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The Role of Lymphatic System in Peripheral Nerve Recovery
Chanel Reid, MD; Shayan Sarrami, MD: Daiki Kitano, MD, PhD; Chiaki Komatsu, MD; Fuat Baris Bengur, MD; Zhazira Irgebay, MD; Kacey Marra, PhD; Carolyn De La Cruz, MD
University of Pittsburgh Medical Center
2025-01-10
Presenter: Chanel Reid
Affidavit:
I certify that the material proposed for presentation in this abstract has not been published or presented at a major meeting. This project represents the original work of Chanel Reid.
Director Name: Vu T. Nguyen, MD
Author Category: Medical Student
Presentation Category: Basic Science Research
Abstract Category: General Reconstruction
Background: Peripheral nerve regeneration is a complex process with potentially unstudied therapeutic targets. Research highlights intraneural revascularization in regeneration of damaged nerve ends, aiding the healing process. The lymphatic system plays a critical role in mediating inflammatory processes, possibly offering novel targets for improving nerve regeneration. This study investigates the role of lymphatics in peripheral nerve recovery utilizing a vascularized lymph node flap for repair.
Methods: 8 murine models were divided into no repair, simple neurorrhaphy, and neurorrhaphy with pedicled subiliac lymph node flap, following sciatic nerve transection. Inguinal lymph nodes were identified with methylene blue injection. Subiliac flap was isolated and tunneled to the sciatic nerve and secured. Contralateral intact sciatic nerves served as controls. Immunofluorescent staining of Podoplanin and CD31 was completed at 8 weeks. Overlap of the two signals confirmed the presence of lymphatic structures. Merged signals were quantified per 500 micrometer squared area.
Results: Control samples had few lymphatic structures localized to the perineurium. No repair and simple neurorrhaphy showed lymphatic structures within the parenchyma of the nerve, likely related to an inflammatory response. Application of a lymph node flap to the repaired sciatic nerve revealed an increase of lymphatic structures within the nerve, likely due to upregulated lymphangiogenic signals from the flap.
Conclusion: This experiment establishes a novel protocol for vascularized lymph node transfer to an injured peripheral nerve in murine models to evaluate lymphatic markers within nervous tissue. We can appreciate the relationship between lymphatics and nerve regeneration influenced using a lymph node flap.
