Update on Research
AN UPDATE ON LYMPHOEDEMA RESEARCH, BY DR MARC G ACHEN (PH.d),
SENIOR RESEARCH FELLOW, LUDWIG INSTITUTE FOR CANCER RESEARCH, ROYAL
MELBOURNE HOSPITAL
Some five years ago my research colleague, Dr. Steven Stacker, and I
discovered a protein growth factor that stimulates the growth of
lymphatic vessels. The name of the factor is VEGF-D. Somewhat
earlier our collaborator, Professor Kari Alitalo (in Helsinki,
Finland), discovered another growth factor for the lymphatics named
VEGF-C . Lymphoedema arises due to damage or inadequate development
of the lymphatics so we thought it could be possible to use these
proteins to stimulate growth/repair of lymphatics that might
facilitate fluid drainage from limbs affected by lymphoedema. Since
that time we (Achen/Stacker in Melbourne and Alitalo and co-workers
in Finland/USA) have tested VEGF-C and VEGF-D in animal models of
lymphoedema. Indeed our initial hypothesis was correct – treatment
with these growth factors does partially Restore lymphatic drainage
suffficient to resolve the lymphoedema. This is exciting news and is
certainly a research breakthrough.
Nevertheless, it is important that lymphoedema patients realise it
takes considerable time to proceed from exciting animal date to
testing a new therapeutic approach in the clinic. This requires
further testing in more sophisticated animal models, agreements with
the biotechnology/pharmaceutical industry, industrial grade
production of the therapeutics to be trialed and approval from
regulatory authorities to proceed. Given these requirements, and
assuming that testing in more sophisticated animal models is as
positive as the results to date, we think it likely that this
workwould proceed to early phase clinical trials with human patients
in about three years.
There are numerous reasons why lymphoedema patients can take heart
from these developments. The obvious one is that this research may
give rise to novel treatments in the future. Another is that there
was no high quality modecular research in lymphodema five years ago
(the problem was simply not on the radar screen of top researchers )
but this situation has changed dramatically as recent findings have
attracted top young researachers into this new field. The treatment
of the future will of course arise from the research of today so
this momentous change is of great importance.
This change has been given even greater impetus by the decision of
the National Institutes of Health (NIH) in the USA to make
lymphoedema a research area of high priority. Accordingly, the NIH
has made considerable monies available for research on this
important condition.
These are exciting times in lymphoedema research although new
treatments are not yet immediately around the corner. Hopefully that
will change soon.
(This article was originally published in the December 2003 issue of
“Swell News”, the newsletter of the Lymphoedema Associate of
Victoria (Australia).
LSN’S CHIEF MEDICAL ADVISOR, PROFESSOR PETER MORTIMER COMMENTS;
Members/Readers can indeed be encouraged by Marc Achen’s article,
but I know he would be the first to caution against over optimism. I
recently spoke with him at a lymphatics meeting in California and he
emphasised there is many a slip between making something work in
animals and then in humans. Nevertheless, I wold reiterate his
comments that there was no high quality lymphatic/lymphoedema
research 5 years ago, but it is now a very “hot” research area. This
can only be good for patients. St George’s is collaborating with
Prof Alitalo in Helsinki as part of our British Heart Foundation
grant into genetic forms of lymphoedema. He is planning trials of
gene therapy and this will include St George’s patients, but a
starting date will be some years hence.
This article by kind permission of LYMPHLINE Summer 2004.
Newsletter of TheLymphoedema support network in the UK.