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乳腺癌相关淋巴水肿导致表皮分化受损和紧密连接功能障碍。

Breast Cancer-Related Lymphedema Results in Impaired Epidermal Differentiation and Tight Junction Dysfunction.

作者信息

Campbell Adana-Christine, Baik Jung Eun, Sarker Ananta, Brown Stav, Park Hyeung Ju, Kuonqui Kevin G, Shin Jinyeon, Pollack Bracha L, Roberts Arielle, Ashokan Gopika, Rubin Jonathan, Kataru Raghu P, Dayan Joseph H, Barrio Andrea V, Mehrara Babak J

机构信息

Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA.

Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA; Department of Biotechnology, Levatio Therapeutics, San Diego, California, USA.

出版信息

J Invest Dermatol. 2025 Jan;145(1):85-97.e4. doi: 10.1016/j.jid.2024.05.017. Epub 2024 Jun 13.


DOI:10.1016/j.jid.2024.05.017
PMID:38879154
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12043072/
Abstract

Breast cancer-related lymphedema (BCRL) is characterized by skin changes, swelling, fibrosis, and recurrent skin infections. Clinical studies have suggested that lymphedema results in skin barrier defects; however, the underlying cellular mechanisms and the effects of bacterial contamination on skin barrier function remain unknown. In matched biopsies from patients with unilateral BCRL, we observed decreased expression of FLG and the tight junction protein ZO-1 in skin affected by moderate lymphedema or by subclinical lymphedema in which dermal backflow of lymph was identified by indocyanine green lymphography, relative to those in the controls (areas without backflow and from the unaffected arm). In vitro stimulation of keratinocytes with lymph fluid obtained from patients undergoing lymphedema surgery led to the same changes as well as increased expression of keratin 14, a marker of immature keratinocytes. Finally, using mouse models of lymphedema, we showed that similar to the clinical scenario, the expression of skin barrier proteins was decreased relative to that in normal skin and that colonization with Staphylococcus epidermidis bacteria amplified this effect as well as lymphedema severity. Taken together, our findings suggest that lymphatic fluid stasis contributes to skin barrier dysfunction in lymphedema.

摘要

乳腺癌相关淋巴水肿(BCRL)的特征为皮肤改变、肿胀、纤维化和反复皮肤感染。临床研究表明,淋巴水肿会导致皮肤屏障缺陷;然而,其潜在的细胞机制以及细菌污染对皮肤屏障功能的影响仍不清楚。在单侧BCRL患者的配对活检中,我们观察到,与对照组(无淋巴回流区域及未受影响手臂)相比,在中度淋巴水肿或亚临床淋巴水肿(通过吲哚菁绿淋巴造影术确定存在真皮淋巴回流)影响的皮肤中,丝聚蛋白(FLG)和紧密连接蛋白ZO-1的表达降低。用淋巴水肿手术患者的淋巴液对角质形成细胞进行体外刺激,也导致了同样的变化,以及未成熟角质形成细胞标志物角蛋白14表达增加。最后,使用淋巴水肿小鼠模型,我们发现,与临床情况类似,与正常皮肤相比,皮肤屏障蛋白的表达降低,表皮葡萄球菌定植会放大这种效应以及淋巴水肿的严重程度。综上所述,我们的研究结果表明,淋巴液淤滞会导致淋巴水肿中的皮肤屏障功能障碍。

相似文献

[1]
Breast Cancer-Related Lymphedema Results in Impaired Epidermal Differentiation and Tight Junction Dysfunction.

J Invest Dermatol. 2025-1

[2]
Indocyanine green-enhanced lymphography for upper extremity lymphedema: a novel severity staging system using dermal backflow patterns.

Plast Reconstr Surg. 2011-10

[3]
Prediction of breast cancer-related lymphedema by dermal backflow detected with near-infrared fluorescence lymphatic imaging.

Breast Cancer Res Treat. 2022-8

[4]
Relation Between Characteristics of Indocyanine Green Lymphography and Development of Breast Cancer-Related Lymphedema.

Lymphat Res Biol. 2024-10

[5]
Epidermal tight junctions: ZO-1 and occludin are expressed in mature, developing, and affected skin and in vitro differentiating keratinocytes.

J Invest Dermatol. 2001-11

[6]
Investigation of the Association Between Breast Cancer-Related Lymphedema and the Side Effects of Taxane-Based Chemotherapy Using Indocyanine Green Lymphography.

Lymphat Res Biol. 2022-12

[7]
Magnetic Resonance Lymphography of Lymphatic Vessels in Upper Extremity With Breast Cancer-Related Lymphedema.

Ann Plast Surg. 2020-1

[8]
Supermicrosurgery lymphaticovenous and lymphaticolymphatic anastomosis: Technical detail and short-term follow-up for immediate lymphatic reconstruction in breast cancer treatment-related lymphedema prevention.

J Vasc Surg Venous Lymphat Disord. 2024-7

[9]
Hyperglycemia Induces Skin Barrier Dysfunctions with Impairment of Epidermal Integrity in Non-Wounded Skin of Type 1 Diabetic Mice.

PLoS One. 2016-11-15

[10]
The earliest finding of indocyanine green lymphography in asymptomatic limbs of lower extremity lymphedema patients secondary to cancer treatment: the modified dermal backflow stage and concept of subclinical lymphedema.

Plast Reconstr Surg. 2011-10

本文引用的文献

[1]
Efficacy of Immediate Lymphatic Reconstruction to Decrease Incidence of Breast Cancer-related Lymphedema: Preliminary Results of Randomized Controlled Trial.

Ann Surg. 2023-10-1

[2]
Skin microbiome alterations in upper extremity secondary lymphedema.

PLoS One. 2023

[3]
Imaging peripheral lymphatic dysfunction in chronic conditions.

Front Physiol. 2023-3-15

[4]
Accessory Lymphatic Drainage Pathways on Indocyanine Green Lymphography in Patients with Breast Cancer-Related Lymphedema.

Plast Reconstr Surg. 2023-6-1

[5]
The Vicious Circle of Stasis, Inflammation, and Fibrosis in Lymphedema.

Plast Reconstr Surg. 2023-2-1

[6]
Type 2 Inflammation Contributes to Skin Barrier Dysfunction in Atopic Dermatitis.

JID Innov. 2022-4-26

[7]
Cost of a lymphedema treatment mandate - 16 years of experience in the Commonwealth of Virginia.

Health Econ Rev. 2022-7-23

[8]
Prediction of breast cancer-related lymphedema by dermal backflow detected with near-infrared fluorescence lymphatic imaging.

Breast Cancer Res Treat. 2022-8

[9]
Lymphatics act as a signaling hub to regulate intestinal stem cell activity.

Cell Stem Cell. 2022-7-7

[10]
Risk Factors and Racial and Ethnic Disparities in Patients With Breast Cancer-Related Lymphedema.

JAMA Oncol. 2022-8-1

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