Abstract:  Lymphoedema Cause 
The real “why” or lowest common denominator of all lymphoedema is often overlooked or missed yet is of extreme importance when considering lymphoedema treatment options. 

Research indicates the causes activating lymphoedema swelling can be many and varied. An accidental bump; an insect bite; an operation; radiation therapy, or cancer therapy. Any of these things can be the trigger of lymphoedema.  

This page explains the ‘why' and common denominator causing all lymphoedema swelling. It shows the simplicity and real objective for all lymphoedema reduction and control procedures regardless of the trigger.

The common denominator of all Lymphoedema.
The common denominator of all lymphoedema (regardless of cause) is the accumulation of excess (plasma) proteins in the interstitial fluids contained in soft tissues of the body, under normal load conditions, and over a prolonged and indefinite period of time due to insufficiency of the lymphatics. Remove the excess proteins and the lymphoedema will reduce. This hypothesis was put forward by Willoughby (UK 1970) and proved by Casley-Smith J.R and Casley-Smith J. (Australia 1980) (4) 

To explain, every person has plasma proteins distributed throughout their body, the majority are contained in the pressurized blood circulatory system with the remainder residing in interstitial fluids at below atmospheric pressure where they are just termed proteins.

Plasma proteins control levels of extra-cellular fluid (blood plasma proteins & protein of interstitial fluids) by osmotic action. They (the plasma proteins) are essential for maintaining an optimally functioning system and control the level of extra cellular fluids distributed within each part of the body, so decreasing intake of protein rich food will not solve or reduce the problem of lymphoedema. 

In soft tissues functioning within normal parameters, there is an optimal set 2% level of (plasma) protein maintained in interstitial fluid (these are the fluids that travel through the interstitial (soft) tissues). The level of protein in interstitial fluids contained in the tissues of the body is approximately one fourth of that found in blood plasma ⁽⁶⁾.

The 2% level of interstitial fluid protein is normally maintained in equilibrium predominantly by the lymphatic system, which remove proteins contained in interstitial fluid equal to the volume they were deposited from the capillary ends of the arterial blood circulatory system, and to a lesser degree by wandering macrophages in the tissues, which by phagocytosis eat up or dissolve a small number of plasma proteins in interstitial fluids.

Conclusion: Lymphoedema is caused by an accumulation of (plasma) protein greater than 2% of interstitial fluids contained in the soft tissues of the body. The cause of accumulated excess protein in the interstitial fluids is resultant from lymphatic dysfunction or lymphatic insufficiency and cessation of macrophage activity from protein overload for a prolonged period of time where lymphoedema swelling is apparent.

It is only by returning the level of proteins back to a ratio of 2% in interstitial tissue fluids will the oedema in Lymphoedema be controlled. This is the real and main objective for all Lymphoedema control procedures. This website provides information and resources to help and assist you achieve this objective. 

© Copyright May 2008 Poppy Lane Skin Care & Lymphoedema Clinic, Lansvale. N.S.W. 2166 Australia  

For more detailed information go to the Lymphoedema control page

References:
1. Casley - Smith JR "Benzo pyrones in lymph.dema" Int Angiol, 1997 in press
2. Casley-Smith JR & Judith R "High Protein Oedema and the Benzo Pyrones, Lippincott Sydney & Balt (1986) History of Lymphatics & Lymphoedema; Chap1, p2 
3. C.R O'Kennedy, R.D Thorns, N.Y Wiley, "Coumarin - 'Biology, Application and modes of action".1997a: 143 - 184
4. Casley-Smith JR & Judith R "Modern Treatment for Lymphoedema "Fifth Edition (Pg 233) Bowden Printing, Adelaide
5.  Robert Twycross, Karen James & Jacquelyne Todd. "Lymphoedema" Ausmed Publications P/L. ISBN 0 9579876 68.
6. Eldra Pearl Solomon, Linda R. Berg, Diana W. Martin.  “Biology”, Fifth Edition,  Saunders College Publishing, Orlando Florida , USA . ISBN: 0-03-022299-0.  Internal Transport 42 p925.

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