highest among neonates undergoing cardiac surgery as well as those with associated hydrops fetalis. Conservative treatment options include bowel rest with administration of parenteral nutrition, followed with medium-chain triglyceride enteral feedings, and octreotide therapy. Severe or persistent cases require surgical intervention. This can involve a unilateral or bilateral pleurectomy and thoracic duct ligation, with or without pleurodesis. Early identification and successful treatment of this condition is contingent upon awareness of the most current evidence and a timely cross-disciplinary approach to care.
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Martens P, Tang WW. Targeting the Lymphatic System for Interstitial Decongestion. JACC Basic Transl Sci 2021; 6:882-884. [PMID: 34869952 PMCID: PMC8617594 DOI: 10.1016/j.jacbts.2021.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Affiliation(s)
- Pieter Martens
- Kaufman Center for Heart Failure Treatment and Recovery, Department of Cardiovascular Medicine, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - W.H. Wilson Tang
- Kaufman Center for Heart Failure Treatment and Recovery, Department of Cardiovascular Medicine, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA
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Wada I, Nakao S, Yamaguchi M, Kaizu Y, Arima M, Sawa S, Sonoda KH. Retinal VEGF-A Overexpression Is Not Sufficient to Induce Lymphangiogenesis Regardless of VEGF-C Upregulation and Lyve1+ Macrophage Infiltration. Invest Ophthalmol Vis Sci 2021; 62:17. [PMID: 34673901 PMCID: PMC8543389 DOI: 10.1167/iovs.62.13.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 09/23/2021] [Indexed: 11/24/2022] Open
Abstract
Purpose No lymphatic vessels have been identified in the retina. This study investigated whether pathological VEGF-A-overexpressing diabetic retina causes lymphangiogenesis. Methods Three genetic mouse models of diabetic retinopathy (DR) (Akita [Ins2+/-], Kimba [vegfa+/+], and Akimba [Akita × Kimba] mice) were used. Retinas were examined by fundus photography, fluorescence angiography (FA), and immunostaining to detect lymphangiogenesis or angiogenesis. Lyve1-GFP (Lyve1EGFP/Cre) mice were used to examine Lyve1-expressing cells by immunostaining. Lymphatic-related factors were investigated in mouse retina and vitreous fluid from proliferative diabetic retinopathy (PDR) patients by RT-PCR and ELISA, respectively. Aged Kimba and Akimba mice were used to examine the retinal phenotype at the late phase of VEGF overexpression. Results FA and immunostaining showed retinal neovascularization in Kimba and Akimba mice but not wild-type and Akita mice. Immunohistochemistry showed that lymphangiogenesis was not present in the retinas of Akita, Kimba, or Akimba mice despite the significant upregulation of lymphatic-related factors (Lyve1, podoplanin, VEGF-A, VEGF-C, VEGF-D, VEGFR2, and VEGFR3) in the retinas of Kimba and Akimba mice by RT-PCR (P < 0.005). Furthermore, lymphangiogenesis was not present in aged Kimba or Akimba mice. Significantly increased numbers of Lyve1-positive cells present in the retinas of Kimba and Akimba mice, especially in the peripheral areas, were CD11b positive, indicating a macrophage population (P < 0.005). VEGF-C in PDR vitreous with vitreous hemorrhage (VH) was higher than in PDR without VH or a macular hole. Conclusions Retinal VEGF-A overexpression did not cause typical lymphangiogenesis despite upregulated lymphatic-related factors and significant Lyve1-positive macrophage infiltration.
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Affiliation(s)
- Iori Wada
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shintaro Nakao
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Department of Ophthalmology, National Hospital Organization, Kyushu Medical Center, Fukuoka, Japan
| | - Muneo Yamaguchi
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshihiro Kaizu
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Mitsuru Arima
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shinichiro Sawa
- Division of Mucosal Immunology, Research Center for Systems Immunology, Kyushu University, Fukuoka, Japan
| | - Koh-Hei Sonoda
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Ravaud C, Ved N, Jackson DG, Vieira JM, Riley PR. Lymphatic Clearance of Immune Cells in Cardiovascular Disease. Cells 2021; 10:cells10102594. [PMID: 34685572 PMCID: PMC8533855 DOI: 10.3390/cells10102594] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 09/26/2021] [Accepted: 09/27/2021] [Indexed: 12/11/2022] Open
Abstract
Recent advances in our understanding of the lymphatic system, its function, development, and role in pathophysiology have changed our views on its importance. Historically thought to be solely involved in the transport of tissue fluid, lipids, and immune cells, the lymphatic system displays great heterogeneity and plasticity and is actively involved in immune cell regulation. Interference in any of these processes can be deleterious, both at the developmental and adult level. Preclinical studies into the cardiac lymphatic system have shown that invoking lymphangiogenesis and enhancing immune cell trafficking in ischaemic hearts can reduce myocardial oedema, reduce inflammation, and improve cardiac outcome. Understanding how immune cells and the lymphatic endothelium interact is also vital to understanding how the lymphatic vascular network can be manipulated to improve immune cell clearance. In this Review, we examine the different types of immune cells involved in fibrotic repair following myocardial infarction. We also discuss the development and function of the cardiac lymphatic vasculature and how some immune cells interact with the lymphatic endothelium in the heart. Finally, we establish how promoting lymphangiogenesis is now a prime therapeutic target for reducing immune cell persistence, inflammation, and oedema to restore heart function in ischaemic heart disease.
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Affiliation(s)
- Christophe Ravaud
- Burdon-Sanderson Cardiac Science Centre, Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford OX1 3PT, UK; (C.R.); (N.V.); (J.M.V.)
| | - Nikita Ved
- Burdon-Sanderson Cardiac Science Centre, Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford OX1 3PT, UK; (C.R.); (N.V.); (J.M.V.)
| | - David G. Jackson
- MRC Human Immunology Unit, MRC Weatherall Institute of Molecular Medicine, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DS, UK;
| | - Joaquim Miguel Vieira
- Burdon-Sanderson Cardiac Science Centre, Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford OX1 3PT, UK; (C.R.); (N.V.); (J.M.V.)
| | - Paul R. Riley
- Burdon-Sanderson Cardiac Science Centre, Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford OX1 3PT, UK; (C.R.); (N.V.); (J.M.V.)
- Correspondence:
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Han S, Mei L, Quach T, Porter C, Trevaskis N. Lipophilic Conjugates of Drugs: A Tool to Improve Drug Pharmacokinetic and Therapeutic Profiles. Pharm Res 2021; 38:1497-1518. [PMID: 34463935 DOI: 10.1007/s11095-021-03093-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 08/05/2021] [Indexed: 01/19/2023]
Abstract
Lipophilic conjugates (LCs) of small molecule drugs have been used widely in clinical and pre-clinical studies to achieve a number of pharmacokinetic and therapeutic benefits. For example, lipophilic derivatives of drugs are employed in several long acting injectable products to provide sustained drug exposure for hormone replacement therapy and to treat conditions such as neuropsychiatric diseases. LCs can also be used to modulate drug metabolism, and to enhance drug permeation across membranes, either by increasing lipophilicity to enhance passive diffusion or by increasing protein-mediated active transport. Furthermore, such conjugation strategies have been employed to promote drug association with endogenous macromolecular carriers (e.g. albumin and lipoproteins), and this in turn results in altered drug distribution and pharmacokinetic profiles, where the changes can be 'general' (e.g. prolonged plasma half-life) or 'specific' (e.g. enhanced delivery to specific tissues in parallel with the macromolecular carriers). Another utility of LCs is to enhance the encapsulation of drugs within engineered nanoscale drug delivery systems, in order to best take advantage of the targeting and pharmacokinetic benefits of nanomedicines. The current review provides a summary of the mechanisms by which lipophilic conjugates, including in combination with delivery vehicles, can be used to control drug delivery, distribution and therapeutic profiles. The article is structured into sections which highlight a specific benefit of LCs and then demonstrate this benefit with case studies. The review attempts to provide a toolbox to assist researchers to design and optimise drug candidates, including consideration of drug-formulation compatibility.
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Affiliation(s)
- Sifei Han
- Drug Delivery, Disposition and Dynamics, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, VIC, 3052, Australia.
- Suzhou Institute of Drug Innovation, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Suzhou, Jiangsu, 215123, China.
| | - Lianghe Mei
- Suzhou Institute of Drug Innovation, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Suzhou, Jiangsu, 215123, China
| | - Tim Quach
- Medicinal Chemistry, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, VIC, 3052, Australia
- PureTech Health, 6 Tide Street, Boston, MA, 02210, USA
| | - Chris Porter
- Drug Delivery, Disposition and Dynamics, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, VIC, 3052, Australia
| | - Natalie Trevaskis
- Drug Delivery, Disposition and Dynamics, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, VIC, 3052, Australia.
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Estébanez A, Puche-Torres M, Sanchis García JM, Cuñat A, Pinazo Canales MI, Rausell Félix MF, Campos S, Márquez Cañada J, Martín Hernández JM. Characteristics of mucocutaneous vascular malformations drawn from a decade of a multidisciplinary committee experience. Dermatol Ther 2021; 34:e15074. [PMID: 34338412 DOI: 10.1111/dth.15074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 06/19/2021] [Accepted: 07/25/2021] [Indexed: 11/29/2022]
Abstract
Vascular malformations (VM) are congenital, benign, and relatively frequent lesions. Scant data have been published about the epidemiology, clinical presentation, and treatment of VM from a dermatologist's perspective. The substantial differences between subtypes, broad range of specialists consulted and confusing nomenclature used over previous years may hamper a correct diagnosis. The main objective of this study is to describe VM epidemiology. As a secondary endpoint we evaluate clinical characteristics, clinical-radiological correlation and treatment approaches. We carried out an observational, descriptive, retrospective study. Cases presented to the multidisciplinary committee of our hospital from 2009 to 2019 were retrieved. Electronic medical records, monthly committee reports and the iconographic archive were reviewed and statistically analyzed. Overall, venous malformations (VeM) are the most frequent VM, followed by capillary malformations (CM), arterioVeM and lymphatic malformations (LM). Considering only patients under 16, CMs are the most frequent ones. Capillary and LMs are larger than venous or arteriovenous. While CMs are usually asymptomatic, symptomatic cases are threefold more frequent in the other subtypes. Decisions on active or conservative management depend on VM size but not location or patient age. CMs are mainly treated with laser therapy; venous with sclerotherapy or surgery; arteriovenous with surgery and lymphatic with surgery or sirolimus. Dermatologists play an important role in VM diagnosis and management. Our 10-year multidisciplinary experience should contribute to the literature and represent a practical resource for clinicians and researchers.
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Affiliation(s)
- Andrea Estébanez
- Department of Dermatology, Clinical University Hospital, Health Research Institute, University of Valencia, Valencia, Spain
| | - Miguel Puche-Torres
- Department of Oral and maxillofacial Surgery, Clinical University Hospital University of Valencia, Valencia, Spain
| | - Juan Manuel Sanchis García
- Department of Interventional Radiology, Clinical University Hospital, University of Valencia, Valencia, Spain
| | - Alberto Cuñat
- Department of Radiology, Clinical University Hospital, University of Valencia, Valencia, Spain
| | - Maria Isabel Pinazo Canales
- Department of Dermatology, Clinical University Hospital, Health Research Institute, University of Valencia, Valencia, Spain
| | - María Francisca Rausell Félix
- Department of Dermatology, Clinical University Hospital, Health Research Institute, University of Valencia, Valencia, Spain
| | - Salvador Campos
- Department of Radiology, Clinical University Hospital, University of Valencia, Valencia, Spain
| | - Juan Márquez Cañada
- Department of Plastic Surgery, Clinical University Hospital, University of Valencia, Valencia, Spain
| | - Jose María Martín Hernández
- Department of Dermatology, Clinical University Hospital, Health Research Institute, University of Valencia, Valencia, Spain
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Fu MR, Axelrod D, Guth A, McTernan ML, Qiu JM, Zhou Z, Ko E, Magny-Normilus C, Scagliola J, Wang Y. The Effects of Obesity on Lymphatic Pain and Swelling in Breast Cancer Patients. Biomedicines 2021; 9:818. [PMID: 34356882 PMCID: PMC8301355 DOI: 10.3390/biomedicines9070818] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 06/26/2021] [Accepted: 07/06/2021] [Indexed: 11/16/2022] Open
Abstract
Lymphatic pain and swelling due to lymph fluid accumulation are the most common and debilitating long-term adverse effects of cancer treatment. This study aimed to quantify the effects of obesity on lymphatic pain, arm, and truncal swelling. Methods: A sample of 554 breast cancer patients were enrolled in the study. Body mass index (BMI), body fat percentage, and body fat mass were measured using a bioimpedance device. Obesity was defined as a BMI ≥ 30 kg/m2. The Breast Cancer and Lymphedema Symptom Experience Index was used to measure lymphatic pain, arm, and truncal swelling. Multivariable logistic regression models were used to estimate the odds ratio (OR) with 95% confidence interval (CI) to quantify the effects of obesity. Results: Controlling for clinical and demographic characteristics as well as body fat percentage, obesity had the greatest effects on lymphatic pain (OR 3.49, 95% CI 1.87-6.50; p < 0.001) and arm swelling (OR 3.98, 95% CI 1.82-4.43; p < 0.001). Conclusions: Obesity is a significant risk factor for lymphatic pain and arm swelling in breast cancer patients. Obesity, lymphatic pain, and swelling are inflammatory conditions. Future study should explore the inflammatory pathways and understand the molecular mechanisms to find a cure.
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Affiliation(s)
- Mei Rosemary Fu
- School of Nursing–Camden, Rutgers, The State University of New Jersey, Camden, NJ 08102, USA
| | - Deborah Axelrod
- Department of Surgery, School of Medicine, New York University, New York, NY 10016, USA; (D.A.); (A.G.)
| | - Amber Guth
- Department of Surgery, School of Medicine, New York University, New York, NY 10016, USA; (D.A.); (A.G.)
| | - Melissa L. McTernan
- Boston College Research Services, Chestnut Hill, MA 02467, USA; (M.L.M.); (Z.Z.)
| | | | - Zhuzhu Zhou
- Boston College Research Services, Chestnut Hill, MA 02467, USA; (M.L.M.); (Z.Z.)
| | - Eunjung Ko
- The Ohio State University College of Nursing, Columbus, OH 43210, USA;
| | | | - Joan Scagliola
- NYU Laura and Isaac Perlmutter Cancer Center, New York, NY 10016, USA;
| | - Yao Wang
- Tandon School of Enginereeng, Electrical and Computer Engeenerng and Biomedical Engineering, New York Universuty, New York, NY 11202, USA;
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Herrera M, Molina P, Souza-Smith FM. Ethanol-induced lymphatic endothelial cell permeability via MAP-kinase regulation. Am J Physiol Cell Physiol 2021; 321:C104-C116. [PMID: 33909502 PMCID: PMC8321794 DOI: 10.1152/ajpcell.00039.2021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 04/20/2021] [Accepted: 04/20/2021] [Indexed: 11/22/2022]
Abstract
Chronic alcohol alters the immune system enhancing the susceptibility to inflammation, bacterial, and viral infections in alcohol users. We have shown that alcohol causes increased permeability of mesenteric lymphatic vessels in alcohol-fed rats. The mechanisms of alcohol-induced lymphatic leakage are unknown. Endothelial cell monolayer permeability is controlled by junctional proteins complexes called tight junctions (TJ) and adherens junctions (AJ), and each can be regulated by MAPK activation. We hypothesize that ethanol induces lymphatic endothelial cell (LEC) permeability via disruption of LEC TJ through MAPK activation. An in vitro model of rat LECs was used. Ethanol-supplemented medium was added at concentrations of 0, 25, and 50 mM to confluent cells. Resistance-based barrier function, transwell permeability, cell viability, TJ, AJ, and MAPK protein activity, TJ and AJ gene expressions, and the role of p38 MAPK in barrier function regulation were measured. Ethanol increased the permeability of LECs compared to controls that was not associated with decreased cell viability. LECs treated with 50 mM ethanol showed an increase in phosphorylated levels of p38. No significant changes in TJ and AJ gene or protein expressions were observed after ethanol treatment. p38 inhibition prevented ethanol-induced increases in permeability. These findings suggest that p38 may play a role in the regulation of ethanol-induced LEC permeability, but altered permeability may not be associated with decreased TJ or AJ protein expression. Further investigation into junctional protein localization is needed to better understand the effects of ethanol on lymphatic endothelial cell-to-cell contacts and hyperpermeability.
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Affiliation(s)
- Matthew Herrera
- Department of Physiology, Alcohol and Drug Abuse Center of Excellence, Louisiana State University Health Sciences Center, New Orleans, Louisiana
| | - Patricia Molina
- Department of Physiology, Alcohol and Drug Abuse Center of Excellence, Louisiana State University Health Sciences Center, New Orleans, Louisiana
| | - Flavia M Souza-Smith
- Department of Physiology, Alcohol and Drug Abuse Center of Excellence, Louisiana State University Health Sciences Center, New Orleans, Louisiana
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Okuda KS, Ng MF, Ruslan NF, Bower NI, Song DSS, Chen H, Baek S, Crosier PS, Koltowska K, Astin JW, Tan PJ, Hogan BM, Patel V. 3,4-Difluorobenzocurcumin Inhibits Vegfc-Vegfr3-Erk Signalling to Block Developmental Lymphangiogenesis in Zebrafish. Pharmaceuticals (Basel) 2021; 14:614. [PMID: 34206901 DOI: 10.3390/ph14070614] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 06/20/2021] [Accepted: 06/23/2021] [Indexed: 01/06/2023] Open
Abstract
Lymphangiogenesis, the formation of new lymphatic vessels from pre-existing vasculature, plays critical roles in disease, including in cancer metastasis and chronic inflammation. Preclinical and recent clinical studies have now demonstrated therapeutic utility for several anti-lymphangiogenic agents, but optimal agents and efficacy in different settings remain to be determined. We tested the anti-lymphangiogenic property of 3,4-Difluorobenzocurcumin (CDF), which has previously been implicated as an anti-cancer agent, using zebrafish embryos and cultured vascular endothelial cells. We used transgenic zebrafish labelling the lymphatic system and found that CDF potently inhibits lymphangiogenesis during embryonic development. We also found that the parent compound, Curcumin, does not inhibit lymphangiogenesis. CDF blocked lymphatic and venous sprouting, and lymphatic migration in the head and trunk of the embryo. Mechanistically, CDF impaired VEGFC-VEGFR3-ERK signalling in vitro and in vivo. In an in vivo pathological model of Vegfc-overexpression, treatment with CDF rescued endothelial cell hyperplasia. CDF did not inhibit the kinase activity of VEGFR3 yet displayed more prolonged activity in vivo than previously reported kinase inhibitors. These findings warrant further assessment of CDF and its mode of action as a candidate for use in metastasis and diseases of aberrant lymphangiogenesis.
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Stone OA, Zhou B, Red-Horse K, Stainier DYR. Endothelial ontogeny and the establishment of vascular heterogeneity. Bioessays 2021; 43:e2100036. [PMID: 34145927 DOI: 10.1002/bies.202100036] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 04/19/2021] [Accepted: 04/21/2021] [Indexed: 02/06/2023]
Abstract
The establishment of distinct cellular identities was pivotal during the evolution of Metazoa, enabling the emergence of an array of specialized tissues with different functions. In most animals including vertebrates, cell specialization occurs in response to a combination of intrinsic (e.g., cellular ontogeny) and extrinsic (e.g., local environment) factors that drive the acquisition of unique characteristics at the single-cell level. The first functional organ system to form in vertebrates is the cardiovascular system, which is lined by a network of endothelial cells whose organ-specific characteristics have long been recognized. Recent genetic analyses at the single-cell level have revealed that heterogeneity exists not only at the organ level but also between neighboring endothelial cells. Thus, how endothelial heterogeneity is established has become a key question in vascular biology. Drawing upon evidence from multiple organ systems, here we will discuss the role that lineage history may play in establishing endothelial heterogeneity.
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Affiliation(s)
- Oliver A Stone
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, UK
| | - Bin Zhou
- The State Key Laboratory of Cell Biology, CAS Center for Excellence on Molecular Cell Science, Shanghai Institute of Biochemistry and Cell Biology, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, China
| | - Kristy Red-Horse
- Department of Biology, Stanford Cardiovascular Institute, Institute for Stem Cell Biology and Regenerative Medicine, Stanford University, Stanford, California, USA
| | - Didier Y R Stainier
- Department of Developmental Genetics, Max Planck Institute for Heart and Lung Research, Bad Nauheim, Germany
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50
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Morfoisse F, De Toni F, Nigri J, Hosseini M, Zamora A, Tatin F, Pujol F, Sarry JE, Langin D, Lacazette E, Prats AC, Tomasini R, Galitzky J, Bouloumié A, Garmy-Susini B. Coordinating Effect of VEGFC and Oleic Acid Participates to Tumor Lymphangiogenesis. Cancers (Basel) 2021; 13:cancers13122851. [PMID: 34200994 PMCID: PMC8227717 DOI: 10.3390/cancers13122851] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 05/18/2021] [Accepted: 05/25/2021] [Indexed: 01/22/2023] Open
Abstract
Simple Summary In cancer, the lymphatic system is hijacked by tumor cells that escape from primary tumor and metastasize to the sentinel lymph nodes. Tumor lymphangiogenesis is stimulated by the vascular endothelial growth factors-C (VEGFC) after binding to its receptor VEGFR-3. However, how VEGFC cooperates with other molecules to promote lymphatic neovessel growth has not been fully determined. Here, we showed that tumor lymphangiogenesis developed in tumoral lesions and in their surrounding adipose tissue (AT). Interestingly, lymphatic vessel density correlated with an increase in circulating free fatty acids (FFA) in the lymph from tumor-bearing mice. We showed that adipocyte-released FFA are uploaded by lymphatic endothelial cells (LEC) to stimulate their sprouting. Lipidomic analysis identified the monounsaturated oleic acid (OA) as the major circulating FFA in the lymph in a tumoral context. OA transporters FATP-3, -6 and CD36 were only upregulated on LEC in the presence of VEGFC showing a collaborative effect of these molecules. OA released from adipocytes is taken up by LECs to stimulate the fatty acid β-oxidation, leading to increased adipose tissue lymphangiogenesis. Our results provide new insights on the dialogue between tumors and adipocytes via the lymphatic system and identify a key role for adipocyte-derived FFA in the promotion of lymphangiogenesis, revealing novel therapeutic opportunities for inhibitors of lymphangiogenesis in cancer. Abstract In cancer, the lymphatic system is hijacked by tumor cells that escape from primary tumor and metastasize to the sentinel lymph nodes. Tumor lymphangiogenesis is stimulated by the vascular endothelial growth factors-C (VEGFC) after binding to its receptor VEGFR-3. However, how VEGFC cooperates with other molecules to promote lymphatics growth has not been fully determined. We showed that lymphangiogenesis developed in tumoral lesions and in surrounding adipose tissue (AT). Interestingly, lymphatic vessel density correlated with an increase in circulating free fatty acids (FFA) in the lymph from tumor-bearing mice. We showed that adipocyte-released FFA are uploaded by lymphatic endothelial cells (LEC) to stimulate their sprouting. Lipidomic analysis identified the monounsaturated oleic acid (OA) as the major circulating FFA in the lymph in a tumoral context. OA transporters FATP-3, -6 and CD36 were only upregulated on LEC in the presence of VEGFC showing a collaborative effect of these molecules. OA stimulates fatty acid β-oxidation in LECs, leading to increased AT lymphangiogenesis. Our results provide new insights on the dialogue between tumors and adipocytes via the lymphatic system and identify a key role for adipocyte-derived FFA in the promotion of lymphangiogenesis, revealing novel therapeutic opportunities for inhibitors of lymphangiogenesis in cancer.
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Affiliation(s)
- Florent Morfoisse
- I2MC, Université de Toulouse, Inserm UMR 1297, UPS, 31000 Toulouse, France; (F.M.); (F.D.T.); (A.Z.); (F.T.); (F.P.); (D.L.); (E.L.); (A.-C.P.); (J.G.); (A.B.)
| | - Fabienne De Toni
- I2MC, Université de Toulouse, Inserm UMR 1297, UPS, 31000 Toulouse, France; (F.M.); (F.D.T.); (A.Z.); (F.T.); (F.P.); (D.L.); (E.L.); (A.-C.P.); (J.G.); (A.B.)
| | - Jeremy Nigri
- CRCM, Inserm UMR 1068, 13001 Marseille, France; (J.N.); (R.T.)
| | - Mohsen Hosseini
- CRCT, Université de Toulouse, Inserm UMR 1037, UPS, 31000 Toulouse, France; (M.H.); (J.-E.S.)
| | - Audrey Zamora
- I2MC, Université de Toulouse, Inserm UMR 1297, UPS, 31000 Toulouse, France; (F.M.); (F.D.T.); (A.Z.); (F.T.); (F.P.); (D.L.); (E.L.); (A.-C.P.); (J.G.); (A.B.)
| | - Florence Tatin
- I2MC, Université de Toulouse, Inserm UMR 1297, UPS, 31000 Toulouse, France; (F.M.); (F.D.T.); (A.Z.); (F.T.); (F.P.); (D.L.); (E.L.); (A.-C.P.); (J.G.); (A.B.)
| | - Françoise Pujol
- I2MC, Université de Toulouse, Inserm UMR 1297, UPS, 31000 Toulouse, France; (F.M.); (F.D.T.); (A.Z.); (F.T.); (F.P.); (D.L.); (E.L.); (A.-C.P.); (J.G.); (A.B.)
| | - Jean-Emmanuel Sarry
- CRCT, Université de Toulouse, Inserm UMR 1037, UPS, 31000 Toulouse, France; (M.H.); (J.-E.S.)
| | - Dominique Langin
- I2MC, Université de Toulouse, Inserm UMR 1297, UPS, 31000 Toulouse, France; (F.M.); (F.D.T.); (A.Z.); (F.T.); (F.P.); (D.L.); (E.L.); (A.-C.P.); (J.G.); (A.B.)
| | - Eric Lacazette
- I2MC, Université de Toulouse, Inserm UMR 1297, UPS, 31000 Toulouse, France; (F.M.); (F.D.T.); (A.Z.); (F.T.); (F.P.); (D.L.); (E.L.); (A.-C.P.); (J.G.); (A.B.)
| | - Anne-Catherine Prats
- I2MC, Université de Toulouse, Inserm UMR 1297, UPS, 31000 Toulouse, France; (F.M.); (F.D.T.); (A.Z.); (F.T.); (F.P.); (D.L.); (E.L.); (A.-C.P.); (J.G.); (A.B.)
| | | | - Jean Galitzky
- I2MC, Université de Toulouse, Inserm UMR 1297, UPS, 31000 Toulouse, France; (F.M.); (F.D.T.); (A.Z.); (F.T.); (F.P.); (D.L.); (E.L.); (A.-C.P.); (J.G.); (A.B.)
| | - Anne Bouloumié
- I2MC, Université de Toulouse, Inserm UMR 1297, UPS, 31000 Toulouse, France; (F.M.); (F.D.T.); (A.Z.); (F.T.); (F.P.); (D.L.); (E.L.); (A.-C.P.); (J.G.); (A.B.)
| | - Barbara Garmy-Susini
- I2MC, Université de Toulouse, Inserm UMR 1297, UPS, 31000 Toulouse, France; (F.M.); (F.D.T.); (A.Z.); (F.T.); (F.P.); (D.L.); (E.L.); (A.-C.P.); (J.G.); (A.B.)
- Correspondence:
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