Fellow: Rachelle Crescenzi, PhD

Institution: Vanderbilt University Medical Center

Principal Investigator: Manus Donahue, PhD

LF Funding History: HRiA/LE&RN/FDRS Postdoctoral Fellowship

Hypothesis: To determine the role of sodium levels and lymphatic function in the pathophysiology of lipedema through the development of molecular and functional MRI biomarkers.

Collaborative Opportunities: We are seeking collaborations to evaluate promising therapeutic strategies using sodium and lymphatic imaging metrics.

Current LF Collaborations: At the 2017 Fat Disorders Research Society (FDRS) Conference we collaborated with the former University of Arizona TREAT team to evaluate screening tools in the form of surveys and biophysical measurements of tissue fluid levels, muscle strength, and gait function.

Research Updates: 

• Magnetic Resonance Imaging reveals high tissue sodium and fat content in women with lipedema

Related news: LE&RN's interview of Rachelle and her research goals

Project: Functional Imaging of Sodium and Lymphatics in Women with Lipedema

Women with lipedema often appear similar to obese women or those with lymphedema of the legs. Yet treatments consisting of diet, exercise, and gastric bypass surgery are generally ineffective for weight loss. These patients also exhibit a superficial and palpable difference in skin texture that is often associated with a painful sensation to touch. The critical barrier to diagnosing lipedema and developing appropriate therapies lies in an overall lack of quantitative imaging modalities that are sensitive to the lymphatics and thus can be used to better understand the mechanisms of lipedema.

To address this need, we are developing clinically-accessible sodium and lymphatic magnetic resonance imaging (MRI) technologies to test the hypothesis that sodium and fat accumulate in tissue affected by impaired lymphatic clearance in women with lipedema. Our preliminary results demonstrate elevated sodium content in the skin and subcutaneous adipose tissue of the calf in patients with lipedema compared to females matched for age, body-mass-index (BMI), race, and calf-circumference. The next phase of our study will explore differences in sodium and fat accumulation due to secondary lymphedema of the legs.

We are actively developing i) sodium MRI technologies for a whole-body approach; ii) functional imaging of lymph nodes related to tissue fat, protein, and metabolite accumulation; and iii) noninvasive imaging of lymphatic vessel architecture to enable the measurement of lymph flow velocity.

The overall goal of this work is to provide imaging biomarkers of lipedema that can be applied in clinical diagnostic settings, as well as to evaluate the influence of therapies on tissue sodium and lymphatic function.