Perspectives Winter/Spring 2018

This theory partially supports that the lymphatic system is responsible for the cleansing and recycling of the interstitial fluids. When overburdened with toxins, the fluids stagnate, altering fluid hemostasis. Inevitably, this leads to changes in the soft tissues, such as fibrosis and collagen proliferation. This may explain the resulting FP, and given the pathological changes, an opportunistic infection such as herpes can readily manifest. The study will begin by utilizing ICG-NIRF to visualize and appreciate the lympathic anatomy of aquatic tur- tles (red-eared sliders/Trachemys scripta elegans) and the Florida softshell turtle (Apalone ferox), and then sea turtle lymphatics using green sea turtles (Chelonia mydas) with and without FP. A three-day pilot study will be conducted at FAU in- volving five Florida softshell turtles and five red-eared sliders. These turtles’ lymphatics will be observed using ICG-NIRF. After injecting the turtles with ICG, the researchers will observe the uptake and flow, revealing details of the lymphatic vessels and structures. Given that ICG has a short half-life, observation will be one to two hours per turtle. Following ICG-NIRF, the turtles will be monitored for one week following ICG to observe weight, feeding habits, and signs of distress. The subsequent study will require a permit modifi- cation to study green sea turtles (Chelonia mydas), as they are a protected species. This study will also employ ICG-NIRF, but it will involve healthy green sea turtles in addition to green sea turtles with fibropap- illomatosis to distinguish if differences exist in their lymphatic systems, such as uptake, flow, congestion, or other morphological impairments. The study turtles will also be monitored for one week post-ICG to observe weight, feeding habits, and signs of distress. Concurrently, an in-depth exploration of the current literature on both FP and human papillomatosis will be conducted to fully appreciate what is currently known about both conditions. Collaboration with marine biol- ogy experts and lymphology experts will explore the histology, genetic, and even molecular presentations of these conditions. The expected outcomes are to better appreciate and understand sea turtle lymphatics, and to determine if, in part, the pathophysiology of human lymphatic failure can partially explain the process of FP in sea turtles, possibly leading to interventions for prevention and management. ● References Ridner S. Pathophysiology of lymphedema. Semin Oncol Nurs. 2013; 29:4-11. Ruocco V, Ruocco E, Brunetti G, et al. Opportunistic localization of skin lesions on vulnerable areas. Clinics in Dermatology . 2011; 29:483-488. Foot of LF pt with nodules A photo of Papillomatosis in humans was taken in Haiti by Heather Hettrick. Dr. Pallavi Patel College of Health Care Sciences 15