From the Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center.
Plast Reconstr Surg. 2023 Feb 1;151(2):330e-341e. doi: 10.1097/PRS.0000000000009866. Epub 2022 Nov 15.
Lymphedema is a progressive disease of the lymphatic system arising from impaired lymphatic drainage, accumulation of interstitial fluid, and fibroadipose deposition. Secondary lymphedema resulting from cancer treatment is the most common form of the disease in developed countries, affecting 15% to 40% of patients with breast cancer after lymph node dissection. Despite recent advances in microsurgery, outcomes remain variable and, in some cases, inadequate. Thus, development of novel treatment strategies is an important goal. Research over the past decade suggests that lymphatic injury initiates a chronic inflammatory response that regulates the pathophysiology of lymphedema. T-cell inflammation plays a key role in this response. In this review, the authors highlight the cellular and molecular mechanisms of lymphedema and discuss promising preclinical therapies.
淋巴水肿是一种由淋巴引流受损、间质液积聚和纤维脂肪沉积引起的渐进性淋巴系统疾病。继发于癌症治疗的淋巴水肿是发达国家最常见的疾病类型，在接受淋巴结清扫术的乳腺癌患者中，有 15%至 40%会发生这种疾病。尽管最近在显微外科方面取得了进展，但结果仍然存在差异，在某些情况下还不够充分。因此，开发新的治疗策略是一个重要目标。过去十年的研究表明，淋巴损伤会引发慢性炎症反应，从而调节淋巴水肿的病理生理学。T 细胞炎症在这种反应中起着关键作用。在这篇综述中，作者强调了淋巴水肿的细胞和分子机制，并讨论了有前途的临床前治疗方法。
