Impact of Interleukin 6 in the management of Lymphedema

Ravikumar Gopalakrishnan; Sivakami Thiagarajan; Sugapradha GR; Jenifer P

Volume : VIII, Issue : XI, November - 2019

Impact of Interleukin 6 in the management of Lymphedema

Ravikumar Gopalakrishnan, Sivakami Thiagarajan, Sugapradha Gr, Jenifer P

Abstract :

Background: Lymphedema is a progressive disease characterized by chronic limb swelling and adipose deposition resulting from congenital abnormalities, obstruction, injury, or infection of the lymphatic system. Current diagnostic options are limited and rely primarily on limb circumference or volume measurements. Identification of a serum marker for lymphedema may facilitate diagnosis and response to treatment. Lymphedema is characterized clinically by adipose tissue deposition and inflammation; therefore, we investigated serum level of interleukin–6 (IL–6), an important physiologic regulator of these processes in various grades of lymphedema. Methods: The study was conducted in the lymphedema unit under the Department of Plastic and Reconstructive Surgery, Thanjavur Medical College from January 2018 to December 2018. Patient demographics including body mass index (BMI) and lymphedema grade were collected. The lymphedema patients were classified into seven stages as per Fifth WHO Expert Committee on Filarial lymphedema and endorsed by the American Society of Lymph ology. Sixty six patients of various stages of lymphedema were evaluated for IL 6 expression in their serum. Results: IL6 is significantly increased in Grade III lymphedema patients. IL–6 is a known regulator of adipose homeostasis in obesity and has been shown to be increased in primary and secondary models of lymphedema. In Grade III lymphedema there is more fat deposition and lipodermatosclerosis. Conclusions: Although it is evident that inflammatory changes are necessary for adipose deposition in lymphedema, it remains unclear which inflammatory pathways regulate adipose homeostasis in lymphedematous tissues. Our study proves that there is a definite correlation between serum levels of IL6 in various stages of lymphedema. Identification of a drug modulating the IL6 level may prevent the progression of lymphedema to higher grades. IL–6 may be a useful serum marker that may aid in the diagnosis and treatment of lymphedema.