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Rivista di Angiologia

Official Journal of the International Union of Angiology, the International Union of Phlebology and the Central European Vascular Forum
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International Angiology 2002 March;21(1):1-8

lingua: Inglese

Role of the endothelium and blood stasis in the appearance of varicose veins

Michiels C., Bouaziz N., Remacle J.

From the Laboratoire de Biochimie et Biologie cel­lu­laire, University of Namur, Namur, Belgium


Today, chron­ic ­venous insuf­fi­cien­cy ­affects mil­lions of peo­ple but the inves­ti­ga­tion of veins and of ­venous dis­eas­es is still very poor. Additionally, the mech­a­nism of the occur­rence of var­i­cose veins is not under­stood. Blood sta­sis is often asso­ciat­ed with these path­o­log­i­cal sit­u­a­tions and we pro­pose that result­ing ischem­ic con­di­tions can trig­ger the endo­the­li­um to ­release inflam­ma­to­ry medi­a­tors and ­growth fac­tors. On one hand, the inflam­ma­to­ry medi­a­tors will ­recruit and acti­vate neu­troph­ils, which then infil­trate the ­venous wall and dam­age com­po­nents of the extra­cel­lu­lar ­matrix. On the other hand, ­growth fac­tors ­induce ­smooth mus­cle cell migra­tion, pro­life­ra­tion and de-dif­fe­ren­ti­a­tion into the syn­thet­ic phe­no­type, all togeth­er lead­ing to the for­ma­tion of neo­in­ti­ma. These pro­cess­es, being repeat­ed over time, would even­tu­al­ly lead to alter­a­tions of the ­venous wall as ­observed in var­i­cose veins. Venotropic drugs are used to treat chron­ic ­venous insuf­fi­cien­cy. They are able to ­increase ­venous tone and to ­decrease vein and cap­il­lary perme­abil­ity but they are also able to pro­tect the endo­the­lial cells ­against ische­mia. Indeed, they tar­get com­plex­es of the mit­o­chon­dri­al res­pir­a­to­ry chain and main­tain ATP pro­duc­tion dur­ing hypox­ia. Hence, the cells are resist­ant to ische­mia and do not ­release inflam­ma­to­ry medi­a­tors and ­growth fac­tors. These drugs ­should thus be able to pre­vent the alter­a­tions of the ­venous wall ­induced by blood sta­sis.

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