Application and prospect of adipose stem cell transplantation in treating lymphedema

BACKGROUND Lymphedema is a chronic,debilitating and incurable disease that affects 0.13%-2%of the global population.Emerging evidence indicates that adipose-derived stem cells(ADSCs)might serve as suitable seed cells for lymphatic tissue engineering and lymphedema therapy.AIM To summarize applications of ADSCs for treating lymphedema in both animal studies and clinical trials.METHODS A systematic search was performed on four databases-PubMed,Clinicaltrials.gov,the evidence-based Cochrane Library,and OVID-using the following search string:(“lymphedema”or“lymphoedema”or“lymphangiogenesis”)and(“adipose-derived stem cells”or“adipose-derived stromal cells”or“adipose-derived regenerative cells”).A manual search was performed by skimming the references of relevant studies.Animal studies and clinical trials using adipose-derived cells for the treatment of any kind of lymphedema were included.RESULTS A total of eight research articles published before November 2019 were included for this analysis.Five articles focused on animal studies and another three focused on clinical trials.ADSC transplantation therapy was demonstrated to be effective against lymphedema in all studies.The animal studies found that coadministration of ADSCs and controlled-release vascular endothelial growth factor-C or platelet-rich plasma could improve the effectiveness of ADSC therapy.Three sequential clinical trials were conducted on breast cancer-related lymphedema patients,and all showed favorable results.CONCLUSION ADSC-based therapy is a promising option for treating lymphedema.Large-scale,multicenter randomized controlled trials are needed to develop more effective and durable therapeutic strategies.

Effect of Clostridium perfringens enterotoxin on gastric cancer cells SGC7901 which highly expressed claudin-4 protein

AIM To investigate the effects of Clostridium perfringens enterotoxin(CPE) on gastric cancer cells which highly expressed claudin-4(CL4) protein.METHODS In this study, we detected expression of CL4 protein in different gastric cancer cell lines. Then, we investigated the effects of CPE on SGC7901 cells which highly expressed CL4 protein and the effects of CPE on sub-cutaneous tumor in nude mice models.RESULTS CL4 are highly expressed in SGC7901 cells. CPE expressedsignificant cytotoxicity in SGC7901 cells. Suppression of CL4 expression significantly decreased CPE-mediated cytotoxicity. CPE also inhibited tumor growth in subcutaneous tumor xenograft models.CONCLUSION CPE showed CL4 mediated cytotoxicity on gastric cancer cells SGC7901 and inhib-ited tumor growth in nude mice models.

Diagnostic workup of lymphedema

Lymphedema is a chronic and progressive pathological state of tissue swelling caused by congenital or acquired lymphatic abnormality.History,physical and laboratory examinations could help to diagnosis>90%lymphedema patients.Early stage lymphedema could be challenging to diagnose.The aim of this review is to provide an objective appraisal of current diagnostic methods,such as lymphoscintigraphy,lympho-fluoroscopies,lymphangiography and etc.focusing on their respective advantages and weaknesses,and hopefully shed some lights on developing a practical diagnosis modality beneficial to early detection and clinical decision making of lymphedema.