Compounds commonly found in everyday food items like apple juice, yogurts, and red wine may offer a new therapeutic avenue for lymphedema, a condition characterized by severe swelling in the arms and legs. Research published in the journal Nature suggests that cyclodextrins, a type of food additive, could potentially reverse this debilitating swelling.
Lymphedema affects an estimated 10 million people in the United States, often as a consequence of cancer treatment. Approximately one in five individuals develop lymphedema in their arm following treatment for breast cancer, which can involve the surgical removal of lymph nodes or radiation therapy. Lymph nodes are vital for filtering waste from the lymphatic system, but damage or blockages caused by cancer treatment can lead to a chronic buildup of lymph fluid.
This fluid accumulation can result in significant swelling, making daily tasks difficult and severely impacting quality of life. Current treatment options are limited and often inconvenient. Compression sleeves and stockings are a common recommendation, but they can cause skin irritation and restrict movement. Manual lymphatic drainage, a type of massage, requires regular application for effectiveness. More invasive procedures like surgery to repair lymphatic vessels or liposuction to remove excess fluid and fat can be prohibitively expensive, with surgery potentially costing tens of thousands of dollars and still requiring ongoing care.
The new study, conducted by scientists at the National University of Singapore and detailed in Nature, focused on cyclodextrins. These compounds are derived from starch and have long been utilized in the food and beverage industries to enhance flavor and mask unwanted odors by trapping molecules within their unique structure. Importantly, cyclodextrins are also used to reduce cholesterol in dairy products by encapsulating cholesterol crystals and facilitating their removal.
Researchers noted a significant correlation between reduced lymphatic flow and increased cholesterol accumulation in the tissues of women with lymphedema undergoing breast cancer treatment. The study's findings indicate that this build-up of cholesterol contributes to inflammation and scarring of lymphatic vessels, further obstructing lymph flow and exacerbating lymphedema.
To test the therapeutic potential of cyclodextrins, researchers administered the compound to mice with lymphedema. Over eight weeks, regular injections into the affected areas led to a significant reduction in swelling and inflammation. Furthermore, the study observed that cyclodextrins appeared to aid in the regeneration of damaged lymphatic vessels, suggesting a potential for symptom reversal.
Experts acknowledge the significance of these findings. Babak Mehrara, chief of plastic and reconstructive surgery at Memorial Sloan Kettering Cancer Center, who reviewed the study for Nature, noted that the condition involves a cycle of fluid retention, inflammation, and further fluid accumulation, complicated by fat and cholesterol deposits. Professor Kefah Mokbel, a consultant breast surgeon at the London Breast Institute, described the discovery as opening a "genuinely new therapeutic avenue" for a condition that currently has no cure.
While the results are promising, further investigation is required. Mokbel emphasized the need for carefully designed human trials to establish the safety and efficacy of cyclodextrins as a lymphedema treatment. He also noted that existing cholesterol-lowering drugs like statins are unlikely to be effective for lymphedema because they target cholesterol in the bloodstream, not specifically within the lymph nodes. The animal study results suggest that cyclodextrins' ability to target cholesterol directly in affected tissues could be key to their potential therapeutic benefit.