Retinoic Acid Induced Lymphangiogenesis for Post-surgical Lymphedema

视黄酸诱导淋巴管生成治疗术后淋巴水肿

• 批准号: 10186087
• 负责人: Alex K. Wong
• 金额: $ 63.13万
• 依托单位: BECKMAN RESEARCH INSTITUTE/CITY OF HOPE
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10186087
• 关键词: Address; Affect; American; Biology; Blood Vessels; Carrier Proteins; Cell Differentiation process; Cell Proliferation; Chronic; Clinical; Clinical Treatment; Cues; Development; Devices; Diagnostic; Differentiation and Growth; Dimerization; Disease; Drainage procedure; Endothelial Cells; Etiology; Excision; Exposure to; FGFR3 gene; FGFR4 gene; Fibroblast Growth Factor Receptors; Fibrosis; Functional disorder; Growth; Hour; Hyaluronic Acid; Immune System Diseases; In Vitro; Individual; Infection; Injury; Intercellular Fluid; KDR gene; Laboratories; Limb structure; Liquid substance; Lymph Node Dissections; Lymphangiogenesis; Lymphatic; Lymphatic Endothelial Cells; Lymphatic Obstruction; Lymphedema; Malignant Neoplasms; Measures; Mediating; Molecular; Natural regeneration; Nuclear Receptors; Operative Surgical Procedures; PPAR gamma; Pathway interactions; Patients; Pelvic Cancer; Pharmacology; Pharmacotherapy; Plastic Surgeon; Pre-Clinical Model; Preventive treatment; Quality of life; RXR; Receptor Protein-Tyrosine Kinases; Recurrence; Risk; Rodent Model; Role; Sampling; Sensitivity and Specificity; Signal Transduction; Skin; Solid Neoplasm; Spectrum Analysis; Surgical Injuries; Swelling; System; Techniques; Technology; Testing; Therapeutic; Tissues; Treatment Protocols; Tretinoin; Vascular Endothelial Growth Factor C; Vascular Endothelial Growth Factor Receptor-3; Vitamin A; Work; alitretinoin; angiogenesis; base; cell growth; cell type; cellular retinoic acid binding protein II; clinical care; clinical translation; disability; early detection biomarkers; effective therapy; experimental study; fatty acid-binding proteins; improved; in vivo; inhibitor/antagonist; lymph nodes; lymphatic circulation; lymphatic drainage; lymphatic insufficiency; lymphatic vessel; malignant breast neoplasm; melanoma; migration; minimally invasive; pre-clinical; predictive modeling; prevent; promoter; receptor; recurrent infection; regeneration following injury; response; retinoic acid receptor alpha; sarcoma; secondary lymphedema; selective expression; side effect; small molecule inhibitor; soft tissue; urologic

Lymphedema is an incurable condition characterized by lymphatic obstruction, tissue swelling, immune dysfunction, and fibrosis after lymphatic injury. Lymphedema affects 5 million Americans and is associated with poor quality of life due to extremity disability, disfigurement, and risk for recurrent limb-threatening infection. In the US, lymphedema is most commonly a consequence of lymph node dissection for the treatment of solid tumors such as breast or pelvic cancer. Despite the fact that lymphedema is common and morbid, there are currently no effective drug treatments. Using preclinical rodent models of lymphedema, we have shown that 9-cis retinoic acid (RA) significantly accelerates lymphatic regeneration following injury, restores functional lymphatic drainage, and prevents development of lymphedema. Our overarching hypothesis is that RA-mediated lymphangiogenesis is a promising therapy for secondary lymphedema. The objective of this proposal, which is the first logical step towards implementing this treatment clinically, is to increase our understanding of the mechanisms by which RAs regulate lymphangiogenesis and develop a translational framework for the use of these compounds. The specific aims of this proposal include Aim 1: Determine how RA selectively induces lymphangiogenesis; Aim 2: Elucidate the roles of FGFR and VEGFR signaling in RA-mediated lymphangiogenesis; and Aim 3: Use early biomarkers of lymphatic insufficiency to develop a predictive model that can guide initiation of RA therapy. Based on the current lack of effective therapy, it is clear that there is a need to develop an etiology-focused treatment for post-surgical lymphedema. The proposed studies will address important mechanistic questions regarding RA mediated lymphangiogenesis and also develop an early biomarker based predictive model that will guide treatment windows for RA therapy. The proposed work will significantly improve our understanding of RA-mediated lymphangiogenesis as well as support clinical translation of a RA as a preventative treatment regimen for post-surgical lymphedema.

淋巴水肿是一种无法治愈的疾病，其特征是淋巴阻塞，组织肿胀， 免疫功能障碍和淋巴损伤后的纤维化。淋巴水肿影响500万美国人， 与肢体残疾，毁容和经常性风险相关的生活质量差 威胁肢体的感染。在美国，淋巴水肿最常见的是淋巴结的结果 解剖治疗实体瘤，例如乳腺癌或骨盆癌。尽管事实 淋巴水肿很常见且病态，目前尚无有效的药物治疗。使用 淋巴水肿的临床前啮齿动物模型，我们已经表明了9-秒视黄酸（RA）明显 损伤后加速淋巴再生，恢复功能性淋巴引流，并 防止淋巴水肿的发展。我们的总体假设是RA介导的 淋巴管生成是一种有前途的继发性淋巴水肿的疗法。该提议的目的 这是在临床上实施此治疗的第一步，是增加我们的 理解RAS调节淋巴管生成并发展的机制 使用这些化合物的翻译框架。该提议的具体目的包括 目标1：确定RA如何选择性诱导淋巴管生成；目标2：阐明FGFR的角色 RA介导的淋巴管生成中的VEGFR信号传导；和目标3：使用早期的生物标志物 淋巴功能不全，以开发可以指导RA治疗开始的预测模型。基于 关于目前缺乏有效疗法，很明显，有必要发展以病因为中心 手术后淋巴水肿的治疗。拟议的研究将解决重要的机理 有关RA介导的淋巴管生成的问题，还会发展基于生物标志物的早期生物标志物 预测模型将指导RA治疗的治疗窗口。拟议的工作将 显着提高我们对RA介导的淋巴管生成并支持临床的理解 将RA作为手术后淋巴水肿的预防治疗方案的翻译。