Pathophysiology of lymphedema

Although lymphedema is a common disease, the pathophysiology and underlying cellular changes that regulate lymphatic dysfunction after injury remain poorly understood. This lack of understanding is a major obstacle to development of targeted treatment options. As a result, the mainstay treatment of lymphedema currently is palliative options such as compression and physical therapy. Recent studies have aimed to address this gap in our knowledge and have increased our ability to identify patients who are at risk for developing lymphedema and, more importantly, to develop novel methods to treat this disease. These studies have shown that obesity, radiation, infections, and genetic changes significantly increase the risk of developing secondary or iatrogenic lymphedema. In addition, advances in animal studies have shown that fibrosis and the cellular mechanisms that regulate this process play a key role in the pathogenesis of lymphedema. The purpose of this review is to highlight these advances and identify potential areas for future research.