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Gardenier JC, Kataru RP, Hespe GE, Savetsky IL, Torrisi JS, Nores GD, Jowhar DK, Nitti MD, Schofield RC, Carlow DC, Mehrara BJ, et al.
Nature communications. Date of publication 2017 Feb 10;volume 8():14345.
1. Nat Commun. 2017 Feb 10;8:14345. doi: 10.1038/ncomms14345. Topical tacrolimus for the treatment of secondary lymphedema. Gardenier JC(1), Kataru RP(1), Hespe GE(1), Savetsky IL(1), Torrisi JS(1), Nores GD(1), Jowhar DK(2), Nitti MD(1), Schofield RC(3), Carlow DC(3), Mehrara BJ(1). Author information: (1)Division of Plastic and Reconstructive Surgery, Department of Surgery, Memorial Sloan Kettering Cancer Center New York, New York, New York 10065, USA. (2)Weill Cornell Medical College New York, New York, New York 10065, USA. (3)Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA. Secondary lymphedema, a life-long complication of cancer treatment, currently has no cure. Lymphedema patients have decreased quality of life and recurrent infections with treatments limited to palliative measures. Accumulating evidence indicates that T cells play a key role in the pathology of lymphedema by promoting tissue fibrosis and inhibiting lymphangiogenesis. Here using mouse models, we show that topical therapy with tacrolimus, an anti-T-cell immunosuppressive drug, is highly effective in preventing lymphedema development and treating established lymphedema. This intervention markedly decreases swelling, T-cell infiltration and tissue fibrosis while significantly increasing formation of lymphatic collaterals with minimal systemic absorption. Animals treated with tacrolimus have markedly improved lymphatic function with increased collecting vessel contraction frequency and decreased dermal backflow. These results have profound implications for lymphedema treatment as topical tacrolimus is FDA-approved for other chronic skin conditions and has an established record of safety and tolerability. DOI: 10.1038/ncomms14345 PMCID: PMC5309859 PMID: 28186091 [Indexed for MEDLINE]
Appears in following Topics:
Lymphedema - Treatment and Emerging Strategies for Prevention