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Keles A, Karaman SK, Duzgun AC, Buyuksireci M, Bayraktaroglu MS. Association between lower extremity venous insufficiency and increased choroidal thickness. J Fr Ophtalmol 2023:S0181-5512(23)00120-1. [PMID: 36948916 DOI: 10.1016/j.jfo.2023.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 01/23/2023] [Indexed: 03/24/2023]
Abstract
PURPOSE The goal of this study is to investigate the association between the choroid and lower extremity venous insufficiency (LEVI). METHODS This prospective cross-sectional study includes 56 patients with LEVI and 50 age/sex-similar control subjects. Choroidal thickness (CT) measurements from 5 different points were captured from all participants by optical coherence tomography. In the group with LEVI on physical examination, reflux at the saphenofemoral junction, and the diameter of the great and small saphenous veins were evaluated via color Doppler ultrasonography. RESULTS The mean subfoveal CT was higher in the varicose group than in the control group (363.04±99.75μm vs. 320.30±73.46μm, P=0.013). In addition, the CTs at the temporal 3mm, temporal 1mm, nasal 1mm, and nasal 3mm distance from the fovea were higher in the LEVI group compared to the controls (for all, P<0.05). There was no correlation between CT and diameter of the great and small saphenous vein in patients with LEVI (for all, P>0.05). However, the great and small saphenous veins of patients with CT above 400μm were observed to be wider in patients with LEVI (P=0.027 and P=0.007, respectively). CONCLUSION Varicose veins can be a feature of systemic venous pathology. Another component of systemic venous disease may be increased CT. Patients with high CT should be investigated for susceptibility to LEVI.
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Affiliation(s)
- A Keles
- Department of Ophthalmology, Faculty of Medicine, Bilecik Seyh Edebali University, Bilecik, Turkey.
| | - S K Karaman
- Department of Ophthalmology, University of Health Sciences, Ankara Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - A C Duzgun
- Department of Cardiovascular Surgery, Ankara Training and Research Hospital, Ankara, Turkey
| | - M Buyuksireci
- Department of Radiology, Çorum Private Hospital, Çorum, Turkey
| | - M S Bayraktaroglu
- Department of Cardiovascular Surgery, Ankara Training and Research Hospital, Ankara, Turkey
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2
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Costa D, Andreucci M, Ielapi N, Serraino GF, Mastroroberto P, Bracale UM, Serra R. Molecular Determinants of Chronic Venous Disease: A Comprehensive Review. Int J Mol Sci 2023; 24:ijms24031928. [PMID: 36768250 PMCID: PMC9916309 DOI: 10.3390/ijms24031928] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/16/2023] [Accepted: 01/17/2023] [Indexed: 01/20/2023] Open
Abstract
Chronic Venous Disease (CVD) refers to several pathological and hemodynamic alterations of the veins of lower limbs causing a wide range of symptoms and signs with a high prevalence in the general population and with disabling consequences in the most severe forms. The etiology and pathophysiology of CVD is complex and multifactorial, involving genetic, proteomic, and cellular mechanisms that result in changes to the venous structure and functions. Expressions of several genes associated with angiogenesis, vascular development, and the regulation of veins are responsible for the susceptibility to CVD. Current evidence shows that several extracellular matrix alterations (ECM) could be identified and in some cases pharmacologically targeted. This review shows the most up to date information on molecular determinants of CVD in order to provide a complete overview of the current knowledge on this topic. In particular, the article explores the genetic influence, the hormonal influence, ECM imbalance, and histopathology of CVD and the role of endothelial dysfunction in CVD.
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Affiliation(s)
- Davide Costa
- Department of Law, Economics and Sociology, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy
- Interuniversity Center of Phlebolymphology (CIFL), International Research and Educational Program in Clinical and Experimental Biotechnology, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy
| | - Michele Andreucci
- Department of Health Sciences, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy
| | - Nicola Ielapi
- Department of Public Health and Infectious Disease, “Sapienza” University of Rome, 00185 Rome, Italy
| | - Giuseppe Filiberto Serraino
- Department of Experimental and Clinical Medicine, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy
| | - Pasquale Mastroroberto
- Department of Experimental and Clinical Medicine, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy
| | | | - Raffaele Serra
- Interuniversity Center of Phlebolymphology (CIFL), International Research and Educational Program in Clinical and Experimental Biotechnology, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy
- Department of Medical and Surgical Sciences, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy
- Correspondence:
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Zha B, Qiu P, Zhang C, Li X, Chen Z. GPR30 Promotes the Phenotypic Switching of Vascular Smooth Muscle Cells via Activating the AKT and ERK Pathways. Onco Targets Ther 2020; 13:3801-3808. [PMID: 32440148 PMCID: PMC7212987 DOI: 10.2147/ott.s244128] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 04/14/2020] [Indexed: 12/24/2022] Open
Abstract
Background Lower extremity varicose veins (LEVVs) are a common venous disorder of venous dilation and tortuosity. The functional integrity of vascular smooth muscle cells (VSMCs), the majority of the cells in venous tissues, and their phenotypic differences play important roles in the occurrence and development of LEVV. However, the underlying mechanism remains unclear. Methods The expression of estrogen receptors ERα and ERβ and G-protein-coupled receptor 30 (GPR30) in LEVV tissues and the role of GPR30 in VSMC phenotypic switching were examined by Western blotting and quantitative real-time PCR. Finally, the related mechanisms underlying LEVVs were explored by Western blotting. Results The serum estradiol content was increased in LEVV patients compared with normal control patients, but the mRNA levels of ERα and ERβ were not significantly different. GPR30 was overexpressed in LEVVs, and high expression of GPR30 promoted the maintenance of a synthetic phenotype in which OPN, MMP-1 and MMP-9 were highly expressed and α-SMA was poorly expressed in VSMCs. Finally, the mechanism by which GPR30 promotes the phenotypic switching of VSMCs is dependent on the ERK1/2 and AKT pathways. Conclusion GPR30 may contribute to the pathogenesis of LEVVs by promoting the maintenance of a synthetic phenotype in VSMCs by activating the ERK1/2 and AKT pathways, and GPR30 might be a novel therapeutic target for clinical LEVV treatment.
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Affiliation(s)
- Binshan Zha
- Department of Vascular and Thyroid Surgery, Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China
| | - Peng Qiu
- Department of Vascular Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, and Vascular Center of Shanghai Jiaotong University, Shanghai, People's Republic of China
| | - Chenxin Zhang
- Department of Cardiovascular Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China
| | - Xinyuan Li
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, People's Republic of China
| | - Zhiyong Chen
- Department of Vascular and Thyroid Surgery, Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China
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García-Honduvilla N, Asúnsolo Á, Ortega MA, Sainz F, Leal J, Lopez-Hervas P, Pascual G, Buján J. Increase and Redistribution of Sex Hormone Receptors in Premenopausal Women Are Associated with Varicose Vein Remodelling. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2018; 2018:3974026. [PMID: 30250632 PMCID: PMC6140006 DOI: 10.1155/2018/3974026] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 07/12/2018] [Accepted: 08/05/2018] [Indexed: 02/07/2023]
Abstract
In chronic venous insufficiency of the lower limbs, data show that the clinical manifestation is varicose veins (VVs), and VV epidemiology suggests that sex hormones directly influence disease development through intracellular receptors. This study aimed to determine the presence and localization of oestrogen receptors (ERs), progesterone receptors (PRs), and androgen receptors (ARs) in both healthy and VV wall cells and their relationship with gender. In this study, samples from patients without a history of venous disease (CV) (n = 18) and with VV (n = 40) were used. The samples were divided by gender: CV women (CVw) = 6, CV men (CVm) = 12, VV women (VVw) = 25, and VV men (VVm) = 15. RT-qPCR and immunohistochemical techniques were performed, and increased ER and PR protein expression was found in VVw in all tunica layers. ARs were localized to the adventitial layer in the CV and were found in the neointima in VVs. mRNA expression was increased for ER and PR in VVw. AR gene expression was significantly decreased in VVm. The increase in the number of these receptors and their redistribution through the wall reinforces the role of sex hormones in varicose vein development.
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Affiliation(s)
- Natalio García-Honduvilla
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares. Networking Biomedical Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
- University Center of Defense of Madrid (CUD-ACD), Madrid, Spain
| | - Ángel Asúnsolo
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
- Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcala, Alcala de Henares, Madrid, Spain
| | - Miguel A. Ortega
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares. Networking Biomedical Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
| | - Felipe Sainz
- Angiology and Vascular Surgery Service, Ruber International Hospital, Madrid, Spain
| | - Javier Leal
- Angiology and Vascular Surgery Service, Central University Hospital of Defense-UAH, Madrid, Spain
| | - Pedro Lopez-Hervas
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
- Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcala, Alcala de Henares, Madrid, Spain
- General Surgery and Digestive Service, Ramón y Cajal University Hospital, Madrid, Spain
| | - Gemma Pascual
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares. Networking Biomedical Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
| | - Julia Buján
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares. Networking Biomedical Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
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Kadam P, Lim J, Paver I, Connor DE, Parsi K. Telangiectatic Matting is Associated with Hypersensitivity and a Bleeding Tendency. Eur J Vasc Endovasc Surg 2018; 55:554-559. [PMID: 29409702 DOI: 10.1016/j.ejvs.2017.12.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 12/14/2017] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The aim was to investigate the pathogenesis of telangiectatic matting (TM) and identify possible risk factors. METHODS This study had two parts. The clinical records of consecutive patients were retrospectively analysed to identify risk factors for TM. In the second part, the haemostatic and coagulation profile of the subset of patients with TM were analysed and compared with controls using standard coagulation tests, platelet function and a global assay of coagulation (rotational thromboelastometry, ROTEM). RESULTS In 352 consecutive patients presenting to a phlebology practice, 25 patients had TM (7.1%). All 25 patients were female with the median age of 45 (27-57) years. A comprehensive medical history was taken. Among 27 possible risk factors assessed, statistically significant associations included recurrent epistaxis, easy bruising, hypersensitivity (eczema, hives, hay fever, and rhinitis), previous treatment with sclerotherapy or endovenous laser for lower limb veins, and a family history of telangiectasias. Variables not associated with TM included oral contraceptive intake, hormone replacement therapy, and age. The haemostatic and coagulation profile of 12 patients (6 male and 6 female) with TM did not differ significantly from those without TM. CONCLUSION TM is associated with both hypersensitivity and a bleeding tendency. This study revealed no significant increase in the incidence of haemostatic abnormalities in patients with TM compared with the control group. Given the significant association with hypersensitivity disorders, the underlying mast cell hyper-reactivity may contribute to both hypersensitivity and a bleeding tendency and predispose patients to TM.
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Affiliation(s)
- Pooja Kadam
- Dermatology, Phlebology and Fluid Mechanics Laboratory, St Vincent's Centre for Applied Medical Research, Darlinghurst, Australia; Department of Dermatology, St Vincent's Hospital, Darlinghurst, Australia; Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Jerrick Lim
- Dermatology, Phlebology and Fluid Mechanics Laboratory, St Vincent's Centre for Applied Medical Research, Darlinghurst, Australia; Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Ian Paver
- Dermatology, Phlebology and Fluid Mechanics Laboratory, St Vincent's Centre for Applied Medical Research, Darlinghurst, Australia; Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - David E Connor
- Dermatology, Phlebology and Fluid Mechanics Laboratory, St Vincent's Centre for Applied Medical Research, Darlinghurst, Australia; Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Kurosh Parsi
- Dermatology, Phlebology and Fluid Mechanics Laboratory, St Vincent's Centre for Applied Medical Research, Darlinghurst, Australia; Department of Dermatology, St Vincent's Hospital, Darlinghurst, Australia; Faculty of Medicine, University of New South Wales, Sydney, Australia.
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Abstract
SummaryIntroduction: Varicose veins affect up to 40 % of men and up to 51 % of women. The patho-physiology of primary varicosis (chronic venous insufficiency, CVI) is poorly understood. Here, the available data on possible endocrine mechanisms in healthy and varicose veins are reviewed.Methods: An extensive literature search was conducted in PubMed using the following key words: Chronic venous insufficiency, CVI, chronic venous disease, CVD, varicosis, saphenous vein, pathogenesis, hormone.Results: Several theories ranging from incompetence of the valves to functional, biological or morphologic changes in different layers of the vein wall have been proposed. However, an increasing body of evidence suggests that endocrine mechanisms might be involved in the pathogenesis of primary varicosis. In this respect a growing number of hormones (e.g. estrogen, progesterone, relaxin-2, and oxytocin) and their receptors have been linked to primary varicosis in experimental, pharmacological and histological studies.Conclusion: In summary, endocrine-based mechanisms seem to play a role in the pathogenesis of primary varicosis. This opens up the perspective for pharmacological treatments targeting the various described endocrine regulatory networks.
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Qiu P, Zha B, Zhu H, Xie W, Si X, Tang D, Zhang C. Association between Clinical and Ultrasonic Characteristics of Varicocele and Lower Extremity Varicose Vein in Men. Ann Vasc Surg 2016; 38:298-304. [PMID: 27531086 DOI: 10.1016/j.avsg.2016.05.105] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 04/03/2016] [Accepted: 05/08/2016] [Indexed: 11/18/2022]
Abstract
BACKGROUND The study investigated the association between lower extremity varicose veins in men and varicocele. METHODS A total of 100 patients who presented to the Department of Vascular Surgery in the First Affiliated Hospital of Anhui Medical University with the diagnosis of lower extremity varicose veins were included in the study group. A total of 100 adults without vascular disease were included as controls. The prevalence of varicocele between the study group and the control group was compared. We compared the prevalence of varicocele and the mean diameter of spermatic veins between the patients with and without reflux in the saphenofemoral junctions. We analyzed the association between the maximum spermatic vein diameter and the maximum diameter of lower extremity varicose veins in patients who had both lower extremity varicose vein and varicocele in the study group. According to their clinic signs, patients with lower extremity varicose veins were divided into C1-C6 by clinic sign grade of Clinical-Etiology-Anatomy-Pathophysiology (CEAP), and we investigated the trend of the incidence of varicocele and the mean diameter of spermatic veins in different grades. RESULTS The patients with lower extremity varicose veins had a statistically significant (χ2 = 20.05, P < 0.01) higher rate of varicocele when compared with controls. We compared the prevalence of varicocele and the mean diameter of spermatic veins between the patients with and without reflux in the saphenofemoral junctions and found no statistically significant differences between them (prevalence of varicocele P > 0.05, diameter P > 0.05). We found a linear correlation between the maximum spermatic vein diameter and the maximum diameter of lower extremity varicose veins in the patients who had both lower extremity varicose veins and varicocele in the study group (coefficient of rank correlation r = 0.4072, P < 0.01). The patients in the study group were classified into 6 grades by CEAP. After the analysis by trend chi-square, we found that the prevalence of varicocele had no statistical trend in different grades (χ2 = 0.8798, P > 0.05), and the mean diameter of spermatic vein also had no statistical trend in different grades (F = 1.59, P > 0.05). CONCLUSIONS In conclusion, we demonstrated that the prevalence of varicocele is higher in patients with varicose veins in lower extremity than the patients without vascular diseases. The reason for the association between varicose vein in lower extremity and varicocele remains uncertain.
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Affiliation(s)
- Peng Qiu
- Department of General Surgery, The Fourth Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Binshan Zha
- Department of Vascular Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Huagang Zhu
- Department of Vascular Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China.
| | - Wentao Xie
- Department of Vascular Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Xiaomao Si
- Department of General Surgery, The TCM Hospital of Nanling County Wuhu City, Wuhu, China
| | - Dongdong Tang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Chao Zhang
- Department of Radiology, Affiliated Yijishan Hospital of Wannan Medical College, Wuhu, China
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Gulcu A, Ozutemiz C, Ugurlu B, Kose T. Duplex ultrasonography findings are not related to menstrual cycle phases in women with early symptoms of lower extremity chronic venous disease. JOURNAL OF CLINICAL ULTRASOUND : JCU 2016; 44:85-91. [PMID: 26178614 DOI: 10.1002/jcu.22287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Revised: 06/11/2015] [Accepted: 06/27/2015] [Indexed: 06/04/2023]
Abstract
PURPOSE To investigate if duplex ultrasonography findings change according to the menstrual cycle phases in women with early symptoms of lower extremity chronic venous disease. METHODS Thirty women (60 extremities) aged 18-50 years with regular menstrual cycles who presented with complaints of telangiectasia and/or trunk varices with accompanying leg pain were evaluated prospectively by duplex ultrasonography at three different times of a single menstrual cycle. Previous DVT or menstrual irregularities were exclusion criteria. All exams were performed by the same radiologist, under the same conditions. Reflux was provoked in the deep veins, great saphenous vein (GSV), and small saphenous vein (SSV) using the Valsalva maneuver. Reflux times in each vein and average diameters of the GSV and SSV were recorded. RESULTS Reflux times showed no significant differences in any of the vein segments and the diameters of GSV and SSV were similar in the different menstrual phases (p > 0.05). Reflux was not predominant at any specific phase, and its presence was independent of menstrual phase. CONCLUSIONS Reflux was not specific to a particular phase of menstrual cycle in women with early symptoms of chronic venous disease.
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Affiliation(s)
- Aytac Gulcu
- Department of Radiology, Dokuz Eylul University, Izmir, Turkey
| | - Can Ozutemiz
- Department of Radiology, Dokuz Eylul University, Izmir, Turkey
| | - Baran Ugurlu
- Department of Thoracic and Cardiovascular Surgery, Dokuz Eylul University, Izmir, Turkey
| | - Timur Kose
- Department of Biostatistics and Medical Informatics, Ege University School of Medicine, Izmir, Turkey
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Özcan S, Odabasi D, Kurt T, Gür AK, Kunt A, Balaharoglu Y, Kunt AS. Impact of elevated serum estradiol/free testosterone ratio on male varicose veins in a prospective study. Wien Klin Wochenschr 2014; 127:764-9. [PMID: 25409949 DOI: 10.1007/s00508-014-0652-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2014] [Accepted: 10/19/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Although some studies indicate an association between increased levels of estradiol and varicose veins in women, the role of sex hormones on varicose veins have a question mark in men. METHODS We investigated estradiol-2/free testosterone (E2/fT) ratio relationship on varicosity in 100 male patients dividing them into two groups. Group A (n = 46) had varicose veins with endocrinological problems, especially infertility, whereas group B (n = 54) also had varicose veins but no endocrinological problems. Venous blood samples were drawn from both groups in the morning to detect the levels of serum estradiol (E2), androstenedione, dehydroepiandrostenedione sulphate and free testosterone (fT). Patient history, physical examination, colour duplex ultrasound of both limbs and classification of CEAP were performed in both groups. Serum E2/fT ratio was calculated in correspondence with CEAP classification. CEAP classification is the varicosity classification, and it is concerned about the clinical class (C), etiology (E), anatomical distribution (A) and underlying pathophysiology (P). RESULTS E2/fT ratio was significantly higher in group A (4.18 ± 0.54) compared with group B (2.98 ± 0.36). Moreover, there is a high correlation between serum E2/fT ratio and CEAP clinical classification in group A (4) compared with group B (2). CONCLUSION Serum E2/fT ratio is associated with varicose veins in male patients.
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Affiliation(s)
- Sedat Özcan
- Department of Cardiovascular Surgery, Faculty Of Medicine, 18 Mart University, Canakkale, Turkey.
| | - Dolunay Odabasi
- Department of Cardiovascular Surgery, Faculty of Medicine, Yuzuncu Yil University, Van, Turkey
| | - Tolga Kurt
- Department of Cardiovascular Surgery, Faculty Of Medicine, 18 Mart University, Canakkale, Turkey
| | - Ali Kemal Gür
- Department of Cardiovascular Surgery, Faculty of Medicine, Yuzuncu Yil University, Van, Turkey
| | - Aysegul Kunt
- Department of Cardiovascular Surgery, Faculty of Medicine, Yuzuncu Yil University, Van, Turkey
| | - Yavuz Balaharoglu
- Department of Biochemistry, Faculty of Medicine, Yuzuncu Yil University, Van, Turkey
| | - Alper Sami Kunt
- Department of Cardiovascular Surgery, Faculty of Medicine, Yuzuncu Yil University, Van, Turkey
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Várbíró S, Sára L, Antal P, Monori-Kiss A, Tőkés AM, Monos E, Benkő R, Csibi N, Szekeres M, Tarszabo R, Novak A, Paragi P, Nádasy GL. Lower-limb veins are thicker and vascular reactivity is decreased in a rat PCOS model: concomitant vitamin D3 treatment partially prevents these changes. Am J Physiol Heart Circ Physiol 2014; 307:H848-57. [PMID: 25015958 DOI: 10.1152/ajpheart.01024.2013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Polycystic ovary syndrome (PCOS) causes vascular damage to arteries; however, there are no data for its effect on veins. Our aim was to clarify the effects of dihydrotestosterone (DHT)-induced PCOS both on venous biomechanics and on pharmacological reactivity in a rat model and to test the possible modulatory role of vitamin D3 (vitD). PCOS was induced in female Wistar rats by DHT treatment (83 μg/day, subcutaneous pellet). After 10 wk, the venous biomechanics, norepinephrine (NE)-induced contractility, and acetylcholine-induced relaxation were tested in saphenous veins from control animals and from animals treated with DHT or DHT with vitD using pressure angiography. Additionally, the expression levels of endothelial nitric oxide synthase (eNOS) and cyclooxygenase (COX-2) were measured using immunohistochemistry. Increased diameter, wall thickness, and distensibility as well as decreased vasoconstriction were detected after the DHT treatment. Concomitant vitD treatment lowered the mechanical load on the veins, reduced distensibility, and resulted in vessels that were more relaxed. Although there was no difference in the endothelial dilation tested using acetylcholine (ACh), the blocking effect of N(G)-nitro-l-arginine methyl ester (l-NAME) was lower and was accompanied by lower COX-2 expression in the endothelium after the DHT treatment. Supplementation with vitD prevented these alterations. eNOS expression did not differ among the three groups. We conclude that the hyperandrogenic state resulted in thicker vein walls. These veins showed early remodeling and altered vasorelaxant mechanisms similar to those of varicose veins. Alterations caused by the chronic DHT treatment were prevented partially by concomitant vitD administration.
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Affiliation(s)
- Szabolcs Várbíró
- Second Department of Obstetrics and Gynecology, Faculty of Medicine, Semmelweis University, Budapest, Hungary;
| | - Levente Sára
- Second Department of Obstetrics and Gynecology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Péter Antal
- Institute of Human Physiology and Clinical Experimental Research, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Anna Monori-Kiss
- Institute of Human Physiology and Clinical Experimental Research, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Anna-Mária Tőkés
- MTA-SE Tumor Progression Research Group, Second Department of Pathology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Emil Monos
- Institute of Human Physiology and Clinical Experimental Research, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Rita Benkő
- Institute of Human Physiology and Clinical Experimental Research, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Noémi Csibi
- Second Department of Obstetrics and Gynecology, Faculty of Medicine, Semmelweis University, Budapest, Hungary; Institute of Human Physiology and Clinical Experimental Research, Faculty of Medicine, Semmelweis University, Budapest, Hungary; MTA-SE Tumor Progression Research Group, Second Department of Pathology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Maria Szekeres
- Department of Physiology, Faculty of Medicine, Semmelweis University, Budapest, Hungary; and
| | - Robert Tarszabo
- Second Department of Obstetrics and Gynecology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Agnes Novak
- Second Department of Obstetrics and Gynecology, Faculty of Medicine, Semmelweis University, Budapest, Hungary; MTA-SE Tumor Progression Research Group, Second Department of Pathology, Faculty of Medicine, Semmelweis University, Budapest, Hungary; Department of Pathology, Bajcsy-Zsilinszky Hospital, Budapest, Hungary
| | - Péter Paragi
- Second Department of Obstetrics and Gynecology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - György L Nádasy
- Institute of Human Physiology and Clinical Experimental Research, Faculty of Medicine, Semmelweis University, Budapest, Hungary
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Smith RK, Golledge J. A systematic review of circulating markers in primary chronic venous insufficiency. Phlebology 2013; 29:570-9. [PMID: 23928282 DOI: 10.1177/0268355513494375] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVES The etiology of primary chronic venous insufficiency is poorly understood. This systematic review aimed to summarize published evidence assessing the association of circulating markers with primary chronic venous insufficiency. METHODS A search was undertaken through the PubMed database using the terms "venous insufficiency" and "biological marker" or "plasma" or "serum". Search limits included English language, human subjects and studies with publication dates from 1994. Studies which classified patients using the Clinical-Etiology-Anatomy-Pathophysiology system of venous disease were analyzed. RESULTS Seventeen studies were included, which have examined > 60 different biomarkers. A total of 13 markers were assessed in >1 study with the number of primary chronic venous insufficiency cases ranging from 41 to 244 and the number of controls ranging from 30 to 144 in these studies. Circulating estradiol, homocysteine and vascular endothelial growth factor were the most consistently associated with primary chronic venous insufficiency. CONCLUSIONS Whilst a number of studies have examined biomarkers associated with primary chronic venous insufficiency, further studies are required using improved and standardized approaches on larger populations. Biomarker research may increase pathogenic knowledge and result in opportunities to decrease chronic venous insufficiency burden.
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Affiliation(s)
- Ross K Smith
- Vascular Biology Unit, Queensland Research Centre for Peripheral Vascular Disease, School of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia
| | - Jonathan Golledge
- Vascular Biology Unit, Queensland Research Centre for Peripheral Vascular Disease, School of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia Department of Vascular and Endovascular Surgery, The Townsville Hospital, Townsville, Queensland, Australia
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12
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Kendler M, Kratzsch J, Wetzig T, Simon JC. Sex steroid hormones are not altered in great saphenous veins after varicose vein treatment in male patients. Phlebology 2013; 29:310-7. [PMID: 23508002 DOI: 10.1177/0268355513478586] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2013] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The objective of this study was to assess differences in blood samples (sex steroid hormone levels and blood counts) before and after surgical treatment of incompetent great saphenous veins (GSV) in males. METHODS Antecubital vein and GSV blood samples were taken from 11 men with varicose veins and GSV reflux before and after treatment. Six patients were treated with high ligation, stripping and phlebectomy. Five patients were treated with endoluminal radiofrequency ablation and phlebectomy. After a four-year follow-up period (FU) cubital vein and GSV blood samples were taken again. RESULTS In men with varicose veins, significantly higher (P < 0.05) serum testosterone (median 25.18 nmol/L, range 8.82-225.1) and oestradiol (median 179 pmol/L, range 79-941) levels were found in the saphenous vein samples before and after the FU (testosterone 18.8 nmol/L, range 7.96-83.1, oestradiol 171 pmol/L range 125-304) compared with the cubital vein samples before therapy (testosterone 15.72 nmol/L, range 8.36-23.29; oestradiol 84 pmol/L, range 41-147) and after the FU (testosterone 14.5 nmol/L, range 6.10-22.2, oestradiol 117 pmol/L, range 95-165). After the FU, one patient demonstrated recurrent varicose veins with groin neovascularization. Another presented with axial reflux of the anterior accessory saphenous vein. Further differences in blood counts and serum androstenedione levels between the upper and lower extremities were not detected. CONCLUSION The differences between testosterone and oestradiol levels in the leg veins compared with the cubital veins persist after treating men with refluxing saphenous veins. These results suggest that local hormone regulation may be different between leg and arm veins in men with varicose veins.
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Affiliation(s)
- M Kendler
- Department of Dermatology, Venerology and Allergology, Leipzig University Medical Center, Leipzig, Germany
| | - J Kratzsch
- Institute for Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, Leipzig University Medical Center, Leipzig, Germany
| | - T Wetzig
- Department of Dermatology, Venerology and Allergology, Leipzig University Medical Center, Leipzig, Germany
| | - J C Simon
- Department of Dermatology, Venerology and Allergology, Leipzig University Medical Center, Leipzig, Germany
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Estrogen is increased in male cholangiocarcinoma patients' serum and stimulates invasion in cholangiocarcinoma cell lines in vitro. J Cancer Res Clin Oncol 2012; 138:1311-20. [PMID: 22476540 DOI: 10.1007/s00432-012-1207-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2011] [Accepted: 03/19/2012] [Indexed: 02/07/2023]
Abstract
PURPOSE Cholangiocarcinoma is defined as a chronic liver disease with altered estrogen metabolism and could result in estrogen retention. Estrogenic response was known as a promoting factor in progression of some cancer. In this study, we determined the significant increase of estrogen level in cholangiocarcinoma patients' sera. METHODS The estrogen levels in cholangiocarcinoma patients' sera were measured and correlated with clinical presentations. Estrogen receptor-α expressions in cholangiocarcinoma tissues were detected by immunohistochemistry method. KKU-100 and KKU-M213 cholangiocarcinoma cell lines were treated with 17β-estradiol and tested the proliferative and invasive effects. RESULTS The estrogen levels showed positive correlations with serum bilirubin and alkaline phosphatase and a negative correlation with albumin. This study also showed an association with shorter survival times when patients with low and high serum estrogen levels were compared. In vitro studies demonstrated the effect of estrogen on cell proliferation and invasion in dose-dependent manners, which could be inhibited by tamoxifen, a clinical used estrogen antagonist. Invasion showed an association with the TFF1 gene expression and could be inhibited by small interfering RNA against TFF1 gene. Estrogen receptor-α was the main estrogen receptor that response to 17β-estradiol stimulation. CONCLUSIONS TFF1 trefoil protein could be one of the effectors for estrogen-induced invasion in cholangiocarcinoma via the estrogen receptor-α. These findings could lead to an understanding of the mechanism of cholangiocarcinoma progression.
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Chu HB, Yan F, Zhao JH, Xu YB, Wang T, Guo WJ. Assessment of the infiltration of inflammatory cells in the walls of thrombotic varicose veins. Angiology 2012; 64:69-72. [PMID: 22297039 DOI: 10.1177/0003319711435147] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The purpose of this study is to describe the infiltration of mast cells as well as T and B cells in the walls of thrombotic varicose great saphenous veins. Sections were obtained from venous segments of patients with varicose veins and stained with toluidine blue for mast cells, while immunohistochemistry for T cells (using CD45RO antibody) and B cells (CD20) was analyzed using light microscopy after staining. The number of mast cells, T, and B cells observed in thrombotic varicose veins was 1.925 ± 1.203, 72.038 ± 34.707, and 19.519 ± 9.899, respectively. In varicose veins, the corresponding values were 0.265 ± 0.099, 0.600 ± 0.432, and 0.488 ± 0.400. Significantly higher number of mast cells, T cells, and B cells were observed in thrombotic varicose veins compared with control veins. A significant difference was not observed between the varicose group and control group. Thrombi in varicose veins can induce infiltration of mast cells, T cells, and B cells, which may be involved in the remodeling of venous walls.
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Affiliation(s)
- Hai-bo Chu
- Center of General Surgery, The 89th Hospital of PLA, West Beigong Road 256, Weifang, China.
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Kendler M, Zajitschek J, Simon JC, Wetzig T. Diagnostic procedures for venous problems. J Dtsch Dermatol Ges 2010; 8:903-10; quiz 911. [DOI: 10.1111/j.1610-0387.2010.07515.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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