Lymphedema is the build-up of fluid in body tissues when the lymphatic system has been damaged or blocked. It is characterized by swelling due to decreased transport of lymphatic fluid, which, over time, results in changes in the architecture of the skin (increase in fatty tissue, thickening and hardening) in affected areas.  Fluid build-up causes swelling which may occur in one or more limbs, and may include other parts of the body. Lymphedema often causes long-term physical, psychological, and social problems for patients and significantly impacts quality of life.

lymphedema examples

Courtesy of Klose Training

Lymphedema can be either primary (occurs on its own) or secondary (caused by another disease or condition). Primary lymphedema is caused by the absence of certain lymph vessels at birth, or abnormalities in the lymphatic vessels.  It is commonly classified by age of onset. Primary lymphedema is uncommon, and is expected to be eligible for orphan designation. Secondary lymphedema usually develops as a result of a blockage or interruption that alters the flow of lymph through the lymphatic system and can develop from an infection, malignancy, surgery, scar tissue formation, trauma, radiation, or other cancer treatment.  Both forms of lymphedema often negatively impact quality of life and can be debilitating.  There is no approved pharmacologic treatment for lymphedema.

Current standard of care includes complete decongestive therapy, which involves an initial intensive regimen of manual lymphatic drainage, exercise, skin care, and use of compression garments, followed by long-term maintenance therapy.  While effective, these approaches are often time-consuming and costly, and do not address the root cause of lymphedema.

Pathogenesis of Lymphedema

Under the direction of Dr. Stanley Rockson at Stanford University, researchers in demonstrated for the first time that a naturally-occurring inflammatory substance known as LTB4 is elevated in both animal models of lymphedema as well as human lymphedema and that elevated LTB4 is a cause of tissue inflammation and impaired lymphatic function. Targeted pharmacologic inhibition of LTB4 promotes physiological lymphatic repair and reverses lymphedema disease in treated animals.  This work demonstrates a novel function of LTB4 in the pathogenesis of lymphedema, suggesting that blocking the effects of LTB4 may be a promising and safe new therapeutic strategy for this disease.  There are currently no approved pharmacological agents for lymphedema.

Eiger Bio has acquired an exclusive license to this technology for targeting the effects of leukotriene B4 (LTB4) to reverse structural tissue changes and improve lymphatic function, providing a potential preventative and therapeutic approach for treating lymphedema.  The technology was invented by Dr. Stanley Rockson, MD, Director of the Center for Lymphatic and Venous Disorders and the Allan and Tina Neill Professor Lymphatic Research and Medicine, both at Stanford University.


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