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9-cis Retinoic Acid Promising for Lymphedema Prevention

Treatment with 9-cis RA linked to increased lymphatic clearance and lymphangiogenesis

MONDAY, Sept. 26, 2016 (HealthDay News) — Treatment with 9-cis retinoic acid (RA) has potential as a preventative agent for postsurgical lymphedema, according to an experimental study published in the August issue of the Annals of Surgery.

Athanasios Bramos, M.D., from the Keck School of Medicine of the University of Southern California in Los Angeles, and colleagues induced lymphedema in the right hind limb following a single fraction of radiation, popliteal lymphadenectomy, and lymphatic vessel ablation in mice. Postoperatively, mice were randomized to receive daily intraperitoneal injections of an oil-based vehicle solution (control) or 9-cis RA dissolved in vehicle solution.

The researchers found that postsurgical lymphedema was seen in 89 percent of cases following the combined injury protocol. Less early postsurgical edema was seen in 9-cis RA-treated animals, and they also had significantly less paw lymphedema at all time points compared with vehicle-treated animals (P < 0.001). Significantly faster lymphatic drainage was seen for RA-treated animals, and they had increased lymphatic vessel density.

“Treatment with 9-cis RA is associated with increased lymphatic clearance and lymphangiogenesis,” the authors write. “Because 9-cis RA (alitretinoin) is already approved for clinical use by the U.S. Food and Drug Administration for other conditions, it has the potential to be repurposed as a preventative agent for postsurgical lymphedema in humans.”

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