title: Modification of a rodent hindlimb model of secondary lymphedema: surgical radicality versus radiotherapeutic ablation.
abstract: Secondary lymphedema is an intractable disease mainly caused by damage of the lymphatic system during surgery, yet studies are limited by the lack of suitable animal models. The purpose of this study was to create an improved model of secondary lymphedema in the hindlimbs of rodents with sustained effects and able to mimic human lymphedema. This was achieved by combining previously reported surgical methods and radiation to induce chronic lymphedema. Despite more radical surgical destruction of superficial and deep lymphatic vessels, surgery alone was not enough to sustain increased hindlimb volume. Radiotherapy was necessary to prolong these effects, with decreased lymphatic flow on lymphoscintigraphy, but hindlimb necrosis occurred after 4 weeks due to radiation toxicity. The applicability of this model for studies of therapeutic lymphangiogenesis was subsequently tested by injecting muscle-derived stem cells previously cocultured with the supernatant of human lymphatic endothelial cells in vitro. There was a tendency for increased lymphatic flow which significantly increased lymphatic vessel formation after cell injection, but attenuation of hindlimb volume was not observed. These results suggest that further refinement of the rodent hindlimb model is needed by titration of adequate radiation dosage, while stem cell lymphangiogenesis seems to be a promising approach.
authors.affiliation: Department of Surgery, Seoul National University College of Medicine, Seoul 110-799, Republic of Korea ; Department of Surgery, Seoul National University Bundang Hospital, 166 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707, Republic of Korea.
authors.forename: Hyung Sub
authors.initials: HS
authors.lastname: Park
authors.affiliation: Department of Surgery, Seoul National University College of Medicine, Seoul 110-799, Republic of Korea ; Department of Surgery, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul 156-707, Republic of Korea.
authors.forename: In Mok
authors.initials: IM
authors.lastname: Jung
authors.affiliation: Department of Surgery, Seoul National University Bundang Hospital, 166 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707, Republic of Korea.
authors.forename: Geum Hee
authors.initials: GH
authors.lastname: Choi
authors.affiliation: Department of Surgery, Seoul National University Bundang Hospital, 166 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707, Republic of Korea.
authors.forename: Soli
authors.initials: S
authors.lastname: Hahn
authors.affiliation: Department of Surgery, Chosun University Hospital, Chosun University College of Medicine, Gwangju 501-717, Republic of Korea.
authors.forename: Young Sun
authors.initials: YS
authors.lastname: Yoo
authors.affiliation: Department of Surgery, Seoul National University College of Medicine, Seoul 110-799, Republic of Korea ; Department of Surgery, Seoul National University Bundang Hospital, 166 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707, Republic of Korea.
authors.forename: Taeseung
authors.initials: T
authors.lastname: Lee
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D042783:Endothelial Cells / Q000473:pathology / Q000528:radiation effects; D006614:Hindlimb / Q000473:pathology* / Q000528:radiation effects / Q000601:surgery; D006801:Humans; D042583:Lymphangiogenesis / Q000502:physiology* / Q000528:radiation effects; D042601:Lymphatic Vessels / Q000473:pathology* / Q000528:radiation effects; D008209:Lymphedema / Q000473:pathology*; D008297:Male; D051379:Mice; D008807:Mice, Inbred BALB C