Affiliation:
1. Department of Plastic and Reconstructive Surgery, Keimyung University School of Medicine
2. Pathology
3. Physical Medicine and Rehabilitation
4. Plastic and Reconstructive Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine.
Abstract
Background:
Many researchers have attempted to induce lymphangiogenesis for the treatment of lymphedema. However, most previous studies had limited clinical usefulness. A high-fat diet (HFD) increases serum β-hydroxybutyrate (β-OHB) levels, which can stimulate lymphangiogenesis. The authors hypothesized that an HFD will ameliorate lymphedema through enhanced lymphangiogenesis.
Methods:
The effects of β-OHB on the lymphangiogenic process in human dermal lymphatic endothelial cells were analyzed. A mouse tail lymphedema model was used to evaluate the effects of an HFD on lymphedema. Experimental mice were fed an HFD (45% kcal as fat, 20% as protein, and 35% as carbohydrates) for 4 weeks. Tail volume was measured using the truncated cone formula. Biopsy specimens were taken 6 weeks after surgical induction of lymphedema.
Results:
In human dermal lymphatic endothelial cells, treatment with 20 mM of β-OHB increased cell viability (P = 0.008), cell migration (P = 0.011), tube formation (P = 0.005), and VEGF-C mRNA and protein expression (P < 0.001) compared with controls. HFD feeding decreased tail volume by 14.3% and fibrosis by 15.8% (P = 0.027), and increased the lymphatic vessel density (P = 0.022) and VEGF-C protein expression (P = 0.005) compared with those of operated, standard chow diet–fed mice.
Conclusions:
The authors’ findings demonstrated that β-OHB promoted lymphatic endothelial cell function and increased VEGF-C mRNA and protein expression. When mice with tail lymphedema were fed an HFD, volume and fibrosis of the tail decreased. Therefore, the authors’ findings suggest that an HFD can be a successful novel dietary approach to treating lymphedema.
Clinical Relevance Statement:
Lymphatic regeneration after vascularized lymph node transfer can be augmented when a high-fat diet is used in conjunction with vascularized lymph node transfer.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Cited by
2 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献