Topical captopril: A promising treatment for secondary lymphedema Journal Article


Authors: Brown, S.; Nores, G. D. G.; Sarker, A.; Ly, C.; Li, C. C.; Gardenier, J.; Hespe, G. E.; Brown, T.; Park, H. J.; Campbell, A.; Shin, J.; Kataru, R. P.; Aras, O.; Dayan, J. H.; Mehrara, B. J.
Article Title: Topical captopril: A promising treatment for secondary lymphedema
Abstract: Transforming growth factor-beta 1 (TGF-β1)-mediated tissue fibrosis is an important regulator of lymphatic dysfunction in secondary lymphedema. However, TGF-β1 targeting can cause toxicity and autoimmune complications, limiting clinical utility. Angiotensin II (Ang II) modulates intracellular TGF-β1 signaling, and inhibition of Ang II production using angiotensin-converting enzyme (ACE) inhibitors, such as captopril, has antifibrotic efficacy in some pathological settings. Therefore, we analyzed the expression of ACE and Ang II in clinical lymphedema biopsy specimens from patients with unilateral breast cancer-related lymphedema (BCRL) and mouse models, and found that cutaneous ACE expression is increased in lymphedematous tissues. Furthermore, topical captopril decreases fibrosis, activation of intracellular TGF-β1 signaling pathways, inflammation, and swelling in mouse models of lymphedema. Captopril treatment also improves lymphatic function and immune cell trafficking by increasing collecting lymphatic pumping. Our results show that the renin-angiotensin system in the skin plays an important role in the regulation of fibrosis in lymphedema, and inhibition of this signaling pathway may hold merit for treating lymphedema. © 2023 Elsevier Inc.
Keywords: mouse; animal; metabolism; animals; mice; lymphedema; fibrosis; angiotensin ii; transforming growth factor beta1; captopril; dipeptidyl carboxypeptidase inhibitor; angiotensin-converting enzyme inhibitors
Journal Title: Translational Research
Volume: 257
ISSN: 1931-5244
Publisher: Elsevier Science, Inc.  
Date Published: 2023-07-01
Start Page: 43
End Page: 53
Language: English
DOI: 10.1016/j.trsl.2023.01.005
PUBMED: 36736951
PROVIDER: scopus
PMCID: PMC10192126
DOI/URL:
Notes: The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PubMed record and PDF. Corresponding author is MSK author Babak J. Mehrara -- Catherine Ly was incorrectly listed a second time on the author list. Stav Brown's first name was incorrectly listed as "Tal" -- Source: Scopus
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MSK Authors
  1. Babak Mehrara
    449 Mehrara
  2. Omer Aras
    75 Aras
  3. Geoffrey Eckerson Hespe
    24 Hespe
  4. Raghu Prasad Kataru
    61 Kataru
  5. Joseph Henry Dayan
    101 Dayan
  6. Catherine L Ly
    15 Ly
  7. Hyeung Ju Park
    20 Park
  8. Jinyeon Shin
    22 Shin
  9. Ananta Sarker
    8 Sarker