Anti-oxidant vitamins and lymphedema
Interesting article out of Germany:
Oxidative stress in chronic lymphoedema
W.G. Siems, R. Brenke1, A. Beier2 and T. Grune2,
From the Herzog-Julius Hospital for Rheumatology and Orthopaedics, Bad Harzburg,
1 Hufeland Hospital Bad Ems, and 2 Clinics of Physical Therapy and
Rehabilitation and Neuroscience Research Centre, Medical Faculty (Charité),
Humboldt University Berlin, Germany
Received 2 November 2001 Accepted for publication 6 August 2002.
Background: Chronic lymphoedema is one of the most frequent and debilitating
complications after surgical and radiological tumour treatment. Prevention and
therapy of lymphoedema is therefore an important problem of the rehabilitation
of those patients.
Aim: To investigate whether chronic lymphoedema results in increased oxidative
stress.
Design: Prospective case-control study.
Methods: We obtained venous blood samples from patients (n=38) with chronic
lymphoedema and determined biomarkers of prooxidative reactions and of
antioxidative defense system in the erythrocytes or blood plasma: reduced and
oxidized glutathione (GSH and GSSG), and lipid peroxidation products such as
malondialdehyde (MDA) and 4-hydroxynonenal (HNE). Healthy volunteers (n=90) and
patients who had undergone surgical and/or radiotherapeutic treatment of tumours
without consequent lymphoedema (n=20) acted as controls.
Results: The blood of patients with chronic lymphoedema contained lower
concentrations of GSH and higher levels of GSSG and of MDA and HNE, compared
with the control group. MDA was increased by about three-fold in the serum of
the lymphoedema patients. Accelerated free radical formation and lipid
peroxidation processes were further demonstrated by the liberation of MDA and
HNE into the blood serum after manual lymph drainage.
Discussion: Our data demonstrate enhanced formation of reactive oxygen species
(ROS) and accelerated lipid peroxidation processes in chronic lymphoedematous
tissue. The strengthening of antioxidative defense mechanisms could be useful in
the therapy of chronic lymphoedema.
Address correspondence to Dr. T. Grune, Neuroscience Research Center, Medical
Faculty (Charité), Humboldt University Berlin, Schumannstr. 20/21, 10117 Berlin,
Germany. e-mail: tilman.grune@c...