1. Breast Cancer-Related Lymphedema Results in Impaired Epidermal Differentiation and Tight Junction Dysfunction.
- Author
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Campbell AC, Baik JE, Sarker A, Brown S, Park HJ, Kuonqui KG, Shin J, Pollack BL, Roberts A, Ashokan G, Rubin J, Kataru RP, Dayan JH, Barrio AV, and Mehrara BJ
- Subjects
- Humans, Female, Animals, Mice, Middle Aged, Breast Cancer Lymphedema metabolism, Breast Cancer Lymphedema etiology, Disease Models, Animal, Zonula Occludens-1 Protein metabolism, Filaggrin Proteins, Staphylococcus epidermidis, Breast Neoplasms pathology, Breast Neoplasms complications, Aged, Lymphedema pathology, Lymphedema metabolism, Lymphedema etiology, Lymphedema physiopathology, Lymphography methods, Keratin-14 metabolism, Tight Junctions metabolism, Tight Junctions pathology, Keratinocytes metabolism, Epidermis pathology, Epidermis metabolism, Cell Differentiation
- Abstract
Breast cancer-related lymphedema (BCRL) is characterized by skin changes, swelling, fibrosis, and recurrent skin infections. Clinical studies have suggested that lymphedema results in skin barrier defects; however, the underlying cellular mechanisms and the effects of bacterial contamination on skin barrier function remain unknown. In matched biopsies from patients with unilateral BCRL, we observed decreased expression of FLG and the tight junction protein ZO-1 in skin affected by moderate lymphedema or by subclinical lymphedema in which dermal backflow of lymph was identified by indocyanine green lymphography, relative to those in the controls (areas without backflow and from the unaffected arm). In vitro stimulation of keratinocytes with lymph fluid obtained from patients undergoing lymphedema surgery led to the same changes as well as increased expression of keratin 14, a marker of immature keratinocytes. Finally, using mouse models of lymphedema, we showed that similar to the clinical scenario, the expression of skin barrier proteins was decreased relative to that in normal skin and that colonization with Staphylococcus epidermidis bacteria amplified this effect as well as lymphedema severity. Taken together, our findings suggest that lymphatic fluid stasis contributes to skin barrier dysfunction in lymphedema., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)
- Published
- 2025
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