LYMPHSPIRATION INVESTIGATION OF THE MECHANISM OF LYMPHOCYTE INJECTION THERAPY IN TREATMENT OF LYMPHEDEMA WITH SPECIAL EMPHASIS ON THE CELL ADHESION MOLECULE (L-SELECTIN)

Abstract

We previously employed intraarterial lymphocyte injection therapy in conjunction withstandard non-operative treatment of peripheral lymphedema of various etiologies. In this study,we further evaluated the clinical outcome of this therapy in 46 patients with unilaterallymphedema of the extremities. The results showed combined therapy (lymphocyte injection withcompression) was effective in 74% (34 of 46 patients) with dramatic reduction in lymphedema in37% (17 of 46 patients). In the most recent 5 patients treated, we examined the expression of celladhesion molecule of the lymphocytes (L-selectin) before, during and after lymphocyte injectiontherapy to study the putative pathomechanism of this treatment method. The expression of Lselectin, a lymphocyte-specific adhesion molecule, increased in the autologous lymphocytesobtained by a blood cell separator and in the lymphocytes from the peripheral blood afterinjection. Moreover, the lymphocyte fraction, which was positive for L-selectin and negative forCD3, a T-cell marker, decreased after lymphocyte injection. We postulate that the lymphocytes ofL-selectin (+) and CD (-) remain in the affected swollen limb and play a role in an ill-definedimmunologic responsiveness that potentiates reduction in edema.