Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Walbrodt, S.
Assessing Lymphatic Flow Changes in Patients with Lymphatic Disease: Effects of Therapy
Humanmedizin; [ Diplomarbeit ] Graz Medical University; 2018. pp. 57
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Goswami Nandu
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- Abstract:
- Introduction: Lymphedema is a disease of the lymphatic system that is disfiguring and still incurable today. While the causes are manifold, pathophysiologically there is always an imbalance between lymph formation and lymph drainage leading to a backlog of lymph which becomes visible as edema. The macromolecule hyaluronate is an integral part of the extracellular space and is present in almost all tissues, but especially in the skin. Several studies have shown that hyaluronic acid is transported in part via the lymph and subsequently reaches the bloodstream before it is finally degraded in the liver and kidneys and could therefore be used as a surrogate for lymphatic flow changes. Aims and objectives: This diploma thesis aims to examine the role of Hyaluronan acid as a potential surrogate for lymph flow in persons with lymphedema. Moreover, this thesis tries to identify possible correlations with plasma density and weight. Methodology: As part of the “Lymph” study of the Department of Physiology at the Medical University of Graz, in cooperation with the LKH Wolfsberg, we took blood samples on fixed days from eight patients with primary or secondary lymphedema, as they underwent a three-weeks treatment of complex decongestive therapy in the hospital. Blood samples were taken at the first, second, seventh, 15th and 20th day before and after the treatment. The amount of hyaluronic acid was measured with a highly sensitive immunofluorescence test. Results: Plasma levels of hyaluronic acid fluctuated strongly over the course of the therapy and between the subjects. Compared to pre-treatment levels, post-treatment levels were often lower, which was found to be statistically significant in the Wilcoxon test (r = 0.35, P < 0.033). Discussion: It appears that complex decongestive therapy does not seem to affect pre- and post-therapy lymphatic flow, as assessed by hyaluronic acid levels. As the route of the hyaluronic acid molecules from connective tissue via the lymphatic system to the blood circulation is influenced by many factors, further research is required.