Zánět obecně a lymfedém

Exsudace

• Vlivem zánětlivých faktorů

Hmyzí bodnutí

Monocyte- and macrophage-associated inflammatory mediators

• Transient spikes
• And temporary increases in the proteins vascular endothelial growth factors (VEGF) and angiopoietin-2 [19]

Herpetická infekce

• Opakované infekce penisu mohou vést k rozvoji lymfedému penisu

Lymphatic pumping oslabení

• Potently inhibits lymphatic muscle contractions: [51]

Histamine

Nitric oxide (NO)

• Endothelial NO synthase (eNOS)
• During infammatory states inducible NO synthase (iNOS)
• Inhibits lymphatic pumping
• Immunosuppression is thus associated with inflammation
• Via NO-mediated inhibition of lymphatic pumping
• Reduced ow to lymph nodes
• Transit of a variety of immune cells via lymph
• Often increased following acute and chronic inflammation [51]

Pustular psoriasis

Sarkoidóza

• Otok může projevit jako erythema nodosum [31]

Mimoplicní sarkoidóza

• Mimo plíce mohou být sarkoidózou postiženy oči, nervy, lymfatický systém, srdce, játra, pohybový aparát, endokrinní systém, ledviny, gastrointestinální trakt, příušní žlázy či reprodukční orgány. Dále může být sarkoidóza příčinou poruch metabolismu (hyperkalcémie, hyperkalciurie) i hematologických abnormalit (anémie, leukopenie, lymfopenie).
• Až 20 % pacientů se sarkoidózou má přidružené autoimunitní onemocnění – hypothyreóza, Gravesova choroba, CVID (Common Variable ImmunoDeficiency).
• www.wikiskripta.eu/w/Sarkoid%C3%B3za_(interna)

CD4+ T helper (TH) cells

• In lymphedematous tissues
• Play a key role in the pathophysiology of lymphedema

Biopsy specimens from women with unilateral BCRL and mouse models of lymphedema

• Number of infiltrating TH cells is increased in lymphedematous tissues
• Increasing numbers of CD4+ cells
• Correlated with the clinical severity of the disease
• (Avraham et al., 2013)

Mouse tail model of the disease

Transgenic mice lacking CD4+ cells

• Did not develop lymphedema following lymphatic injury

Mice treated with neutralizing antibodies against CD4+ cells

• Did not develop lymphedema following lymphatic injury

Depletion of B cells, cytotoxic (CD8+) T cells, or macrophages

• Either has no effect or worsens the pathology
• (Zampell et al., 2012a; Ghanta et al., 2015; García Nores et al., 2018)

Limited numbers of CD4+ cells that

• Remained after total body irradiation
• Adoptive transfer of CD4+ cells to CD4 knockout mice
• Resulted in the development of lymphedema following skin and lymphatic resection. (Ly et al., 2019a)
• www.frontiersin.org/articles/10.3389/fphar.2022.828513/full