Anti-inflammatory pharmacotherapy with ketoprofen ameliorates experimental lymphatic vascular insufficiency in mice
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BACKGROUND: Disruption of the lymphatic vasculature causes edema, inflammation, and end-tissue destruction. To assess the therapeutic efficacy of systemic anti-inflammatory therapy in this disease, we examined the impact of a nonsteroidal anti-inflammatory drug (NSAID), ketoprofen, and of a soluble TNF-alpha receptor (sTNF-R1) upon tumor necrosis factor (TNF)-alpha activity in a mouse model of acquired lymphedema. METHODS AND FINDINGS: Lymphedema was induced by microsurgical ablation of major lymphatic conduits in the murine tail. Untreated control mice with lymphedema developed significant edema and extensive histopathological inflammation compared to sham surgical controls. Short-term ketoprofen treatment reduced tail edema and normalized the histopathology while paradoxically increasing TNF-alpha gene expression and cytokine levels. Conversely, sTNF-R1 treatment increased tail volume, exacerbated the histopathology, and decreased TNF-alpha gene expression. Expression of vascular endothelial growth factor-C (VEGF-C), which stimulates lymphangiogenesis, closely correlated with TNF-alpha expression. CONCLUSIONS: Ketoprofen therapy reduces experimental post-surgical lymphedema, yet direct TNF-alpha inhibition does not. Reducing inflammation while preserving TNF-alpha activity appears to optimize the repair response. It is possible that the observed favorable responses, at least in part, are mediated through enhanced VEGF-C signaling.
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Ketoprofen and the LTB4 inhibitor bestatin showed promise in their respective mouse studies, but neither clinical trial produced limb volume reduction in lymphedema patients.
“The nonsteroidal anti-inflammatory drug ketoprofen (148) and the leukotriene B4 (LTB4) inhibitor bestatin (44) showed promise in their respective mouse studies, but neither clinical trial produced limb volume reduction in lymphedema patients (trial identifiers NCT02257970, NCT02700529).”
From Transport and Immune Functions of the Lymphatic System. (2025) · cites this paper as [148]
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- Authors
- Nakamura, K., Radhakrishnan, K., Wong, Y. M., & Rockson, S. G.
- Affiliations
- Stanford Medicine (US)
- Corresponding author
- Rockson, Stanley G.
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2009-12-21
- Volume
- 4
- Issue
- 12
- Pages
- e8380
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC2791214
- OpenAlex
- W1988070199
- Cited by
- 118
- References
- 47
- Citations by year
- 2026: 6 · 2025: 9 · 2024: 9 · 2023: 7 · 2022: 15 · 2021: 12 · 2020: 6 · 2019: 10 · 2018: 4 · 2017: 9 · 2016: 5 · 2015: 4 · 2014: 6 · 2013: 3 · 2012: 5
- FWCI
- 2.00
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- PLoS ONE (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- Susan G. Komen for the Cure
- American Heart Association
- Amgen
- Topics
- Health Sciences › Medicine › Oncology › Lymphatic System and Diseases
- Health Sciences › Medicine › Surgery › Lymphatic Disorders and Treatments
- Health Sciences › Medicine › Infectious Diseases › Parasitic Diseases Research and Treatment
- Keywords
- ketoprofen, lymphedema, nonsteroidal anti-inflammatory drugs, TNF-α, VEGF-C, lymphangiogenesis, inflammation
- MeSH terms
- Animals, Anti-Inflammatory Agents, Anti-Inflammatory Agents, Non-Steroidal, Gene Expression Regulation, Ketoprofen, Lymphedema, Organ Specificity, Solubility, Cytokines, Models, Immunological, Inflammation Mediators, Reverse Transcriptase Polymerase Chain Reaction, Lymphatic Vessels, Receptors, Tumor Necrosis Factor, Type I, Mice
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