Short term treatment of secondary lymphedema with hyaluronidase injections reduces mouse hindlimb lymphedema

J Plast Surg Hand Surg. 2023 Jun 20:58:40-47. doi: 10.2340/jphs.v58.7791.

Abstract

Lymphedema is a common complication following breast cancer treatment with axillary lymphadenectomy and radiotherapy. Currently, there is no curative treatment for this disease, hence there is a need for new therapeutic suggestions. The aim of this study was to investigate the effect of hyaluronidase (HYAL) injections after inducing hindlimb lymphedema in 36 female C57BL/6 mice. HYAL injections were administered every second day for 14 days in three groups: (1) HYAL for 1 week followed by saline for 1 week, (2) HYAL for 2 weeks, and (3) saline injections for 2 weeks. Volume of the lymphedema limb was weekly assessed with micro-computed tomography (μ-CT) scans for a total course of 6 weeks. Lymph vessel morphometry was assessed in the end of the study after staining cross-sections of the hindlimb for anti-LYVE-1 blindly. Lymphatic function was assessed by lymphoscintigraphy to assess lymphatic clearance. There was a significant reduction of the volume of lymphedema in mice treated with HYAL-7 compared with mice treated with HYAL-14 (p < 0.05) and saline (p < 0.05). No differences were detected in lymph vessel morphometry and the lymphoscintigraphy between groups. Short-term treatment with HYAL-7 might be a potential therapeutic suggestion for secondary lymphedema induced in mouse hindlimbs. In the future, clinical studies are needed to investigate the potential of HYAL treatment in human beings.

MeSH terms

  • Animals
  • Chronic Disease
  • Female
  • Hindlimb
  • Humans
  • Hyaluronoglucosaminidase* / pharmacology
  • Hyaluronoglucosaminidase* / therapeutic use
  • Lower Extremity
  • Lymphedema* / diagnostic imaging
  • Lymphedema* / drug therapy
  • Lymphedema* / etiology
  • Lymphoscintigraphy / adverse effects
  • Mice
  • Mice, Inbred C57BL
  • X-Ray Microtomography / adverse effects

Substances

  • Hyaluronoglucosaminidase