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间充质干细胞治疗乳腺癌相关继发性淋巴水肿(综述)

Mesenchymal stem cell therapy for breast cancer-related secondary lymphedema (Review).

作者信息

Han Shunxin, Cai Junrong, Zhang Yuteng, Lu Feng

机构信息

Department of Plastic and Cosmetic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China.

Department of Plastic Surgery, First Clinical Medical College, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China.

出版信息

Mol Clin Oncol. 2025 Jun 23;23(2):73. doi: 10.3892/mco.2025.2868. eCollection 2025 Aug.

Abstract

Secondary lymphedema, affecting ~15-30% of patients who survive breast cancer, is a common consequence following treatment. At present, there is no gold standard for the treatment of breast cancer-related lymphedema (BCRL). Conventional methods such as physiotherapy and surgery demonstrate a limited effectiveness in mitigating lymphatic swelling or discomfort and fail to provide substantial physiological improvement or a definitive cure for lymphedema. However, stem cell therapy has garnered notable attention due to its regenerative potential and its capacity to modulate inflammatory processes. Mesenchymal stem cell (MSC) therapies exhibit promise in ameliorating BCRL by addressing edema, promoting lymphangiogenesis and mitigating fibrosis. It is shown that MSC therapy promotes the regeneration of autologous lymphatic networks and improves vascular conditions in rodent tail and hindlimb lymphedema models, which offers relief from lymphedema symptoms including limb volume asymmetry and impaired lymphatic drainage. However, currently, due to a lack of a universally recognized or standardized treatment regimen for BCRL, there is a need for additional clinical studies featuring larger sample sizes and extended follow-up periods to further investigate this prospective therapeutic modality. The present review aims to provide guidance for further research and therapeutic interventions following the results observed in both preclinical and clinical settings. The present study investigated the pathogenesis of secondary lymphedema, previous advancements in stem cell therapy for this condition and an analysis of persisting challenges.

摘要

继发性淋巴水肿影响着约15%至30%的乳腺癌幸存者,是治疗后的常见后果。目前,乳腺癌相关淋巴水肿(BCRL)的治疗尚无金标准。物理治疗和手术等传统方法在减轻淋巴肿胀或不适方面效果有限,无法为淋巴水肿提供实质性的生理改善或根治方法。然而,干细胞疗法因其再生潜力和调节炎症过程的能力而备受关注。间充质干细胞(MSC)疗法在通过解决水肿、促进淋巴管生成和减轻纤维化来改善BCRL方面展现出前景。研究表明,MSC疗法可促进自体淋巴网络的再生,并改善啮齿动物尾巴和后肢淋巴水肿模型中的血管状况,从而缓解淋巴水肿症状,包括肢体体积不对称和淋巴引流受损。然而,目前由于缺乏针对BCRL的普遍认可或标准化治疗方案,需要开展更多样本量更大、随访期更长的临床研究,以进一步研究这种有前景的治疗方式。本综述旨在根据临床前和临床观察结果为进一步研究和治疗干预提供指导。本研究调查了继发性淋巴水肿的发病机制、此前干细胞治疗该疾病的进展以及对持续存在的挑战的分析。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a76f/12210111/e1f138ac069e/mco-23-02-02868-g00.jpg

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