Researchers from ETH Zurich and Aristotle University of Thessaloniki have discovered that certain cells in the immune system called regulatory T cells suppress the development of lymphedema.
This recent study not only sheds some light on how lymphedema develops, but also carries the potential to inform future therapies and treatments.
“Our work shows that you can keep lymphedema in check by suppressing inflammation,” ETH professor Michael Detmar, MD, explained in an article on the study. “Our study suggests a paradigm shift. When treating lymphedema, you should focus instead on inflammatory responses. It is likely that this approach would make a cure for lymphedema possible for the first time.”
This is some pretty big news for lymphatic research, that much is obvious—but what do these findings mean, and how will it change the way lymphedema is treated?
First—a biology lesson
In this study, scientists focused on a specific set of cells called regulatory T cells. Produced in the bone marrow and developed in the thymus, T cells are a subtype of lymphocytes, which are in turn a subtype of white blood cells.
T cells make up part of the body’s line of defense: they fight bacteria, viruses, and cancer cells in the blood and lymph nodes. Dr. Allan Bruckheim explained it best when he said, “The T cell is like a quarterback, interpreting the enemy’s composition and signaling other cells to get into action.”
There are a bunch of different types of T cells working hard in your body, all with very specific functions: cytotoxic T cells, which directly attack invaders; helper T cells, which round up other immune cells and organize an immune response; natural killer T cells; memory T cells, which recognize markers on bacteria, viruses, or cancer cells they’ve encountered before; and regulatory T cells.
Regulatory T cells do exactly as their name suggests: they regulate the immune system. By suppressing certain immune responses, they ensure the system maintains balance and doesn’t overreact. (An example of an immune system overreaction are autoimmune diseases.)
Their experiments and findings
The study indicates that inflammatory processes in the body are involved in the onset of lymphedema, a finding that could change the techniques and therapies used in the treatment of lymphedema and, eventually, lead to a cure.
From the ETH Zurich article:
The researchers, led by ETH Professor Michael Detmar, uncovered the connection between regulatory T cells and lymphedema when they were measuring the concentration of various RNA molecules in the lymphedema tissue of mice. They found particularly high concentrations of molecules that control the gene activity in regulatory T cells. The researchers therefore concluded that such cells are more active in lymphedema tissue. In subsequent cell biology investigations of both mouse tissue and biopsies of patients, the researchers were also able to corroborate this cell type directly.
The scientists were further able to clarify the role of regulatory T cells in lymphedema after conducting further experiments wherein they gave mice transfusions of these cells. The mice with increased numbers of regulatory T cells had significantly less swelling than the mice lacking the cells, a result that indicates regulatory T cells inhibit the development of lymphedema.
A transfusion of regulatory T cells might one day be possible in humans: “This is already being done in the context of clinical trials for other diseases, for complications after organ transplants and for certain autoimmune diseases,” said Epameinondas Gousopoulos, a physician and doctoral student in Dr. Detmar’s group.
For now, though, Dr. Detmar suggests considering anti-inflammatory drugs as part of lymphedema treatment.
What do you think about these findings? Could this be what leads to a cure? Let me know your thoughts!
Special thanks to lymphie Judith M. in Switzerland for sending me the research article—you rock!
This is fantastic news!!!
This summer was literally unbearable for me, with high temps and even higher humidity levels that took me tonall new miserable levels.
What are the anti-inflammatory drugs that might provide
Symptomatic relief now? I’m anxious to do anything that I can
to provide some relief.
Hello!
I’m not sure which anti-inflammatory drugs Dr. Detmar is referring to, as the original article about the study didn’t specify. I recommend speaking with your doctor or lymphedema therapist about anti-inflammatory medication to see what your options are!
Best of luck to you, and I hope you find some relief soon.
Be well,
Alexa
I’ve had to direct my own care pretty much ever since I found out I had LE back in 1999. This is cutting edge research. My Dr. isn’t going to know what will work, or might work. It’ll be trial and error.
Before I was dx’d with LE my (then) Dr. treated me incorrectly for 7 years.
This is interesting! In addition to having lymphedema, I have T-Cell Lymphoma and Lipedema. Perhaps these are all corrrelatedwith problems with my body’s T Cells
I find this fascinating because Having been recently diagnosed with Diabetes, I am attempting to treat with diet. I joined a FB group for reversing diabetes with diet. Their premise is extremely low carb, less than 20 grams a day. While I am not ready to try that, I have been reading many posts of success in blood sugar control, and weight loss. But the really interesting thing is many have huge drops or cessation of the symptoms of their inflammatory diseases! The connection seems to be the low carb diet that removes inflammatory foods. I am watching closely now to see how my diet affects my arthritis and my LE.
This makes sense to me, and is something I’ve been trying to get my daughter’s doctors to think about for years now. She has eczema, and I noticed that the topical steroid cream we use occasionally for her eczema helped soften her LE limb and reduce swelling pretty significantly. Every time she has an eczema flare her LE worsens, and every time she gets sick her LE worsens. We unfortunately did not have any luck with a change in diet helping her LE, but she has primary LE, which I believe comes with some other issues, and those with secondary may have more luck
Hesorry to hear about your daugther. Mine is primary lymphedema too. lymph nodes works when there is an infection, if you already have a compromised lymphatic system it is logic that whenever you have an infection/ you are sick, your le will be worse. In fact sometimes my le is worse an i wonder why, next day i have the flue or something. Anti-inflammatory foods ( slow juicing) helped me a lit, though you need to be consistent. Like every day green leaves, selery, flat parsley and red beets with ginger cucumber and lemon… And no processed food, low sugar, low carbs, low dairy, no meat…. ( a lots of vegetables in fact :) ). That is really really helping. After some months i had almost no water retention, but since i have less time to prepare all this and take it to work, the results are not that good anymore . Good luck!
Hello Margaret. Could you say more about the other issues you see with primary LE? I have had primary tarda for six years starting at age 59. Also, are you applying topical steroid cream to the LE limb? Thanks, Donna
Hi I’d like your thoughts on the lymphedema surgeries that are being done? Dr Becker is the pioneer of this surgery. I’ve researched it but insurance won’t pay for it. I hope one of the new things being researched is available soon.
Hi, Sandy,
I don’t know a whole lot about the surgeries being done, although I’ve talked to a couple patients who’ve had them. I think that surgery seems like an effective way to reduce swelling, and is a great option for a lot of people. I share your hope, too, that they become more readily available (and affordable!) for patients.
Here are some blogs of patients who have had lymphedema surgeries:
https://lymphnodetransplant.wordpress.com/
https://lymphosaurusrex.wordpress.com/posts-page/
http://ninjasfightinglymphedema.vpweb.com/
And some articles:
http://www.mirror.co.uk/news/real-life-stories/brave-cancer-survivor-who-lost-9353869
http://www.dailymail.co.uk/health/article-3958264/Do-suffer-painful-swollen-limbs-new-bypass-operation-Sarah-s-arms-shrink-normal-size-easing-constant-agony.html
Hope those help!
Be well,
Alexa
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Alexa, great blog for all of us to marinate on positive thoughts. I had lymphedema come out of nowhere when I was working, tirelessly, on a high maintenance dressage horse farm for a year and a half. I was the barn farm girl, doing everything from mucking stalls to painting window trim on outbuildings. I am in shape, athletically inclined, and thrive on eating wholesome and organic foods as much as possible. My ankle started swelling and from there on, the influx has moved up to encompass my entire right leg. Left leg is entirely normal. 5 years living with this…I am a completely compliant patient. I wrap my leg when needed, don a sexy Elvarex thigh high all day long, wear a Solaris night garment, massage 2 times a day, elevate whenever possible, and am exhausted taking care of this condition. I have become so frustrated at times that I have considered surgery and possibly sapl, but just can’t bring myself to go through with it. Deep down in my soul, I do believe that lymphedema is based on inflammatory response. I have experienced episodes of swelling, which I know are brought on by certain factors. Being compromised, we need to keep our immune systems strong and maintain a healthy body weight to assist in healing. Hoping my words of endurance and strength are beneficial to someone out there…stay strong.
XO,
Lisa