Metabolomic profiling of biological fluids of patients with lymphedema

Lymphedema is a congenital or acquired pathology which appears as an accumulation of a protein-rich fluid in the interstitial space, the limbs swelling, and subsequently fibrous changes in the skin and subcutaneous tissue due to functional disorders of the lymphatic bed. In our days, the use of conservative and surgical treatment can only stanch symptoms, slow down the progress of the disease and prevent complications. But, even in this case, the patient’s quality of life deteriorates. This makes the search for new and effective methods for the early diagnosis and treatment of lymphedema extremely urgent. This is especially important for patients after complex treatment of breast cancer. One of the main objectives of the paper is to identify changes in the metabolomic profiles of human biological fluids, such as blood serum and interstitial fluid. This work is aimed at identifying metabolomic markers - lymphedema precursors in the blood serum of patients in the early stages of the disease development. Metabolomic analysis allows to establishing the molecular mechanisms of lymphedema. The simultaneous use of high-field NMR spectroscopy and high-performance liquid chromatography with optical and mass spectrometric detection is sufficient for quantitative metabolomic profiling of biological fluids. The use of a metabolomic approach to the study of changes in the human lymphatic system functioning will contribute to both a better understanding of the mechanisms of the onset and development of lymph outflow dysfunction, and the development of new tools for early diagnosis and personalized treatment of lymphedema of various origins.