Published online Jul 26, 2020. doi: 10.4252/wjsc.v12.i7.676
Peer-review started: February 18, 2020
First decision: April 25, 2020
Revised: May 8, 2020
Accepted: May 28, 2020
Article in press: May 28, 2020
Published online: July 26, 2020
Lymphedema is a chronic, debilitating and incurable disease that affects 0.13%-2% of the global population. Emerging evidence indicates that adipose-derived stem cells (ADSCs) might serve as suitable seed cells for lymphatic tissue engineering and lymphedema therapy.
To summarize applications of ADSCs for treating lymphedema in both animal studies and clinical trials.
A systematic search was performed on four databases – PubMed, Clinicaltrials.gov, the evidence-based Cochrane Library, and OVID – using the following search string: (“lymphedema” or “lymphoedema” or “lymphangiogenesis”) and (“adipose-derived stem cells” or “adipose-derived stromal cells” or “adipose-derived regenerative cells”). A manual search was performed by skimming the references of relevant studies. Animal studies and clinical trials using adipose-derived cells for the treatment of any kind of lymphedema were included.
A total of eight research articles published before November 2019 were included for this analysis. Five articles focused on animal studies and another three focused on clinical trials. ADSC transplantation therapy was demonstrated to be effective against lymphedema in all studies. The animal studies found that coadministration of ADSCs and controlled-release vascular endothelial growth factor-C or platelet-rich plasma could improve the effectiveness of ADSC therapy. Three sequential clinical trials were conducted on breast cancer-related lymphedema patients, and all showed favorable results.
ADSC-based therapy is a promising option for treating lymphedema. Large-scale, multicenter randomized controlled trials are needed to develop more effective and durable therapeutic strategies.
Core tip: Lymphedema is a growing global health problem. Adipose-derived stem cells might serve as suitable seed cells for tissue engineering of lymphatic vessels in vitro and in vivo. A systematic search of publications on the application of adipose-derived stem cells in the treatment of lymphedema identified five animal studies and three clinical trials. All eight studies showed improvement of lymphedema after treatment with adipose-derived stem cells. Animal studies conducted with acute lymphedema mouse models provided data for finding the proper dose and methods of administration. Clinical trials were conducted on breast cancer-related lymphedema patients and are important references for further application.