Impact of platelet rich plasma and adipose stem cells on lymphangiogenesis in a murine tail lymphedema model

• PRP and ASC significantly reduce wound size and improve epithelialization.
• PRP leads to a significantly reduced development of lymphedema after surgery.
• PRP leads to significantly increased lymph vessel densities.
• PRP achieved superior lymphatic endothelial cell proliferation and survival in vitro.
• Laser Doppler Imaging shows significantly increased perfusion of PRP treated wounds.

BackgroundLymphedema is an underdiagnosed pathology which in industrialized countries mainly affects cancer patients that underwent lymph node dissection and/or radiation. Currently no effective therapy is available so that patients' life quality is compromised by swellings of the concerned body region. This unfortunate condition is associated with body imbalance and subsequent osteochondral deformations and impaired function as well as with an increased risk of potentially life threatening soft tissue infections.MethodsThe effects of PRP and ASC on angiogenesis (anti-CD31 staining), microcirculation (Laser Doppler Imaging), lymphangiogenesis (anti-LYVE1 staining), microvascular architecture (corrosion casting) and wound healing (digital planimetry) are studied in a murine tail lymphedema model.ResultsWounds treated by PRP and ASC healed faster and showed a significantly increased epithelialization mainly from the proximal wound margin. The application of PRP induced a significantly increased lymphangiogenesis while the application of ASC did not induce any significant change in this regard.ConclusionsPRP and ASC affect lymphangiogenesis and lymphedema development and might represent a promising approach to improve regeneration of lymphatic vessels, restore disrupted lymphatic circulation and treat or prevent lymphedema alone or in combination with currently available lymphedema therapies.