Research Unit of Plastic Surgery, Department of Plastic Surgery, Odense University Hospital, Odense, Denmark; Clinical Institute, University of Southern Denmark, Odense, Denmark.
Laboratory of Radiation Physics, Odense University Hospital, Odense, Denmark; Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.
J Plast Surg Hand Surg. 2023 Jun 20;58:40-47. doi: 10.2340/jphs.v58.7791.
Lymphedema is a common complication following breast cancer treatment with axillary lymphadenectomy and radiotherapy. Currently, there is no curative treatment for this disease, hence there is a need for new therapeutic suggestions. The aim of this study was to investigate the effect of hyaluronidase (HYAL) injections after inducing hindlimb lymphedema in 36 female C57BL/6 mice. HYAL injections were administered every second day for 14 days in three groups: (1) HYAL for 1 week followed by saline for 1 week, (2) HYAL for 2 weeks, and (3) saline injections for 2 weeks. Volume of the lymphedema limb was weekly assessed with micro-computed tomography (μ-CT) scans for a total course of 6 weeks. Lymph vessel morphometry was assessed in the end of the study after staining cross-sections of the hindlimb for anti-LYVE-1 blindly. Lymphatic function was assessed by lymphoscintigraphy to assess lymphatic clearance. There was a significant reduction of the volume of lymphedema in mice treated with HYAL-7 compared with mice treated with HYAL-14 (p < 0.05) and saline (p < 0.05). No differences were detected in lymph vessel morphometry and the lymphoscintigraphy between groups. Short-term treatment with HYAL-7 might be a potential therapeutic suggestion for secondary lymphedema induced in mouse hindlimbs. In the future, clinical studies are needed to investigate the potential of HYAL treatment in human beings.
淋巴水肿是乳腺癌腋窝淋巴结清扫和放疗后的常见并发症。目前,这种疾病没有治愈的方法,因此需要新的治疗建议。本研究旨在探讨透明质酸酶(HYAL)注射在后肢淋巴水肿诱导的 36 只 C57BL/6 雌性小鼠中的作用。HYAL 注射每隔一天注射一次,共 14 天,分为三组:(1)HYAL 注射 1 周,然后盐水注射 1 周;(2)HYAL 注射 2 周;(3)盐水注射 2 周。使用微计算机断层扫描(μ-CT)每周评估一次肢体肿胀的体积,共 6 周。在研究结束时,通过对后肢进行抗 LYVE-1 染色的横断面进行盲法淋巴管形态计量学评估。通过淋巴闪烁显像术评估淋巴清除率来评估淋巴功能。与 HYAL-14(p<0.05)和盐水组(p<0.05)相比,HYAL-7 治疗组的肢体肿胀体积明显减小。各组之间的淋巴管形态计量学和淋巴闪烁显像术无差异。HYAL-7 的短期治疗可能是一种治疗小鼠后肢继发性淋巴水肿的潜在治疗方法。未来需要进行临床研究,以探讨 HYAL 治疗在人类中的潜力。