Cited by 118Lymphatic System and DiseasesLymphatic Disorders and TreatmentsParasitic Diseases Research and Treatment

Anti-inflammatory pharmacotherapy with ketoprofen ameliorates experimental lymphatic vascular insufficiency in mice

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Nakamura, Kenta, Radhakrishnan, Kavita, Wong, Yat Man, Rockson, Stanley G.·2009·PLoS ONE

Abstract

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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Research works printed but not linked: 2

  1. [14]Rockson SG 2001 Lymphedema. Am J Med 110 288 295 11239847
  2. [19]Ulfgren AK Andersson U Engstrom M Klareskog L Maini RN 2000 Systemic anti-tumor necrosis factor alpha therapy in rheumatoid arthritis down-regulates synovial tumor necrosis factor alpha synthesis. Arthritis Rheum 43 2391 2396 11083259

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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
Published
2009-12-21
Volume
4
Issue
12
Pages
e8380
ISSN
1932-6203 (ISSN-L)
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
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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