From the first moment my wife discovered
she had breast cancer, there was a deafening silence from the men I know. Even
ones whose wives, mothers or girlfriends had breast cancer seemed to have
received a gag order from some Central Cancer Command and did little more than
mumble about the experience. Not one to shut up for any known reason, I started
this blog…
Every month, I’ll be highlighting breast
cancer research that is going on RIGHT NOW! Harvested from different websites,
journals and podcasts, I’ll translate them into understandable English and
share them with you. Today:
So, I found out
something new: the hardening of the skin due to lymphedema is NOT peculiar to
breast cancer!
Last month, the
following Keystone Symposium was held: “Injury, Inflammation, and Fibrosis: Fibrosis
is a common response of many organs to chronic injury and inflammation. This
leads to destruction of organ architecture with loss of function. Until
recently, there have been no therapies to slow the progression of fibrosis and
to maintain normal organ function. Recent advances have provided new insights
into the pathogenesis of fibrosis, new drug targets, and new drugs in clinical
studies. This conference will bring together basic biologists and translational
and clinical researchers to discuss core mechanisms underlying inflammation and
fibrosis, to compare and contrast fibrotic diseases, preclinical models, the
potential for regeneration and regression of fibrosis, and potential therapies.
The interaction between the host genetics, the environment and the microbiome
in the pathogenesis of fibrotic diseases will be addressed. Also, non-invasive
methods to assess fibrosis including advanced imaging and intermediate
biomarkers will be discussed. This conference will be a unique opportunity for
investigators who are focused on organ-specific diseases – i.e., medical
subspecialists – to participate in cross-disciplinary, multi-organ discussions
in order to gain new insights into their research. ”
A brief reading of
the papers presented don’t address fibrosis following the removal of lymph
nodes due to radical mastectomy, but it appears to ME (remember, I’m a layman –
a biology (and chemistry, physics, astronomy, etc.) teacher with about 30 years
of classroom teaching experience) that several of the subjects covered seem to
me to have lymphedema applications.
I suppose I SHOULD
clarify what they’re talking about above: “Long standing lymphedema causes
a condition known as fibrosis. As the fluid continually collects in a limb, it
becomes hard and dense. With each stage of lymphedema there is also a change in
the tissue texture of a limb. Each stage of lymphedema presents
additional difficulties and worsening of fibrosis, if treatment is not
received. Initially, there is no fibrosis associated with lymphedema. It is also
important to remember that the size of a limb (arm lymphedema, leg lymphedema)
is NOT an indication of how much fibrosis there is. I have seen very
slightly swollen legs that were as hard as a rock because of late stage
fibrosis.”
Surprisingly, I
just realized that I have seen fibrosis – it happened to my mother because of
her Congestive Heart Failure (CHF). Her legs were essentially normal in size,
but had become so rigidly hard (she refuse to do physical therapy, allow her
legs to be wrapped, or even, eventually to walk at all…) that lymphorrea – “the
light amber colored fluid that drains from open skin areas (wounds) on a
lymphodemous limb. It is not normal plasma, but is a protein-rich
substance that can lead to serious complications for the lymphedema patient.
The composition of lymphorrhea is approximately 1.0=5.5 g/ml of protein” -- leaked from her legs on a regular basis.
Back to the
Symposium: While none of the papers is
currently available, I’ll be looking for them in the coming months and waiting
to see if any of the research is being applied. While my area of interest is
fibrosis of the limbs, it’s clear that fibrosis can happen to the heart, liver,
kidneys, skin (in a condition that an old friend of mine had called
scleroderma), and bile ducts.
In particular I’ll
be looking to see if any of this new information…leaks…into the field of
lymphedema of the extremities: MicroRNAs as Potential Therapeutic Targets in
Fibrotic Diseases, Mitochondrial Priming by Matrix Stiffness Sensitizes
Myofibroblasts to BH3 Mimetic-Induced Apoptosis in Scleroderma Fibrosis, Multistep
Cancer-Associated Fibroblast Activation: A Notch/CSL-Gli Regulatory Axis, Cellular
and Molecular Heterogeneity of Fibroblast Responses in Mouse Model of
Dermal Fibrosis, Molecular Signatures of Collagen-Producing Cells in Multiple
Models of Pathologic Tissue Fibrosis.
We shall see!
Resources: https://www.keystonesymposia.org/17c8,
http://www.lymphedemapeople.com/thesite/lymphedema_fibrosis.htm
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