An international team led by National University of Singapore researchers has linked secondary lymphedema to excessive cholesterol buildup inside skin and around lymphatic vessels. Excess cholesterol deposition tracked with dermal fat cell enlargement, fat cell dysfunction, cell death, and fibrosis, while cholesterol-clearing interventions reduced swelling and improved lymphatic drainage in mouse models, alongside reduced tissue cholesterol and clinical procedures that improved drainage.
Secondary lymphedema involves impaired lymphatic drainage with progressive swelling, fat expansion, inflammation, and fibrosis, often following cancer treatment, infection, or injury. Lymphatic vessels transport cholesterol from peripheral tissues back into circulation, placing cholesterol clearance inside the functional scope of normal lymphatic drainage. Lymphatic vessels also have roles in immune surveillance, tissue fluid balance, and lipid transport.
In the study, “Targeting excessive cholesterol deposition alleviates secondary lymphoedema,” published in Nature, researchers investigated whether lymphatic insufficiency alters cholesterol handling and adipose tissue architecture.