Project: Role of fascial alterations in lipedema

Principal Investigator: Carla Stecco, MD
Professor of Human Anatomy and Movement Sciences
University of Padova
Padova, Italy

Co-Principal Investigator: Caterina Fede, PhD
Department of Neurosciences, Institute of Human Anatomy
University of Padova
Padova, Italy

Co-Principal Investigator: Carmelo Pirri, MD, PT, PhD
Department of Neurosciences, Institute of Human Anatomy
University of Padova
Padova, Italy

Summary

This research explores the microscopic alterations related to lipedema and changes of subcutaneous tissue associated with the development and evolution of the disease. A correct staging and diagnosis of the pathology is at the basis of a targeted therapy for the improvement of the patients' quality of life.  

Background

The pathophysiology of lipedema remains unclear and the diagnosis is currently made on clinical grounds. Our hypothesis is that the superficial fascia (SF) and the subcutaneous connective tissue play a key role in the pathogenesis. The SF is well vascularized and innervated, and the tissue changes according to various physiopathological factors. We will measure SF features by Ultrasound imaging and histology/microanatomy studies, revealing changes of the tissue not highlighted on normal clinical inspection.

Methodology

This is an imaging and microanatomy study of lipedema. We’ll analyze 24 inferior limbs for each condition (healthy/lipedema) by ultrasound imaging (US): the superficial fascia (SF) and retinacula cutis will be analyzed with an accurate assessment, to monitor changes associated with the development and evolution of the disease. Then, we’ll analyze the general organization of the tissue (thickness of the retinacula cutis, orientation of the fibrous ligaments, thickness of the SF) in 24 human samples for healthy and lipedema. We'll evaluate HA, collagen-I and -III, elastic fibers, innervation, to understand what layer is more involved in lipedema. Besides, we will correlate US and histology results to understand which structure is majorly involved in the pathogenesis of the disease. We aim to demonstrate the role of the connective tissue in organizing and supporting the adipose tissue and to define what are the optimal definitions of pathological cut-offs among the ultrasound parameters.  

Expected outcomes

We expect to find on lipedema patients an alteration of thickness, echogenicity and texture analysis at the level of the superficial fascia, retinacula cutis and adipose tissue revealed by US imaging. Moreover, our hypothesis is that the composition of SF (collagen/hyaluronan/elastic fibers), as well as innervation, vascularization and lymphatic vessels will be altered in lipedema patients. These alterations will help to better characterize the pathology, permitting a good diagnosis and stadiation of lipedema.

Practical implementations of results

To improve the diagnosis of lipedema and its staging, supporting the clinical evaluation with ultrasound imaging. In such a way it will be possible to target a better and more personalized therapy.

Our Research Grantees by:   Topic | Recent Projects | Past Projects

LF52_22