When Dr. Spencer Gibson arrived at the University of Alberta four years ago, he knew he was stepping into an overlooked area of medicine.
Appointed as the Dianne and Irving Kipnes Endowed Chair in Lymphatic Disorders, Gibson became the only scientist in Canada working specifically on lymphedema—a condition marked by painful swelling of the arms or legs caused by fluid buildup in the lymphatic system.
Lymphedema comes in two forms. Primary lymphedema is caused by genetic mutations that disrupt the lymphatic system from birth.
Secondary lymphedema is far more common and occurs when cancer treatments, infections, or injuries damage an otherwise healthy system. In both cases, the swelling can be disabling.
Current treatments, such as compression garments or manual drainage, only provide temporary relief. “Once you stop, it comes right back,” Gibson explained.
The question driving Gibson’s research is why some people develop lymphedema after lymphatic damage while others do not. His latest study, published in EMBO Molecular Medicine, begins to shed light on the role diet may play.
Over the past three years, Gibson and his team built a biobank of blood samples from 70 patients with lymphedema.
Because obesity and excess weight are known risk factors, the researchers started by examining fats, or lipids, in the blood. They found that people with lymphedema had fewer healthy fats and more harmful ones.
To test this further, they turned to animal models. The results were striking: a high-fat diet either triggered or worsened lymphedema, while returning to healthier food reversed the condition.
“This clearly shows us diet is contributing to the progression of lymphedema,” Gibson said. But diet alone doesn’t explain everything. After all, many people eat high-fat diets without developing the condition.
Here, earlier cancer research provided a clue. A protein called fatty acid binding protein 4 (FABP4), which ferries fatty acids into cells, was found to be nearly three times higher in lymphedema patients compared to those without it.
When Gibson’s team blocked FABP4 in animal models—using a chemical already in clinical trials for other conditions—they saw a 50% reduction in lymphedema.
The combination of these findings points toward a potential new path for prevention and treatment. In the short term, Gibson hopes to test whether a low-saturated-fat diet could reduce stress on FABP4, allowing it to process beneficial fats instead of harmful ones. He is also investigating other environmental stressors that may make the lymphatic system more vulnerable, such as cancer therapies, low oxygen levels, and oxidative stress.
Importantly, Gibson is not working alone. He collaborates with colleagues across disciplines, including experts in lipid biology, nutrition, rehabilitation, and oncology. This team-based approach could lead to a range of solutions—from dietary changes and supplements to repurposing existing FDA-approved drugs.
For Gibson, what began as a lonely endeavor has quickly gained momentum. More trainees are entering the field, and patients themselves are increasingly engaged in research, often sharing their experiences to help guide future studies.
“Patients who participate in studies share their experiences, and this creates hope for others,” Gibson said. “It becomes a positive feedback loop, with patients contributing to research and research contributing back to the patients.”
The message of his work is hopeful: while lymphedema remains incurable, diet and targeted treatments may offer new ways to manage—and perhaps even prevent—it in the future.
