Extracorporeal shock wave therapy combined with vascular endothelial growth factor-C hydrogel for lymphangiogenesis.

Abstract

BACKGROUND/AIMS:

Lymphedema is a clinically incurable disease that occurs commonly after lymph node dissection and/or irradiation. Several studies have recently demonstrated that extracorporeal shock wave therapy (ESWT) could promote lymphangiogenesis associated with expression of vascular endothelial growth factor (VEGF)-C. This research concerned primarily the synergistic effect of ESWT combined with VEGF-C incorporated hydrogel (VEGF-C hydrogel) combination therapy for promoting lymphangiogenesis and ultimately alleviating lymphedema.

METHODS:

The VEGF-C hydrogel was applied to the injury site in a mouse model of lymphedema and then regularly underwent ESWT (0.05 mJ/mm(2), 500 shots) every 3 days for 4 weeks.

RESULTS:

Four weeks after the treatment, mice treated with VEGF-C hydrogel and ESWT showed signs of the greatest decrease in edema/collagenous deposits when compared with the other experimental group. LYVE-1-positive vessels also revealed that the VEGF-C/ESWT group had significantly induced the growth of new lymphatic vessels compared to the other groups. Western blot analysis showed that expression of VEGF-C (1.24-fold) and VEGF receptor-3 (1.41-fold) was significantly increased in the VEGF-C/ESWT group compared to the normal group.

CONCLUSION:

These results suggested that VEGF-C and ESWT had a synergistic effect and were very effective in alleviating the symptoms of lymphedema and promoting lymphangiogenesis.

• Authors: In Gul Kim, Ji Youl Lee, David S Lee, Jeong Yi Kwon, Ji Hye Hwang
• Journal: Journal of vascular research (J Vasc Res) Vol. 50 Issue 2 Pg. 124-33 ( 2013) ISSN: 1423-0135 [Electronic] Switzerland
• PMID: 23208012 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2012 S. Karger AG, Basel.

Chemical References

• Drug Implants
• Hydrogels
• Vascular Endothelial Growth Factor C
• vascular endothelial growth factor C, mouse
• Gelatin
• Vascular Endothelial Growth Factor Receptor-3

Topics

• Animals
• Combined Modality Therapy
• Disease Models, Animal
• Drug Evaluation, Preclinical
• Drug Implants
• Female
• Gelatin
• Gene Expression Regulation (drug effects)
• High-Energy Shock Waves (therapeutic use)
• Hindlimb
• Hydrogels
• Lymphangiogenesis (drug effects)
• Lymphatic Vessels (drug effects, injuries, physiology)
• Lymphedema (drug therapy, therapy)
• Macrophage Activation (drug effects)
• Mice
• Mice, Inbred BALB C
• Regeneration (drug effects)
• Vascular Endothelial Growth Factor C (administration & dosage, biosynthesis, genetics, therapeutic use)
• Vascular Endothelial Growth Factor Receptor-3 (biosynthesis, genetics)
• Wound Healing (drug effects, physiology)