CHANGES OF TISSUE FLUID HYALURONAN (HYALURONIC ACID) IN PERIPHERAL LYMPHEDEMA

Abstract

Hyaluronan (hyaluronic acid or HA) is an important component of the extracellular matrixwhich is synthesized in the tissue, transported in lymph and catabolized mainly in lymph nodesand the liver. In 39 patients with chronic peripheral lymphedema, the HA content inlymphedematous interstitial fluid was measured using radioimmunoassay. For comparison, theconcentration of HA in serum and normal tissue fluid were also determined. These samples werealso tested for protein concentration. The results showed that the HA concentration in interstitialfluid of a lymphedema limb was 22x103 ± 103 (aspiration) and 30x103 ± 4x103 (wick) ng/ml whichwere significantly higher than that in interstitial fluid, serum and lymph of normal limbs(control) and interstitial fluid of limbs with venous edema (p<0.001). The protein concentrationin these fluids did not show significant differences between lymphedema and those with normallimbs. The findings suggest that HA stagnates in the limb with impaired lymph drainage whichmay exert a deleterious effect on the interstitium.