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]
