Our Research
Treatment of metastatic breast cancer requires surgical treatment and radiation therapy of the axillary lymph nodes. The disruption in the lymphatic flow may cause swelling of the affected limb known as lymphedema. Initial lymphedema often develops into chronic lymphedema, a progressive disease characterized by the loss of lymphatic function, accumulation of interstitial fluid and gradually to irreversible accumulation of fibrous adipose tissue. Lymphatic stasis, fibrosis, inflammation and adipose tissue expansion have been shown to play a role in lymphedema development, but the pathophysiology of lymphedema is still unresolved.
Our group investigates the pathophysiology, prediction and treatment of breast cancer-related lymphedema. We study the tissue composition and gene expression of both normal and lymphedematous skin and adipose tissue, with a particular focus on immune cells. We use single-cell RNA sequencing, spectral flow cytometry and immunofluorescence staining to obtain a comprehensive view on which cellular and molecular mediators are responsible for the initiation of adipose deposition and fibrosis in lymphedema. We are also characterizing the changes that take place in lymphatic endothelial cells as lymphedema progresses. Our aim is to clarify the pathophysiology of lymphedema and to pave the way for novel therapeutic approaches for this chronic and debilitating condition.
Lymphedema skin tissue. Blue shows anti-vimentin (intermediate filaments), red Lyve 1 (lymphatic vessels), lime anti-Ki67 (proliferating cells), and white DNA3 (nuclear staining). Imaging done with the Hyperion imaging mass cytometer by Gabriela Martinez Chacon.
Selected Publications (from 2020 onwards)
- Rannikko, Eeva H, Susanna Pajula, Sinikka H Suominen, Juha Kiiski, Maria R Mani, Martin Halle, Ilkka S Kaartinen, et al. “Phase II Study Shows Potential Benefit of Adenoviral Vascular Endothelial Growth Factor C (VEGF-C) and Lymph Node Transfer in Lymphedema.” Plastic & Reconstructive Surgery, August 12, 2024. https://doi.org/10.1097/PRS.0000000000011675.
- Conway, James R. W., Defne D. Dinç, Gautier Follain, Oona Paavolainen, Jasmin Kaivola, Pia Boström, Pauliina Hartiala, Emilia Peuhu, and Johanna Ivaska. “IGFBP2 Secretion by Mammary Adipocytes Limits Breast Cancer Invasion.” Science Advances 9, no. 28 (July 14, 2023): eadg1840. https://doi.org/10.1126/sciadv.adg1840.
- Leppäpuska, Ida-Maria, Pauliina Hartiala, Sinikka Suominen, Erkki Suominen, Ilkka Kaartinen, Maija Mäki, Marko Seppänen, et al. “Phase 1 Lymfactin® Study: 24-Month Efficacy and Safety Results of Combined Adenoviral VEGF-C and Lymph Node Transfer Treatment for Upper Extremity Lymphedema.” Journal of Plastic, Reconstructive & Aesthetic Surgery 75, no. 11 (November 2022): 3938–45. https://doi.org/10.1016/j.bjps.2022.08.011.
- Leppäpuska, Ida-Maria, Eeva H. Rannikko, Mervi Laukka, Emilia Peuhu, Raili Veemaa, Tiina Viitanen, Ilkka Koskivuo, and Pauliina Hartiala. “Low TGF-Β1 in Wound Exudate Predicts Surgical Site Infection After Axillary Lymph Node Dissection.” Journal of Surgical Research 267 (November 2021): 302–8. https://doi.org/10.1016/j.jss.2021.05.039.
- Hartiala, Pauliina, Sinikka Suominen, Erkki Suominen, Ilkka Kaartinen, Juha Kiiski, Tiina Viitanen, Kari Alitalo, and Anne M Saarikko. “Phase 1 LymfactinⓇ Study: Short-Term Safety of Combined Adenoviral VEGF-C and Lymph Node Transfer Treatment for Upper Extremity Lymphedema.” Journal of Plastic, Reconstructive & Aesthetic Surgery 73, no. 9 (September 2020): 1612–21. https://doi.org/10.1016/j.bjps.2020.05.009.