Cheon Hwayeong, Gelvosa Ma Nessa, Kim Sang Ah, Song Ho-Young, Jeon Jae Yong
Biomedical Engineering Research Center Asan Institute for Life Sciences, Asan Medical Center Seoul Republic of Korea.
Department of Rehabilitation Medicine Asan Medical Center, University of Ulsan College of Medicine Seoul Republic of Korea.
Bioeng Transl Med. 2022 Jul 5;8(1):e10371. doi: 10.1002/btm2.10371. eCollection 2023 Jan.
Secondary lymphedema is a severe complication of cancer treatment, but there is no effective curative method yet. Lymph node dissection and radiation therapy for cancer treatment may lead to secondary lymphedema, which is a chronic disease induced by malfunction of lymphatic flow. The lymphatic channel sheet (LCS) is an artificial micro-fluidic structure that was fabricated with polydimethylsiloxane to maintain lymphatic flow and induce lymphangiogenesis. The structure has two-dimensional multichannels that increase the probability of lymphangiogenesis and allow for relatively easy application. We verified the efficacy of the lymphatic channel sheet through macroscopic and microscopic observation in small animal models, which underwent brachial lymph node dissection and irradiation. The lymphatic channel sheet enabled the successful transport of lymphatic fluid from the distal to the proximal area in place of the removed brachial lymph nodes. It prevented swelling and abnormal lymphatic drainage during the follow-up period. Lymphangiogenesis was also identified inside the channel by histological analysis after 8 weeks. According to these experimental results, we attest to the roles of the lymphatic channel sheet as a lymphatic pathway and scaffold in the rat upper limb model of secondary lymphedema. The lymphatic channel sheet maintained lymphatic flow after lymph node dissection and irradiation in an environment where lymph flow is cut off. It also relieved symptoms of secondary lymphedema by providing a lymph-friendly space and inducing lymphangiogenesis.
继发性淋巴水肿是癌症治疗的一种严重并发症，但目前尚无有效的治愈方法。癌症治疗中的淋巴结清扫和放射治疗可能会导致继发性淋巴水肿，这是一种由淋巴液流动功能障碍引起的慢性疾病。淋巴通道片（LCS）是一种人工微流体结构，由聚二甲基硅氧烷制成，用于维持淋巴液流动并诱导淋巴管生成。该结构具有二维多通道，增加了淋巴管生成的可能性，并且应用相对容易。我们通过对接受臂部淋巴结清扫和照射的小动物模型进行宏观和微观观察，验证了淋巴通道片的功效。淋巴通道片能够成功地将淋巴液从远端输送到近端区域，替代已切除的臂部淋巴结。在随访期间，它预防了肿胀和异常的淋巴引流。8周后通过组织学分析还在通道内发现了淋巴管生成。根据这些实验结果，我们证实了淋巴通道片在继发性淋巴水肿大鼠上肢模型中作为淋巴通路和支架的作用。在淋巴液流动被切断的环境中，淋巴通道片在淋巴结清扫和照射后维持了淋巴液流动。它还通过提供有利于淋巴的空间并诱导淋巴管生成，缓解了继发性淋巴水肿的症状。
