Adipose Tissue and Biological Factors. Possible Link between Lymphatic System Dysfunction and Obesity

Antoniak, Klaudia; Hansdorfer-Korzon, Rita; Mrugacz, Małgorzata; Zorena, Katarzyna

doi:10.3390/metabo11090617

Cited by 15 publications

(15 citation statements)

References 183 publications

(431 reference statements)

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“…This action mechanism of MLD therapy has been confirmed by the results of studies by Shim et al [ 55 ]. Increasing the parasympathetic activity of the autonomic nervous system plays a key role in reducing inflammation [ 56 ], reducing the risk of obesity, diabetes and chronic vascular complications [ 29 ]. Secondly, MLD therapy could increase the contractility and transport capacity of lymphatic vessels, which was the subject of several studies [ 30 , 33 ].…”

Section: Discussionmentioning

confidence: 99%

“…In recent years, health care professionals have started to pay particular attention to the role of the lymphatic system in the course of obesity [ 25 , 26 , 27 , 28 ]. Several studies, including ours, indicate that obesity may cause pathological changes in the lymphatic system that may impair its function, and vice versa—dysregulation of the lymphatic system may lead to the pathogenesis of obesity [ 28 , 29 ]. In our preliminary studies (three cases with a 3-month follow-up), an improvement in the C-peptide concentration and lipid profile was observed, as well as reduction of inflammation and improvement in the quality of life of patients with an abnormal body mass index after manual lymphatic drainage (MLD) therapy [ 28 ].…”

Section: Introductionmentioning

confidence: 99%

“…The studies, during and after MLD therapy, showed increased contractility of lymphatic vessels in healthy subjects [ 33 ] as well as in patients with lymphedema [ 33 , 34 ]. A more detailed description of imaging studies is available in our previous publication [ 29 ].…”

Section: Introductionmentioning

confidence: 99%

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Significant Decrease in Glycated Hemoglobin, 2h-Post-Load Glucose and High-Sensitivity C-Reactive Protein Levels in Patients with Abnormal Body Mass Index after Therapy with Manual Lymphatic Drainage

et al. 2022

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The objective of this study was to investigate the effect of manual lymphatic drainage (MLD) on the insulin resistance parameter (HOMA-IR), glycated hemoglobin (HbA1c), C-peptide, insulin, fasting plasma glucose (FPG), 2h-post-loadglucose (2h-PG) and the concentration of high-sensitivity C-reactive protein (hsCRP) in patients with abnormal body mass index. The study involved 30 patients, including patients with normal body weight (as a control group; group I; n = 14), overweight patients (group II; n = 9) and obese patients (group III; n = 7). Each patient underwent 10 sessions of MLD therapy, 3 times a week for 30 min. In addition, we measured body mass index (BMI) and waist-to-hip ratio (WHR) and performed body composition analysis as well as biochemical tests before MLD therapy (stage 0′) and after MLD therapy (stage 1′). A statistically significant correlation was demonstrated between the concentration of C-peptide, BMI, the amount of visceral adipose tissue (r = 0.87, p = 0.003; r = 0.76, p = 0.003, respectively), and the HOMA-IR index, BMI and the amount of visceral adipose tissue (r = 0.86, p = 0.005; r = 0.84, p = 0.042, respectively), before and after MLD therapy. In overweight patients (group II), a statistically significant (p = 0.041) decrease in the hsCRP level by 2.9 mg/L and a significant (p = 0.050) decrease in the 2h-PG level by 12 mg/dL after the MLD therapy was detected. Moreover, in the group of obese patients (group III), a statistically significant (p = 0.013) decrease in HbA1c level by 0.2% after MLD therapy was demonstrated. Our results indicate that MLD may have a positive effect on selected biochemical parameters, with the most favorable changes in overweight patients. Further studies in a larger number of patients are warranted to confirm our findings, to test in-depth their mechanism, and to investigate clinical benefits of this alternative therapy in patients with abnormal body mass index.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Significant Decrease in Glycated Hemoglobin, 2h-Post-Load Glucose and High-Sensitivity C-Reactive Protein Levels in Patients with Abnormal Body Mass Index after Therapy with Manual Lymphatic Drainage

et al. 2022

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“…In light of the above reports, we hypothesized that the use of therapy, including manual lymphatic drainage (MDL), may improve the dysfunction of the lymphatic system in people with abnormal body mass index. Manual lymphatic drainage is founded on the stimulation ofthe lymphatic system by increasing lymph circulation, expediting the removal of harmful metabolites from body tissues and enhancing body fluid dynamics [24,29]. So far, MLD has been applied in the treatment of lymphoedema and lipoedema [30,31].…”

Section: Introductionmentioning

confidence: 99%

Favourable Changes in C-Peptide, C-Reactive Protein and Lipid Profile, and Improved Quality of Life in Patients with Abnormal Body Mass Index after the Use of Manual Lymphatic Drainage: A Case Series with Three-Month Follow-Up

et al. 2022

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Aim: to try to assess the effect of manual lymphatic drainage on the biochemical parameters and quality of life of patients with abnormal body mass index. The study included three women, average age 46 years (patient 1 with normal body weight as a control; patient 2: overweight; patient 3 with class 2 obesity). After qualification, physiotherapeutic interview and examination was carried out; the concentrations of glycosylated haemoglobin (HbA1c), C-peptide, high-sensitivity C-reactive protein (hsCRP), lipid profile, and quality of life were also examined. Additionally, in patients with abnormal body mass index, biochemical parameters were monitored for 3 months. Each patient underwent 10 manual lymphatic drainage (MLD) therapy sessions, three times a week for 30 min. In the overweight patient (patient 2), a decrease in the concentration of C-peptide, hsCRP and triglycerides was observed after the series of MLD therapy. An improvement in the quality of life, intestinal motility, and a reduction in the frequency of flatulence were also noted. Moreover, after the therapy, patient 2 reported better sleep and increased vitality. In contrast, in patient 3 (with grade 2 obesity), a decrease in triglyceride levels, but not other biomarkers, was detected after the series of MDL therapy. Additionally, in patient 3, an improvement in the quality of life, an improvement in intestinal peristalsis, and reduction of menstrual pain were observed after MLD therapy. For comparison, in a patient with a normal body weight as a control (patient 1), there were no changes in biochemical parameters or improvement in the quality of life after MLD therapy. Our preliminary research indicates improvement of the concentration C-peptide, lipid profile, a reduction in the inflammation, and improved quality of life in patients with abnormal body mass index after MLD therapy. However, more studies are needed to elucidate the effectiveness of MLD therapy in patients with varying degrees of abnormal body mass index, i.e., from overweight to obesity.

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“…For instance, obese and type-2 diabetic mice displayed increased lymphatic vascular permeability (Scallan et al, 2015); in a rat model for metabolicsyndrome, the intrinsic contractility of mesenteric lymphatics was impaired (Zawieja et al, 2012) and thoracic ducts displayed blunted flow-mediated responses and reduced expression of nitric oxide synthase (Zawieja et al, 2016); and in wild-type mice, feeding of a high fat diet resulted in reduced contractile frequency and impaired response to mechanostimulation in collecting lymphatics in vivo (Blum et al, 2014), and impaired lymphatic fluid transport and impaired dendritic cell migration (Weitman et al, 2013). A more complete and in-depth discussion of the available studies focusing on the understanding of how lymphatic function is regulated/dysregulated in obesity has been presented in recent reviews (Kataru et al, 2020;Antoniak et al, 2021).…”

Section: Introductionmentioning

confidence: 99%

Lymphatic Valve Dysfunction in Western Diet-Fed Mice: New Insights Into Obesity-Induced Lymphedema

Castorena‐Gonzalez

2022

Front. Pharmacol.

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A two-way connection between obesity and lymphatic dysfunction has now been established. Clinical studies have demonstrated that obesity significantly increases the risk for developing secondary lymphedema. Using animal-models, obesity and metabolic syndrome have been linked to different aspects of lymphatic structural abnormalities and lymphatic dysfunction, including impaired contractility, impaired flow-mediated responses, impaired fluid transport, as well as increased permeability, and abnormal dendritic cell migration among others. Dysfunction of lymphatic valves is a main form of lymphatic dysfunction, known to result in severe edematous phenotypes; however, the extent of lymphatic valve deficiency in secondary lymphedema, including obesity-induced lymphedema, remains unknown. Therefore, the aims of the present study were 1) to determine whether western diet-induced obesity results in lymphatic valve dysfunction, and 2) to determine whether lymphatic valve dysfunction in western diet-induced obesity results from the diet itself, or as a consequence of the metabolic alterations induced by the diet. First, we quantitatively assessed and compared valve function in isolated popliteal and mesenteric collecting lymphatic vessels from control and western diet-induced obese C57BL/6J (WT) mice. Feeding a western diet for 14 weeks induced obesity and elevated plasma glucose and cholesterol levels when compared to controls. The function of lymphatic valves in popliteal lymphatics was not affected by diet-induced obesity; however, significant back-leak of pressure was observed in mesenteric lymphatic valves. Dysfunctional, leaky valves from obese animals also required significantly higher adverse pressure to trigger valve closure. Importantly, when subjected to treatment with a western diet, globally deficient PAI-1 mice were significantly protected against metabolic dysfunction and displayed fully functional, competent mesenteric lymphatic valves. In conclusion, our findings show for the first time that, in association with the metabolic alterations induced by the western diet, lymphatic valve dysfunction can be a critical component of obesity-induced lymphedema.

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Adipose Tissue and Biological Factors. Possible Link between Lymphatic System Dysfunction and Obesity

Cited by 15 publications

References 183 publications

Significant Decrease in Glycated Hemoglobin, 2h-Post-Load Glucose and High-Sensitivity C-Reactive Protein Levels in Patients with Abnormal Body Mass Index after Therapy with Manual Lymphatic Drainage

Significant Decrease in Glycated Hemoglobin, 2h-Post-Load Glucose and High-Sensitivity C-Reactive Protein Levels in Patients with Abnormal Body Mass Index after Therapy with Manual Lymphatic Drainage

Favourable Changes in C-Peptide, C-Reactive Protein and Lipid Profile, and Improved Quality of Life in Patients with Abnormal Body Mass Index after the Use of Manual Lymphatic Drainage: A Case Series with Three-Month Follow-Up

Lymphatic Valve Dysfunction in Western Diet-Fed Mice: New Insights Into Obesity-Induced Lymphedema

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