Cheon Hwayeong, Woo Dong-Cheol, Cha Seungwoo, Chae Yeon Ji, Maeng Inhee, Oh Seung Jae, Jeon Jae Yong
Rehabilitation Research Center, Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea.
Department of Convergence Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Acta Neuropathol Commun. 2025 Apr 8;13(1):72. doi: 10.1186/s40478-025-01953-w.
The potential negative impact of lymphatic dysfunction caused by head and neck cancer treatment remains underexplored. Emerging evidence suggests that waste clearance and fluidic balance in the brain are connected to the peripheral lymphatic system in the head and neck region, implying that lymphatic injury in this area could contribute to brain damage. This study aimed to investigate the pathological alterations in the brain induced by peripheral lymphatic dysfunction in the head and neck region using the lymphatic obstruction animal model. An animal model underwent cervical lymph node dissection combined with radiation therapy to simulate the condition with the peripheral lymphatic dysfunction in the head and neck region after cancer treatment. Lymphatic drainage impairment in the head and neck region was associated with significant swelling, disrupted lymphatic drainage, and immune cell infiltration in the white matter. The imaging techniques revealed ventricular enlargement and increased brain water content caused by fluid imbalance leading to significant structural alterations in the brain. Histopathological analysis demonstrated structural brain alterations similar to that of hydrocephalus and cerebral edema, while rotarod tests showed a substantial decline in motor performance. These findings highlight the impact of peripheral lymphatic dysfunction on brain integrity and function. This study provides evidence that brain damage in head and neck cancer patients may be influenced not only by chemotherapy or radiotherapy but also by lymphatic dysfunction caused by surgical interventions. Lymphatic injury in the head and neck region emerges as a potential risk factor for brain damage, underscoring the need for further research into preventive and therapeutic strategies.
头颈癌治疗引起的淋巴功能障碍的潜在负面影响仍未得到充分探索。新出现的证据表明,大脑中的废物清除和液体平衡与头颈区域的外周淋巴系统有关,这意味着该区域的淋巴损伤可能导致脑损伤。本研究旨在使用淋巴阻塞动物模型,研究头颈区域外周淋巴功能障碍引起的大脑病理改变。一种动物模型接受了颈部淋巴结清扫联合放射治疗,以模拟癌症治疗后头颈区域外周淋巴功能障碍的情况。头颈区域的淋巴引流受损与白质明显肿胀、淋巴引流中断和免疫细胞浸润有关。成像技术显示,由于液体失衡导致脑室扩大和脑含水量增加,从而导致大脑结构发生显著改变。组织病理学分析显示大脑结构改变类似于脑积水和脑水肿,而转棒试验显示运动性能大幅下降。这些发现突出了外周淋巴功能障碍对大脑完整性和功能的影响。本研究提供的证据表明,头颈癌患者的脑损伤可能不仅受化疗或放疗的影响,还受手术干预引起的淋巴功能障碍的影响。头颈区域的淋巴损伤成为脑损伤的一个潜在危险因素,强调了对预防和治疗策略进行进一步研究的必要性。