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A Journal on Phlebology
Acta Phlebologica 2013 December;14(3):99-107
The effects of minocycline on extracellular matrix in patients with chronic venous leg ulcers
Serra R. 1, 2, Grande R. 1, Buffone G. 1, Gallelli L. 3, De Franciscis S. 1, 2
1 Department of Medical and Surgical Science Magna Graecia University, Catanzaro, Italy;
2 Interuniversity Center of Phlebolymphology International Research and Educational Program in Clinical and Experimental Biotechnology Magna Graecia University, Catanzaro, Italy;
3 Department of Health Science Magna Graecia University, Catanzaro, Italy
Aim: Chronic venous disease is widespread in western countries and its main complication, venous ulceration of lower limbs, represents an important issue affecting health care economic systems and quality of life of patients. Dysfunction in extracellular matrix often caused by metalloproteinases alteration may play an important role in ulcer formation and in delaying wound healing. Tetracyclines seems to have a modulatory effect on metalloproteinases. In this study we tested the efficacy of minocycline in therapeutic managing of venous ulcers.
Methods: An open label, parallel-groups, single clinical center study was conducted between January 2010 and October 2012. Sixty patients with venous ulceration of the lower limbs were recruited and were randomized into two groups: Group A 28 patients (6M/22F), Group B 32 patients (11M/21F). Patients of Group A received the administration of oral doses of minocycline 50 mg b.i.d. for 3 months in addition to basic treatment (compression therapy followed or not by vein surgery). Patients of Group B received basic treatment only.
Results: Group A showed a higher healing rate compared with group B as documented also by evaluation of levels of metalloproteinase-9, neutrophil gelatinase-associated lipolicalin and vascular endothealial growth factor documented in plasma, wound fluid and biopsies collected from both groups.
Conclusion: Minocycline administration, through the inhibition of MMPs and its immunomodulatory and anti-inflammatory actions in extracellular matrix showed a beneficial therapeutic effect on wound healing of chronic venous ulcers.