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Guo P, Fang Q, Wang Y. Associations between varicose veins and heart failure: A genetic correlation and mendelian randomization study. Medicine (Baltimore) 2024; 103:e38175. [PMID: 38758877 PMCID: PMC11098184 DOI: 10.1097/md.0000000000038175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 04/17/2024] [Indexed: 05/19/2024] Open
Abstract
Varicose veins and heart failure (HF) are increasingly prevalent. Although numbers of observational studies have indicated that varicose veins might contribute to the risk of HF, the causal relationship between them remains unclear due to the uncontrolled confounding factors and reverse causation bias. Therefore, this study aimed to explore the potential causal relationship between varicose veins and HF. Based on publicly released genome-wide association studies (GWAS), gene correlation was assessed using linkage disequilibrium score (LDSC) regression, and we conducted a two-sample Mendelian randomization (TSMR) analysis to infer the causal relationship. We performed the Inverse variance weighted (IVW) method as the primary analysis, and used Weighted median, MR-Egger, weighted mode, simple mode, and MR-pleiotropy residual sum and outlier (MR-PRESSO) methods to detect and correct for horizontal pleiotropy. LDSC revealed there was a positive genetic correlation between varicose veins and HF (rg = 0.1726184, Se = 0.04511803, P = .0001). The results of the IVW method indicated that genetically predicted varicose veins were associated with an increased risk of HF (odds ratio (OR) = 1.03; 95% confidence interval (CI): 1.01-1.06; P = .009). Our findings illustrated the significant causal effect of varicose veins on HF, suggesting that people with varicose veins might have a higher risk of HF. The results provided a novel and important perspective into the development mechanism of HF.
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Affiliation(s)
- Ping Guo
- Division of Cardiology and Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Key Laboratory of Genetics and Molecular Mechanisms of Cardiological Disorders, Wuhan, China
| | - Qin Fang
- Division of Cardiology and Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Key Laboratory of Genetics and Molecular Mechanisms of Cardiological Disorders, Wuhan, China
| | - Yan Wang
- Division of Cardiology and Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Key Laboratory of Genetics and Molecular Mechanisms of Cardiological Disorders, Wuhan, China
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Min S, Xing M, Jiang H, Zhang L, Chen C, Ma Y, Ma Y. Exploring causal correlations between inflammatory cytokines and varicose veins: A Mendelian randomization analysis. Int Wound J 2024; 21:e14714. [PMID: 38353374 PMCID: PMC10865274 DOI: 10.1111/iwj.14714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 01/08/2024] [Accepted: 01/11/2024] [Indexed: 02/16/2024] Open
Abstract
This study aimed to investigate the causal relationship between inflammatory cytokines and the risk of varicose veins. The data were sourced from genome-wide association studies (GWAS) of European individuals. Multiple Mendelian randomization (MR) methods were used to evaluate the association between inflammatory cytokines and varicose veins. The study found significant associations between elevated levels of certain inflammatory biomarkers (e.g., CASP-8, Vascular endothelial growth factor A levels (VEGF_A)) and an increased risk of varicose veins, while others (e.g., 4EBP1, MMP-10) showed a protective effect. The MR-Egger Intercept and heterogeneity tests indicated no significant pleiotropy or heterogeneity. This comprehensive MR analysis identifies several cytokines as potential contributors to the pathogenesis of varicose veins, offering insights into novel therapeutic targets. Our findings underscore the importance of inflammation in varicose veins and suggest that targeting specific cytokines could be a promising strategy for the treatment and prevention of varicose veins.
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Affiliation(s)
- Shen Min
- Department of Acupuncture and Massage CollegeShandong University of Traditional Chinese MedicineJinanChina
| | - Mengzhen Xing
- Department of Acupuncture and Massage CollegeShandong University of Traditional Chinese MedicineJinanChina
| | - Hehe Jiang
- Department of Acupuncture and Massage CollegeShandong University of Traditional Chinese MedicineJinanChina
| | - Linlin Zhang
- Department of Acupuncture and Massage CollegeShandong University of Traditional Chinese MedicineJinanChina
| | - Chen Chen
- Department of Acupuncture and Massage CollegeShandong University of Traditional Chinese MedicineJinanChina
| | - Yuning Ma
- Department of Acupuncture and Massage CollegeShandong University of Traditional Chinese MedicineJinanChina
| | - Yuxia Ma
- Department of Acupuncture and Massage CollegeShandong University of Traditional Chinese MedicineJinanChina
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Fan Q, Meng Y, Nie Z, Xie S, Chen C. Sex hormone-binding globulin exerts sex-related causal effects on lower extremity varicose veins: evidence from gender-stratified Mendelian randomization. Front Endocrinol (Lausanne) 2023; 14:1230955. [PMID: 38152135 PMCID: PMC10752419 DOI: 10.3389/fendo.2023.1230955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 11/20/2023] [Indexed: 12/29/2023] Open
Abstract
Background The association between serum sex hormones and lower extremity varicose veins has been reported in observational studies. However, it is unclear whether the association reflects a causal relationship. Besides, serum sex hormone-binding globulin (SHBG) has been rarely studied in lower extremity varicose veins. Here, we aim to investigate the association between serum levels of SHBG, testosterone, and estradiol and the risk of lower extremity varicose veins using Mendelian randomization (MR). Methods We obtained genome-wide association study summary statistics for serum SHBG levels with 369,002 European participants, serum testosterone levels with 424,907 European participants, serum estradiol levels with 361,194 European participants, and lower extremity varicose veins with 207,055 European participants. First, a univariable MR was performed to identify the causality from SHBG and sex hormone levels to lower extremity varicose veins with several sensitivity analyses being performed. Then, a multivariable MR (MVMR) was performed to further assess whether the causal effects were independent. Finally, we performed a gender-stratified MR to understand the role of genders on lower extremity varicose veins. Results Genetically predicted higher serum SHBG levels significantly increased the risk of lower extremity varicose veins in the univariable MR analysis (OR=1.39; 95% CI: 1.13-1.70; P=1.58×10-3). Sensitivity analyses and MVMR (OR=1.50; 95% CI:1.13-1.99; P=5.61×10-3) verified the robustness of the causal relationships. Gender-stratified MR revealed that higher serum SHBG levels were associated with lower extremity varicose veins in both sexes. However, the OR of serum SHBG levels on lower extremity varicose veins risk in females (OR=1.51; 95% CI: 1.23-1.87; P=1.00×10-4) was greater than in males (OR=1.26; 95% CI: 1.04-1.54; P=1.86×10-2). Conclusions Serum SHBG levels are positively related to lower extremity varicose veins risk in both sexes, especially in females. This may partly explain the higher prevalence of varicose vines among females.
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Affiliation(s)
- Qinglu Fan
- Department of Thoracic Surgery, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yang Meng
- Department of Ophthalmology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Zhihao Nie
- Department of Thoracic Surgery, Renmin Hospital of Wuhan University, Wuhan, China
| | - Songping Xie
- Department of Thoracic Surgery, Renmin Hospital of Wuhan University, Wuhan, China
| | - Changzheng Chen
- Department of Ophthalmology, Renmin Hospital of Wuhan University, Wuhan, China
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Helkkula P, Hassan S, Saarentaus E, Vartiainen E, Ruotsalainen S, Leinonen JT, Palotie A, Karjalainen J, Kurki M, Ripatti S, Tukiainen T. Genome-wide association study of varicose veins identifies a protective missense variant in GJD3 enriched in the Finnish population. Commun Biol 2023; 6:71. [PMID: 36653477 PMCID: PMC9849365 DOI: 10.1038/s42003-022-04285-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 11/21/2022] [Indexed: 01/19/2023] Open
Abstract
Varicose veins is the most common manifestation of chronic venous disease that displays female-biased incidence. To identify protein-inactivating variants that could guide identification of drug target genes for varicose veins and genetic evidence for the disease prevalence difference between the sexes, we conducted a genome-wide association study of varicose veins in Finns using the FinnGen dataset with 17,027 cases and 190,028 controls. We identified 50 associated genetic loci (P < 5.0 × 10-8) of which 29 were novel including one near ERG with female-specificity (rs2836405-G, OR[95% CI] = 1.09[1.05-1.13], P = 3.1 × 10-8). These also include two X-chromosomal (ARHGAP6 and SRPX) and two autosomal novel loci (TGFB2 and GJD3) with protein-coding lead variants enriched above 56-fold in Finns over non-Finnish non-Estonian Europeans. A low-frequency missense variant in GJD3 (p.Pro59Thr) is exclusively associated with a lower risk for varicose veins (OR = 0.62 [0.55-0.70], P = 1.0 × 10-14) in a phenome-wide scan of the FinnGen data. The absence of observed pleiotropy and its membership of the connexin gene family underlines GJD3 as a potential connexin-modulating therapeutic strategy for varicose veins. Our results provide insights into varicose veins etiopathology and highlight the power of isolated populations, including Finns, to discover genetic variants that inform therapeutic development.
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Grants
- MC_PC_17228 Medical Research Council
- Academy of Finland (Suomen Akatemia)
- Sydäntutkimussäätiö (Finnish Foundation for Cardiovascular Research)
- Academy of Finland Center of Excellence in Complex Disease Genetics (Grant No 312062), Sigrid Juselius Foundation (S.Ri. and T.T.), University of Helsinki HiLIFE Fellow and Grand Challenge grants (S.Ri.), University of Helsinki three-year research project grant (T.T.), FIMM-EMBL PhD program doctoral funding (S.H.), Nylands Nation, University of Helsinki (P.H.) The FinnGen project is funded by two grants from Business Finland (HUS 4685/31/2016 and UH 4386/31/2016) and the following industry partners: AbbVie Inc., AstraZeneca UK Ltd, Biogen MA Inc., Bristol Myers Squibb (and Celgene Corporation & Celgene International II Sàrl), Genentech Inc., Merck Sharp & Dohme Corp, Pfizer Inc., GlaxoSmithKline Intellectual Property Development Ltd., Sanofi US Services Inc., Maze Therapeutics Inc., Janssen Biotech Inc, Novartis AG, and Boehringer Ingelheim. Following biobanks are acknowledged for delivering biobank samples to FinnGen: Auria Biobank (www.auria.fi/biopankki), THL Biobank (www.thl.fi/biobank), Helsinki Biobank (www.helsinginbiopankki.fi), Biobank Borealis of Northern Finland (https://www.ppshp.fi/Tutkimus-ja-opetus/Biopankki/Pages/Biobank-Borealis-briefly-in-English.aspx), Finnish Clinical Biobank Tampere (www.tays.fi/en-US/Research_and_development/Finnish_Clinical_Biobank_Tampere), Biobank of Eastern Finland (www.ita-suomenbiopankki.fi/en), Central Finland Biobank (www.ksshp.fi/fi-FI/Potilaalle/Biopankki), Finnish Red Cross Blood Service Biobank (www.veripalvelu.fi/verenluovutus/biopankkitoiminta) and Terveystalo Biobank (www.terveystalo.com/fi/Yritystietoa/Terveystalo-Biopankki/Biopankki/).
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Affiliation(s)
- Pyry Helkkula
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Shabbeer Hassan
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Elmo Saarentaus
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Emilia Vartiainen
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Sanni Ruotsalainen
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Jaakko T Leinonen
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Aarno Palotie
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Program in Medical and Population Genetics and Stanley Center for Psychiatric Research, Broad Institute of Harvard and MIT, Cambridge, MA, USA
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Juha Karjalainen
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Broad Institute of the Massachusetts Institute of Technology and Harvard University, Cambridge, MA, USA
| | - Mitja Kurki
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Broad Institute of the Massachusetts Institute of Technology and Harvard University, Cambridge, MA, USA
| | - Samuli Ripatti
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Broad Institute of the Massachusetts Institute of Technology and Harvard University, Cambridge, MA, USA
- Department of Public Health, Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Taru Tukiainen
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland.
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Chang SF, Tsai HE, Kuo JT, Ruan YR, Chen CY, Wang SY, Liu PY, Lee DY. Blood Reflux-Induced Epigenetic Factors HDACs and DNMTs Are Associated with the Development of Human Chronic Venous Disease. Int J Mol Sci 2022; 23:12536. [PMID: 36293392 PMCID: PMC9603923 DOI: 10.3390/ijms232012536] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 10/12/2022] [Accepted: 10/17/2022] [Indexed: 11/04/2023] Open
Abstract
Blood reflux and metabolic regulation play important roles in chronic venous disease (CVD) development. Histone deacetylases (HDACs) and DNA methyltransferases (DNMTs) serve as repressors that inhibit metabolic signaling, which is induced by proatherogenic flow to promote aortic endothelial cell (EC) dysfunction and atherosclerosis. The aim of this study was to elucidate the relationship between blood reflux and epigenetic factors HDACs and DNMTs in CVD. Human varicose veins with different levels of blood reflux versus normal veins with normal venous flow were examined. The results show that HDAC-1, -2, -3, -5, and -7 are overexpressed in the endothelium of varicose veins with blood reflux. Blood reflux-induced HDACs are enhanced in the varicose veins with a longer duration time of blood reflux. In contrast, these HDACs are rarely expressed in the endothelium of the normal vein with normal venous flow. Similar results are obtained for DNMT1 and DNMT3a. Our findings suggest that the epigenetic factors, HDACs and DNMTs, are induced in venous ECs in response to blood reflux but are inhibited in response to normal venous flow. Blood reflux-induced HDACs and DNMTs could inhibit metabolic regulation and promote venous EC dysfunction, which is highly correlated with CVD pathogenesis.
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Affiliation(s)
- Shun-Fu Chang
- Department of Medical Research and Development, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan
- Center for General Education, Chiayi Chang Gung University of Science and Technology, Chiayi 613, Taiwan
| | - Hsiao-En Tsai
- Division of Cardiovascular Surgery, Department of Surgery, National Taiwan University Hsin-Chu Hospital, Hsinchu 300, Taiwan
| | - Jong-Tar Kuo
- Department of Biological Science and Technology, China University of Science and Technology, Taipei 115, Taiwan
| | - Yu-Rong Ruan
- Department of Biological Science and Technology, China University of Science and Technology, Taipei 115, Taiwan
| | - Chiu-Yen Chen
- Department of Biological Science and Technology, China University of Science and Technology, Taipei 115, Taiwan
| | - Shin-Yi Wang
- Department of Bioscience and Biotechnology, National Taiwan Ocean University, Keelung 202, Taiwan
| | - Po-Yu Liu
- Division of Infectious Diseases, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung 407, Taiwan
| | - Ding-Yu Lee
- Department of Bioscience and Biotechnology, National Taiwan Ocean University, Keelung 202, Taiwan
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Cao Y, Cao Z, Wang W, Jie X, Li L. MicroRNA‑199a‑5p regulates FOXC2 to control human vascular smooth muscle cell phenotypic switch. Mol Med Rep 2021; 24:627. [PMID: 34212977 PMCID: PMC8281299 DOI: 10.3892/mmr.2021.12266] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 04/26/2021] [Indexed: 01/18/2023] Open
Abstract
Varicose veins are among the most common disorders of the vascular system; however, the pathogenesis of varicose veins remains unclear. The present study aimed to investigate the roles of microRNA (miR)‑199a‑5p in varicose veins and in the phenotypic transition of vascular smooth muscle cells (VSMCs). Bioinformatics analysis confirmed that miR‑199a‑5p had target sites on the forkhead box C2 (FOXC2) 3'‑untranslated region. Reverse transcription‑quantitative PCR (RT‑qPCR) and western blotting were used to detect the expression levels of miR‑199a‑5p and FOXC2 in varicose vein and normal great saphenous vein tissues. Cell Counting Kit‑8 and Transwell migration assays were performed to validate the effects of miR‑199a‑5p on VSMCs. Contractile markers, such as smooth muscle 22α, calponin, smooth muscle actin and myosin heavy chain 11 were used to detect phenotypic transition. RT‑qPCR revealed that miR‑199a‑5p was downregulated in varicose veins compared with expression in normal great saphenous veins, whereas FOXC2 was upregulated in varicose veins. In addition, biomarkers of the VSMC contractile phenotype were downregulated in varicose veins. Overexpression of miR‑199a‑5p by mimics suppressed VSMC proliferation and migration, whereas depletion of miR‑199a‑5p enhanced VSMC proliferation and migration. Notably, the effects caused by miR‑199a‑5p could be reversed by FOXC2 overexpression. Dual luciferase reporter analysis confirmed that FOXC2 was a target of miR‑199a‑5p. In conclusion, miR‑199a‑5p may be a novel regulator of phenotypic switching in VSMCs by targeting FOXC2 during varicose vein formation.
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Affiliation(s)
- Yushi Cao
- Department of Hepatobiliary Surgery, The First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
| | - Zhongwen Cao
- Department of Vascular Surgery, Qianwei Hospital of Jilin Province, Changchun, Jilin 130012, P.R. China
| | - Weitie Wang
- Department of Cardiovascular Surgery, The Second Hospital of Jilin University, Changchun, Jilin 130041, P.R. China
| | - Xiangyu Jie
- Department of Vascular Surgery, Qianwei Hospital of Jilin Province, Changchun, Jilin 130012, P.R. China
| | - Lei Li
- Department of Vascular Surgery, Qianwei Hospital of Jilin Province, Changchun, Jilin 130012, P.R. China
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Abstract
Venous disease is a term that broadly covers both venous thromboembolic disease and chronic venous disease. The basic pathophysiology of venous thromboembolism and chronic venous disease differ as venous thromboembolism results from an imbalance of hemostasis and thrombosis while chronic venous disease occurs in the setting of tissue damage because of prolonged venous hypertension. Both diseases are common and account for significant mortality and morbidity, respectively, and collectively make up a large health care burden. Despite both diseases having well-characterized environmental components, it has been known for decades that family history is an important risk factor, implicating a genetic element to a patient's risk. Our understanding of the pathogenesis of these diseases has greatly benefited from an expansion of population genetic studies from pioneering familial studies to large genome-wide association studies; we now have multiple risk loci for each venous disease. In this review, we will highlight the current state of knowledge on the epidemiology and genetics of venous thromboembolism and chronic venous disease and directions for future research.
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Affiliation(s)
- Richard A. Baylis
- Department of Surgery, Division of Vascular Surgery, Stanford University School of Medicine, CA
| | - Nicholas L. Smith
- Department of Epidemiology, University of Washington, Seattle WA 98195, USA
- Kaiser Permanente Washington Health Research Institute, Kaiser Permanente Washington, Seattle WA 98101, USA
- Seattle Epidemiologic Research and Information Center, Department of Veterans Affairs Office of Research and Development, Seattle WA 98108, USA
| | - Derek Klarin
- Division of Vascular Surgery, University of Florida College of Medicine, Gainesville, FL
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Eri Fukaya
- Department of Surgery, Division of Vascular Surgery, Stanford University School of Medicine, CA
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Guo Z, Luo C, Zhu T, Li L, Zhang W. Elevated c-fos expression is correlated with phenotypic switching of human vascular smooth muscle cells derived from lower limb venous varicosities. J Vasc Surg Venous Lymphat Disord 2020; 9:242-251. [PMID: 32360331 DOI: 10.1016/j.jvsv.2020.03.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Accepted: 03/04/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Lower limb venous varicosities (VVs) are clinically common; however, their molecular underpinnings are far from well elucidated. Previous studies have demonstrated that the phenotypic transition of vascular smooth muscle cells (VSMCs) plays a critical role in VV pathogenesis and that c-fos is upregulated in VSMCs from VVs. The present study investigated the histologic and cytologic changes in VVs and the correlation between c-fos upregulation and VSMC phenotypic switching. METHODS Thirty-four patients with VVs (VV group) and 13 patients undergoing coronary artery bypass using autologous great saphenous vein segments (normal vein [NV] group) were enrolled in the present study. The great saphenous veins of both groups were harvested for subsequent experiments. Hematoxylin and eosin staining was performed for vein morphologic analysis. Real-time quantitative polymerase chain reaction, immunohistochemistry, and Western blot assays were used to assess mRNA and protein expression of c-fos, α-smooth muscle actin (α-SMA), and osteopontin (OPN). Simple linear regression was used to evaluate the correlation between c-fos and OPN/α-SMA. Primary VSMCs were isolated from both groups and cultured in vitro. A cell counting kit-8 assay and scratch-wound assay were used to analyze the proliferation and migration abilities of the cells, respectively. RESULTS The mean age of the patients in the NV and VV groups was 61.4 ± 3.8 years and 59.5 ± 10.4 years, respectively. The vein cavities of the VV group were dilated, and the arrangement of the cells was disordered. The tunica media of the VV group was thicker than that of the NV group owing to the accumulation and proliferation of VSMCs. Significantly elevated mRNA levels of c-fos and OPN were observed in the VV group compared with the NV group, and a positive correlation was further demonstrated between the mRNA levels of c-fos and OPN/α-SMA (R2, 0.5524; P < .001). The VSMCs derived from the VV group were more numerous (as shown by the cell counting kit-8 assay) and had a significantly greater migration speed (as shown by the scratch-wound assay) than those derived from the NV group. Moreover, the protein expression of c-fos was significantly upregulated in VSMCs derived from the VV group, and this change was accompanied by a decrease in α-SMA and an increase in OPN expression. CONCLUSIONS Both mRNA and protein expression of c-fos were upregulated in VV specimens, and the phenotypic biomarkers (OPN/α-SMA) were altered concurrently. VSMCs derived from VVs showed increased proliferation and migration abilities. Upregulation of c-fos might play a role in the phenotypic switching of VSMCs and subsequently participate in the pathogenesis of VVs. CLINICAL RELEVANCE C-fos is an immediate early gene owing to the transient and rapid change in its expression in response to stimuli. It is involved in the regulation of cell proliferation, cell growth, and cell movement. In the present study, varicose vein specimens showed increased mRNA and protein expression of c-fos, accompanied by altered phenotypic biomarkers. The upregulation of the c-fos gene in smooth muscle cells cultured from varicose vein specimens might be associated with phenotypic switching and functional disturbance. These results could contribute to the exploration of the molecular mechanisms underlying the pathogenesis of varicose veins and the development of new therapeutic strategies.
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Affiliation(s)
- Zhenyu Guo
- Department of Vascular Surgery Fudan University, Shanghai, People's Republic of China
| | - Chentao Luo
- Department of Cardiac Surgery, Fudan University, Shanghai, People's Republic of China
| | - Ting Zhu
- Department of Vascular Surgery Fudan University, Shanghai, People's Republic of China
| | - Li Li
- Zhongshan Hospital and Department of Vascular Surgery, Huadong Hospital, Fudan University, Shanghai, People's Republic of China
| | - Wan Zhang
- Zhongshan Hospital and Department of Vascular Surgery, Huadong Hospital, Fudan University, Shanghai, People's Republic of China.
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9
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Huang X, Liu Z, Shen L, Jin Y, Xu G, Zhang Z, Fang C, Guan W, Liu C. Augmentation of miR-202 in varicose veins modulates phenotypic transition of vascular smooth muscle cells by targeting proliferator-activated receptor-γ coactivator-1α. J Cell Biochem 2018; 120:10031-10042. [PMID: 30556158 DOI: 10.1002/jcb.28287] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 11/19/2018] [Indexed: 02/04/2023]
Abstract
In varicose veins, vascular smooth muscle cells (VSMCs) often show abnormal proliferative and migratory rates and phenotypic transition. This study aimed to investigate whether microRNA (miR)-202 and its potential target, peroxisome proliferator-activated receptor-γ coactivator-1α (PGC-1α), were involved in VSMC phenotypic transition. miR-202 expression was analyzed in varicose veins and in VSMCs conditioned with platelet-derived growth factor. The effect of miR-202 on cell proliferation and migration was assessed. Furthermore, contractile marker SM-22α, synthetic markers vimentin and collagen I, and PGC-1α were analyzed by Western blot analysis. The modulation of PGC-1α expression by miR-202 was also evaluated. In varicose veins and proliferative VSMCs, miR-202 expression was upregulated, with decreased SM-22α expression and increased vimentin and collagen I expression. Transfection with a miR-202 mimic induced VSMC proliferation and migration, whereas a miR-202 inhibitor reduced cell proliferation and migration. miR-202 mimic constrained luciferase activity in HEK293 cells that were cotransfected with the PGC-1α 3'-untranslated region (3'-UTR) but not those with mutated 3'-UTR. miR-202 suppressed PGC-1α protein expression, with no influence on its messenger RNA expression. PGC-1α mediated VSMC phenotypic transition and was correlated with reactive oxygen species production. In conclusion, miR-202 affects VSMC phenotypic transition by targeting PGC-1α expression, providing a novel target for varicose vein therapy.
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Affiliation(s)
- Xianchen Huang
- Department of Gastrointestinal Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, Jiangsu, China
- Department of Vascular Surgery, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, Jiangsu, China
| | - Zhao Liu
- Department of Vascular Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Liming Shen
- Department of Vascular Surgery, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, Jiangsu, China
| | - Yiqi Jin
- Department of Vascular Surgery, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, Jiangsu, China
| | - Guoxiong Xu
- Department of Vascular Surgery, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, Jiangsu, China
| | - Zhixuan Zhang
- Department of Vascular Surgery, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, Jiangsu, China
| | - Changwen Fang
- Department of Vascular Surgery, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, Jiangsu, China
| | - Wenxian Guan
- Department of Gastrointestinal Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Changjian Liu
- Department of Vascular Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, Jiangsu, 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. Oxid Med Cell Longev 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] [What about the content of this article? (0)] [Affiliation(s)] [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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11
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Studennikova VV, Severgina LO, Dzyundzya AN, Korovin IA. [Lower extremity varicose veins in childhood and at a young age: Mechanism of development and specific features]. Arkh Patol 2018; 79:56-60. [PMID: 28792000 DOI: 10.17116/patol201779456-60] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
In Russia more than 125,000 patients with various venous diseases, lower extremity varicose veins (LEVV) being predominant, were annually operated on. In recent years, there has been a trend toward younger patients with signs of LEVV. Screening studies have revealed the signs of the disease in 10-15% of high-school children. The high prevalence of LEVV as a whole and its younger onset in recent decades cause more attention to an investigation of the relationship between the development of varicose veins, in childhood and adolescence in particular, and genomic changes. Patients with varicose veins have been noted to have a genetically reduced capacity for contraction of the smooth muscle cells of the vein walls, their remodeling due to the increased synthesis of matrix Gla protein, overproduction of TGF-β1, a matrix metalloproteinase inhibitor, hyperhomocysteinemia, and mutations in the genes encoding the synthesis of thrombomodulin. Varicose vein transformation is considered to be a minor phenomenon of undifferentiated connective tissue dysplasia (UCTD) leading to failure of their walls due to abnormalities in the fibrous structures and extracellular matrix. Confirmation of the role of UCTD in the development of varicose veins will be able to provide an individual approach to treating patients and to choosing adequate postoperative therapy aimed at preventing a disease recurrence.
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Affiliation(s)
- V V Studennikova
- I.M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation, Moscow, Russia
| | - L O Severgina
- I.M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation, Moscow, Russia
| | - A N Dzyundzya
- I.M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation, Moscow, Russia
| | - I A Korovin
- I.M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation, Moscow, Russia
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12
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Shadrina AS, Smetanina MA, Sokolova EA, Shamovskaya DV, Sevost'ianova KS, Shevela AI, Soldatsky EY, Seliverstov EI, Demekhova MY, Shonov OA, Ilyukhin EA, Voronina EN, Pikalov IV, Zolotukhin IA, Kirienko AI, Filipenko ML. Allele rs2010963 C of the VEGFA gene is associated with the decreased risk of primary varicose veins in ethnic Russians. Phlebology 2016; 33:27-35. [PMID: 27932624 DOI: 10.1177/0268355516683611] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective To study the association of polymorphisms rs699947, rs2010963, rs3025039 in the VEGFA gene region and rs1870377, rs2305949, rs2071559 in the VEGFR2 gene region with the risk of primary varicose veins in ethnic Russians. Methods Genotypes were determined by real-time PCR allelic discrimination. The case group consisted of 448 patients with primary varicose veins and the control group comprised 609 individuals without a history of chronic venous disease. Association was studied by logistic regression analysis. Results Allele rs2010963 C was associated with the decreased risk of varicose veins (additive model of inheritance: odds ratio = 0.73, 95% confidence interval = 0.59-0.91, P = 0.004). Conclusions Our results provide evidence that polymorphism rs2010963 located in the 5' untranslated region of the VEGFA gene can influence genetic susceptibility to primary varicose veins in Russians. Otherwise, it can be in linkage disequilibrium with another functional single nucleotide polymorphism that can alter the level of vascular endothelial growth factor A protein.
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Affiliation(s)
- Alexandra S Shadrina
- 1 Institute of Chemical Biology and Fundamental Medicine, Russia
- 2 Novosibirsk State University, Russia
| | | | - Ekaterina A Sokolova
- 1 Institute of Chemical Biology and Fundamental Medicine, Russia
- 2 Novosibirsk State University, Russia
| | | | | | - Andrey I Shevela
- 1 Institute of Chemical Biology and Fundamental Medicine, Russia
| | | | | | | | | | | | - Elena N Voronina
- 1 Institute of Chemical Biology and Fundamental Medicine, Russia
- 2 Novosibirsk State University, Russia
| | | | | | | | - Maxim L Filipenko
- 1 Institute of Chemical Biology and Fundamental Medicine, Russia
- 2 Novosibirsk State University, Russia
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13
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Shadrina AS, Smetanina MA, Sokolova EA, Sevost'ianova KS, Shevela AI, Demekhova MY, Shonov OA, Ilyukhin EA, Voronina EN, Zolotukhin IA, Kirienko AI, Filipenko ML. Association of polymorphisms near the FOXC2 gene with the risk of varicose veins in ethnic Russians. Phlebology 2015; 31:640-8. [PMID: 26420053 DOI: 10.1177/0268355515607404] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To investigate the association of polymorphisms located near the FOXC2 gene with the risk of varicose veins in ethnic Russians. METHODS Allele, genotype, and haplotype frequencies were determined in the sample of 474 patients with primary varicose veins and in the control group of 478 individuals without a history of chronic venous disease. RESULTS Polymorphisms rs7189489, rs4633732, and rs1035550 showed the association with the increased risk of varicose veins, but none of the observed associations remained significant after correction for multiple testing. Haplotype analysis revealed the association of haplotype rs7189489 C-rs4633732 T-rs34221221 C-rs1035550 C-rs34152738 T-rs12711457 G with the increased risk of varicose veins (OR = 2.67, P = 0.01). CONCLUSIONS Our results provide evidence that the studied polymorphisms do not play a major role in susceptibility to varicose veins development in the Russian population.
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Affiliation(s)
- Alexandra S Shadrina
- Institute of Chemical Biology and Fundamental Medicine, Novosibirsk, Russia Novosibirsk State University, Novosibirsk, Russia
| | - Mariya A Smetanina
- Institute of Chemical Biology and Fundamental Medicine, Novosibirsk, Russia
| | - Ekaterina A Sokolova
- Institute of Chemical Biology and Fundamental Medicine, Novosibirsk, Russia Novosibirsk State University, Novosibirsk, Russia
| | | | - Andrey I Shevela
- Institute of Chemical Biology and Fundamental Medicine, Novosibirsk, Russia
| | | | - Oleg A Shonov
- Private Surgery Center "Medalp", Saint Petersburg, Russia
| | | | - Elena N Voronina
- Institute of Chemical Biology and Fundamental Medicine, Novosibirsk, Russia Novosibirsk State University, Novosibirsk, Russia
| | - Igor A Zolotukhin
- Pirogov Russian National Research Medical University, Moscow, Russia
| | | | - Maxim L Filipenko
- Institute of Chemical Biology and Fundamental Medicine, Novosibirsk, Russia Novosibirsk State University, Novosibirsk, Russia Kazan Federal University, Kazan, Republic of Tatarstan, Russia
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Kunt AT, Isbir S, Gormus U, Kahraman OT, Arsan S, Yilmaz SG, Isbir T. Polymorphisms of MMP9 and TIMP2 in Patients with Varicose Veins. In Vivo 2015; 29:461-465. [PMID: 26130791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND Genetic predisposition is a suggested risk factor in the etiology of varicose veins. The matrix metalloproteinase (MMP) family degrades extracellular matrix (ECM) and may lead to disturbances in vein wall structure. The activity of MMPs in the ECM are controlled by specific tissue inhibitors of MMPs (TIMP). The present study aimed to investigate the relationship between MMP9 and TIMP2 gene polymorphisms and varicose vein risk. MATERIALS AND METHODS Genotyping of the polymorphisms of MMP9 (1562 C/T) and TIMP2 (418G/C) was performed using polymerase chain reaction and restriction-fragment length polymorphism assays in a group of patients with varicose veins (n=63) and healthy controls (n=70). RESULTS The frequencies of MMP9 alleles and genotypes did not differ significantly between patient and control groups. However, TIMP2 -418 C allele was associated with increased risk for varicose vein formation (p=0.007). It was also shown that the frequency of the GG genotype was significantly higher in the control group than in the patient group (odds ratio=0.333, 95% confidence interval=0.14-0.78, p=0.012). CONCLUSION TIMP2 -418 C allele is associated with susceptibility for varicose vein formation and individuals with GG genotype may have a lower risk for varicose vein formation.
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Affiliation(s)
- Atike Tekeli Kunt
- Department of Cardiovascular Surgery, Kocaeli Derince Education and Research Hospital, Kocaeli, Turkey
| | - Selim Isbir
- Department of Cardiovascular Surgery, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Uzay Gormus
- Department of Biochemistry, Faculty of Medicine, Istanbul Bilim University, Istanbul, Turkey
| | - Ozlem Timirci Kahraman
- Department of Molecular Medicine, Istanbul University Institute of Experimental Medicine, Istanbul, Turkey
| | - Sinan Arsan
- Department of Cardiovascular Surgery, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Seda Gulec Yilmaz
- Department of Molecular Medicine, Institute of Health Sciences, Yeditepe University, Istanbul, Turkey
| | - Turgay Isbir
- Department of Medical Biology, Faculty of Medicine, Yeditepe University, Istanbul, Turkey
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15
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Shchukin SP. [Modern methods of diagnosis of thrombophylic states and complex treatment of patients with thrombotic complications of severe forms of varicose disease]. Klin Khir 2014:38-41. [PMID: 25675742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Actual issues of surgical treatment of patients, suffering complications of severe forms of varicose disease of the lower extremities (VDLE) are discussed. The causes of unsatisfactory results of treatment in patients, suffering varicothrombophlebitis (VTHPH), the main of which--absence of the only one tactics for operative treatment and anticoagulant therapy, were analyzed. The results of patients examination, suffering thrombotic complications of severe forms of VDLE, while its recurrent course, in conjunction of VTHPH and thrombosis of deep veins of the lower extremities, using diagnostic complex "PLR genetics thrombophilia", are adduced. Differential tactics of treatment in patients, suffering severe forms of VDLE, while various localization of thrombotic process, concerning the presence of thrombophilic states, is proposed.
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16
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Jiang H, Lun Y, Wu X, Xia Q, Zhang X, Xin S, Zhang J. Association between the hypomethylation of osteopontin and integrin β3 promoters and vascular smooth muscle cell phenotype switching in great saphenous varicose veins. Int J Mol Sci 2014; 15:18747-61. [PMID: 25329616 PMCID: PMC4227244 DOI: 10.3390/ijms151018747] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2014] [Revised: 09/28/2014] [Accepted: 10/09/2014] [Indexed: 12/28/2022] Open
Abstract
Lower extremity varicose veins are a common condition in vascular surgery and proliferation of vascular smooth muscle cells (VSMCs) in the intima is a significant pathological feature of varicosity. However, the pathogenesis of varicose veins is not fully understood. Osteopontin (OPN) could promote the migration and adhesion of VSMCs through the cell surface receptor integrin β3 and the cooperation of OPN and integrin β3 is involved in many vascular diseases. However, the role of OPN and integrin β3 in varicosity remains unclear. In the current study, we found that the methylation levels in the promoter regions of OPN and integrin β3 genes in the VSMCs of varicose veins are reduced and the protein expression of OPN and integrin β3 are increased, compared with normal veins. Furthermore, it was observed that VSMCs in the neointima of varicose veins were transformed into the synthetic phenotype. Collectively, hypomethylation of the promoter regions for OPN and integrin β3 genes may increase the expression of these genes in varicosity, which is closely related to VSMC phenotype switching. Hypomethylation of the promoter regions for OPN and integrin β3 genes may be a key factor in the pathogenesis of varicosity.
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Affiliation(s)
- Han Jiang
- Department of Vascular and Thyroid Surgery, the First Affiliated Hospital of China Medical University, Shenyang 110001, China.
| | - Yu Lun
- Department of Vascular and Thyroid Surgery, the First Affiliated Hospital of China Medical University, Shenyang 110001, China.
| | - Xiaoyu Wu
- Department of Vascular and Thyroid Surgery, the First Affiliated Hospital of China Medical University, Shenyang 110001, China.
| | - Qian Xia
- Department of Vascular and Thyroid Surgery, the First Affiliated Hospital of China Medical University, Shenyang 110001, China.
| | - Xiaoyu Zhang
- Department of Vascular and Thyroid Surgery, the First Affiliated Hospital of China Medical University, Shenyang 110001, China.
| | - Shijie Xin
- Department of Vascular and Thyroid Surgery, the First Affiliated Hospital of China Medical University, Shenyang 110001, China.
| | - Jian Zhang
- Department of Vascular and Thyroid Surgery, the First Affiliated Hospital of China Medical University, Shenyang 110001, China.
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17
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Li X, Jiang XY, Ge J, Wang J, Chen GJ, Xu L, Xie DY, Yuan TY, Zhang DS, Zhang H, Chen YH. Aberrantly expressed lncRNAs in primary varicose great saphenous veins. PLoS One 2014; 9:e86156. [PMID: 24497937 PMCID: PMC3908920 DOI: 10.1371/journal.pone.0086156] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2013] [Accepted: 12/05/2013] [Indexed: 12/11/2022] Open
Abstract
Long non-coding RNAs (lncRNAs) are key regulatory molecules involved in a variety of biological processes and human diseases. However, the pathological effects of lncRNAs on primary varicose great saphenous veins (GSVs) remain unclear. The purpose of the present study was to identify aberrantly expressed lncRNAs involved in the prevalence of GSV varicosities and predict their potential functions. Using microarray with 33,045 lncRNA and 30,215 mRNA probes, 557 lncRNAs and 980 mRNAs that differed significantly in expression between the varicose great saphenous veins and control veins were identified in six pairs of samples. These lncRNAs were sub-grouped and mRNAs expressed at different levels were clustered into several pathways with six focused on metabolic pathways. Quantitative real-time PCR replication of nine lncRNAs was performed in 32 subjects, validating six lncRNAs (AF119885, AK021444, NR_027830, G36810, NR_027927, uc.345-). A coding-non-coding gene co-expression network revealed that four of these six lncRNAs may be correlated with 11 mRNAs and pathway analysis revealed that they may be correlated with another 8 mRNAs associated with metabolic pathways. In conclusion, aberrantly expressed lncRNAs for GSV varicosities were here systematically screened and validated and their functions were predicted. These findings provide novel insight into the physiology of lncRNAs and the pathogenesis of varicose veins for further investigation. These aberrantly expressed lncRNAs may serve as new therapeutic targets for varicose veins. The Human Ethnics Committee of Shanghai East Hospital, Tongji University School of Medicine approved the study (NO.: 2011-DF-53).
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Affiliation(s)
- Xiang Li
- Key Laboratory of Arrhythmia of the Ministry of Education of China, East Hospital, Tongji University School of Medicine, Shanghai, China
- Institute of Medical Genetics, Tongji University, Shanghai, China
- Department of Pathology and Pathophysiology, Tongji University School of Medicine, Shanghai, China
| | - Xiao-Yan Jiang
- Key Laboratory of Arrhythmia of the Ministry of Education of China, East Hospital, Tongji University School of Medicine, Shanghai, China
- Institute of Medical Genetics, Tongji University, Shanghai, China
- Department of Pathology and Pathophysiology, Tongji University School of Medicine, Shanghai, China
| | - Jin Ge
- Department of Vascular Surgery, East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jing Wang
- Key Laboratory of Arrhythmia of the Ministry of Education of China, East Hospital, Tongji University School of Medicine, Shanghai, China
- Institute of Medical Genetics, Tongji University, Shanghai, China
| | - Guo-Jun Chen
- Department of Vascular Surgery, East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Liang Xu
- Key Laboratory of Arrhythmia of the Ministry of Education of China, East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Duan-Yang Xie
- Key Laboratory of Arrhythmia of the Ministry of Education of China, East Hospital, Tongji University School of Medicine, Shanghai, China
- Institute of Medical Genetics, Tongji University, Shanghai, China
- Department of Pathology and Pathophysiology, Tongji University School of Medicine, Shanghai, China
| | - Tian-You Yuan
- Key Laboratory of Arrhythmia of the Ministry of Education of China, East Hospital, Tongji University School of Medicine, Shanghai, China
- Institute of Medical Genetics, Tongji University, Shanghai, China
- Department of Pathology and Pathophysiology, Tongji University School of Medicine, Shanghai, China
| | - Da-Sheng Zhang
- Key Laboratory of Arrhythmia of the Ministry of Education of China, East Hospital, Tongji University School of Medicine, Shanghai, China
- Institute of Medical Genetics, Tongji University, Shanghai, China
| | - Hong Zhang
- Key Laboratory of Arrhythmia of the Ministry of Education of China, East Hospital, Tongji University School of Medicine, Shanghai, China
- Institute of Medical Genetics, Tongji University, Shanghai, China
| | - Yi-Han Chen
- Key Laboratory of Arrhythmia of the Ministry of Education of China, East Hospital, Tongji University School of Medicine, Shanghai, China
- Institute of Medical Genetics, Tongji University, Shanghai, China
- Department of Pathology and Pathophysiology, Tongji University School of Medicine, Shanghai, China
- * E-mail:
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19
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Görmüş U, Kahraman OT, Isbir S, Tekeli A, Isbir T. MMP2 gene polymorphisms and MMP2 mRNA levels in patients with superficial varices of lower extremities. In Vivo 2011; 25:387-391. [PMID: 21576412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND Although superficial varices of lower extremities with high morbidity are common, their etiology has not been elucidated yet. Previously, it was thought that venous hypertension was responsible for such cases by causing valvular insufficiency, but recent findings indicate that the changes in the venous wall structure might be main initiating factors. Matrix metalloproteinase enzyme-2 (MMP2) is one of the enzymes known to have functions in remodelling of the extracellular matrix mainly in vascular structures. MATERIALS AND METHODS We studied two functional gene polymorphisms in -735 and -1306 regions of matrix metalloproteinase enzyme-2 (MMP2) gene, and their effects on mRNA expression of MMP2. We used a previously defined (PCR-RFLP) method for polymorphism analyses. RESULTS CC genotype and C allele for MMP2 -735 gene region were more common in the control group and there was no significant difference between groups for MMP2 - 1306 gene polymorphisms. MMP2 mRNA levels were higher in the group that had both varices and coronary artery disease (CAD). CONCLUSION There was no significant effect of MMP2 polymorphisms on mRNA expression. As MMP2 mRNA levels were higher in varices patients with CAD compared to the CAD only and varices only groups, it is necessary to make advanced researches to elucidate the relationship between CAD and varices.
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Affiliation(s)
- Uzay Görmüş
- Department of Biochemistry, Faculty of Medicine, Istanbul Bilim University, Istanbul, Turkey
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20
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Naoum JJ, Hunter GC, Woodside KJ, Chen C. Current Advances in the Pathogenesis of Varicose Veins. J Surg Res 2007; 141:311-6. [PMID: 17070551 DOI: 10.1016/j.jss.2006.08.007] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2006] [Revised: 08/07/2006] [Accepted: 08/10/2006] [Indexed: 01/13/2023]
Abstract
Varicose veins have a wide prevalence and are characterized by their tortuous, dilated, and serpentine appearance. This pattern is the result of disruption of the normal arrangement of the extracellular matrix (ECM) and smooth muscle cells (SMC) in veins. Valvular incompetence and the effect of increased hydrostatic pressure have been implicated in the pathogenesis of varicose veins. Alterations in the ECM and varied expression of metalloproteinases and their inhibitors can effect changes in venous wall remodeling. Gene expression and specific candidate markers have been identified in varicose veins. Differential gene transcription may influence the adaptive response of the venous wall to stimuli and the remodeling of the ECM that leads to the development of varicose veins.
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Affiliation(s)
- Joseph J Naoum
- Michael E. DeBakey Department of Surgery, Molecular Surgeon Research Center, Division of Vascular Surgery and Endovascular Therapy, Baylor College of Medicine, Houston, Texas 77030, USA
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21
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Cario-Toumaniantz C, Boularan C, Schurgers LJ, Heymann MF, Le Cunff M, Léger J, Loirand G, Pacaud P. Identification of differentially expressed genes in human varicose veins: involvement of matrix gla protein in extracellular matrix remodeling. J Vasc Res 2007; 44:444-59. [PMID: 17643059 DOI: 10.1159/000106189] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2007] [Accepted: 05/07/2007] [Indexed: 01/07/2023] Open
Abstract
This study was designed to identify the global pattern of differentially expressed genes in human varicose veins. Using suppressive subtractive hybridization, we identified overexpression of genes known to be associated with extracellular matrix remodeling, including collagen III, tissue inhibitor of metalloproteinases I, dermatopontin, matrix Gla protein (MGP) and tenascin C. Real-time polymerase chain reaction analysis confirmed the differential expression of these genes. The overexpression of MGP transcript was associated with increased MGP level in varicose veins, in particular the undercarboxylated form of the protein. Smooth muscle cells from varicose veins showed increased proliferation rate and enhanced matrix mineralization. This observation correlated with the presence of ectopic mineralization areas in the varicose vein walls. The use of warfarin, to inhibit MGP activity, or siRNA targeting MGP transcript induced a reduction in the exacerbated proliferation of varicose vein smooth muscle cells. Our results suggest that high expression of MGP in varicose veins may contribute to venous wall remodeling by affecting proliferation and mineralization processes probably through impaired carboxylation of MGP. In addition, suppressive subtractive hybridization results also produce a profile of differentially expressed genes in varicose veins, in particular extracellular matrix components. Further study of these genes will provide insights into their specific roles in the etiology of venous disease.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Calcinosis/genetics
- Calcinosis/metabolism
- Calcinosis/pathology
- Calcium-Binding Proteins/antagonists & inhibitors
- Calcium-Binding Proteins/genetics
- Calcium-Binding Proteins/metabolism
- Case-Control Studies
- Cell Proliferation
- Cells, Cultured
- Dose-Response Relationship, Drug
- Extracellular Matrix/metabolism
- Extracellular Matrix Proteins/antagonists & inhibitors
- Extracellular Matrix Proteins/genetics
- Extracellular Matrix Proteins/metabolism
- Gene Expression Profiling/methods
- Gene Expression Regulation
- Glycerophosphates/metabolism
- Humans
- Male
- Middle Aged
- Muscle, Smooth, Vascular/drug effects
- Muscle, Smooth, Vascular/metabolism
- Muscle, Smooth, Vascular/pathology
- Oligonucleotide Array Sequence Analysis
- Protein Processing, Post-Translational
- RNA Interference
- RNA, Messenger/metabolism
- RNA, Small Interfering/metabolism
- Reproducibility of Results
- Reverse Transcriptase Polymerase Chain Reaction
- Saphenous Vein/metabolism
- Up-Regulation
- Varicose Veins/genetics
- Varicose Veins/metabolism
- Varicose Veins/pathology
- Warfarin/pharmacology
- Matrix Gla Protein
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Mellor RH, Brice G, Stanton AWB, French J, Smith A, Jeffery S, Levick JR, Burnand KG, Mortimer PS. Mutations in
FOXC2
Are Strongly Associated With Primary Valve Failure in Veins of the Lower Limb. Circulation 2007; 115:1912-20. [PMID: 17372167 DOI: 10.1161/circulationaha.106.675348] [Citation(s) in RCA: 132] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background—
Mutations in the
FOXC2
gene cause lymphedema distichiasis, an inherited primary lymphedema in which a significant number of patients have varicose veins. Because lymphedema distichiasis is believed to be caused by lymphatic valve failure (reflux), and FOXC2 is highly expressed on venous valves in mouse embryos, we tested the hypothesis that
FOXC2
mutations may be linked to venous valve failure and reflux.
Methods and Results—
The venous system of the leg was investigated with Duplex ultrasound. Pathological reflux was recorded by color Duplex ultrasound in all 18 participants with a
FOXC2
mutation, including 3 without lymphedema. Every participant with a mutation in
FOXC2
showed reflux in the great saphenous vein (n=18), compared with only 1 of 12 referents (including 10 family members;
P
<0.0001, Fisher exact test). Deep vein reflux was recorded in 14 of 18 participants.
Conclusions—
FOXC2
is the first gene in which mutations have been strongly associated with primary venous valve failure in both the superficial and deep veins in the lower limb. This gene appears to be important for the normal development and maintenance of venous and lymphatic valves.
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Affiliation(s)
- Russell H Mellor
- Cardiac & Vascular Sciences, St George's, University of London, Cranmer Terrace, London, SW17 0RE, UK
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23
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Saiki S, Sakai K, Saiki M, Kitagawa Y, Umemori T, Murata K, Matsui M, Hirose G. Varicose veins associated with CADASIL result from a novel mutation in the Notch3 gene. Neurology 2006; 67:337-9. [PMID: 16864835 DOI: 10.1212/01.wnl.0000224758.52970.19] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
No genetically diagnosed cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) pedigrees with venous insufficiency have been described. In a CADASIL pedigree with varicose veins, the authors have identified a novel heterozygous mutation in the 3' splice acceptor site of intron 15 of the Notch3 gene. This, based on mRNA analysis, resulted in skipping of exon 16 including eight cysteine residues of EGF-like repeats.
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Affiliation(s)
- S Saiki
- Department of Neurology, Kanazawa Medical University, Ishikawa, Japan.
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24
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Ng MYM, Andrew T, Spector TD, Jeffery S. Linkage to the FOXC2 region of chromosome 16 for varicose veins in otherwise healthy, unselected sibling pairs. J Med Genet 2006; 42:235-9. [PMID: 15744037 PMCID: PMC1736007 DOI: 10.1136/jmg.2004.024075] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND The FOXC2 gene on 16q24 is mutated in lymphoedema distichiasis (LD), in which varicose veins (VV) are a common feature. We hypothesised that this gene might be implicated in the development of VV in the normal population, therefore, after performing a classical twin study, we tested for linkage and association in white women. We also tested for linkage with haemorrhoids (H), as a separate venous anomaly at the same locus. METHODS A total of 2060 complete female twin pairs aged 18-80 years from the St Thomas' Adult UK Twin registry replied to questions on VV and H as part of a broader postal survey of 6600 twins (62% response rate). Dizygotic female twin pairs were tested for linkage and association to the candidate marker D16S520 (1903 individuals genotyped), which is located about 80 kb from FOXC2. RESULTS Casewise concordance rates were significantly higher for monozygotic than dizygotic twins for both phenotypes (VV 67% v 45%; p = 2.2x10(-6); H 68% v 59%; p = 0.01; H including during pregnancy 73% v 64%; p = 2.1x10(-4)), corresponding to additive genetic heritabilities in liability of 86% (95% confidence interval (CI) 73% to 99%) for VV and 56-61% for H (95% CI 43% to 73%). The presence of VV and H were significantly correlated. We found significant evidence of linkage to the marker for VV (MLS(ASP) = 1.37, p = 0.01; GLM(ASP/DSP) Z = 3.17 p = 0.002), but no association. Both linkage and association tests were negative for H. The combined phenotype of having VV and H did not show any evidence of linkage or association. CONCLUSION These results demonstrate VV and H to be heritable, related conditions, and the data strongly suggest FOXC2 to be implicated in the development of VV in the general population.
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Affiliation(s)
- M Y M Ng
- Twin Research and Genetic Epidemiology Unit, St. Thomas' Hospital, London SE1 7EH
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25
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Abstract
BACKGROUND There has been little information reported about the genetic event concerning the pathophysiology of varicose vein (VV). OBJECTIVES The purpose of this study was to examine the differentiation of gene expression in the wall of VV using complementary deoxyribonucleic acid (cDNA) microarrays. METHODS The study was performed with four pairs of VVs and control veins (CVs). cDNA specimens of VVs were prepared from the ribonucleic acid-isolated VVs of patients who underwent venous obliteration, using radiofrequency, as well as from CVs of those who underwent aortocoronary bypass grafting. Each set of VVs and CVs was hybridized with high-density microarray containing 3,063 human cDNAs. The finding of microarray hybridization were scanned, analyzed, and classified with the cluster program. RESULTS Among 3,063 cDNA clones, 82 genes were up-regulated in VVs, and some of the up-regulated genes, which were detected by cDNA microarray, including transforming growth factor 3-induced gene (BIGH3), tubulin, lumican, actinin, collagen type I, versican, actin, and tropomyosin, belonged to extracelluar matrix molecules, cytoskeletal proteins, or myofibroblasts. CONCLUSIONS Many up-regulated genes were found in Ws by applying cDNA microarray. These gene profiles suggested a pathway associated with fibrosis and that wound healing might be related to the pathophysiology of VVs.
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Affiliation(s)
- Seokjong Lee
- Department of Dermatology, Kyungpook National University School of Medicine, Daegu, Korea
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26
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Abstract
BACKGROUND A number of changes in protein expression have been described in primary varicose veins, but the altered gene expressions in this disease are unknown. The aim of this study was to identify differentially expressed genes in primary varicose veins. MATERIALS AND METHODS Total RNAs were isolated from two groups of greater saphenous veins (four primary varicose veins and three normal) and then were reverse transcribed into cDNAs. We used the differential display reverse transcription-polymerase chain reaction technique to screen the differences in the mRNA expression profiles of the groups. RESULTS We found that three cDNAs showed differences in expression patterns between normal and diseased saphenous veins. The cDNAs are prominently expressed only in patients with varicose veins. We identified that the cDNAs had significant similarities to the L1M4 repeat sequence of clone RP11-57L9, clone RP11-299H13, and Alu repetitive sequence of human tropomyosin 4 mRNA. CONCLUSIONS Our results suggest that the screened cDNA clones are useful disease markers in the genetic diagnosis of primary varicose vein and that the L1 and Alu elements possibly participated in the development of primary varicose veins through their expression patterns in genes encoded with structural proteins, such as collagen, elastin, and tropomyosin. Further studies are required to elucidate the potential relationship between repeat sequences and primary varicose veins.
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Affiliation(s)
- Dong-Ik Kim
- Division of Vascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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27
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Hollingsworth SJ, Powell GL, Barker SGE, Cooper DG. Primary Varicose Veins: Altered Transcription of VEGF and its Receptors (KDR, flt-1, Soluble flt-1) with Sapheno-femoral Junction Incompetence. Eur J Vasc Endovasc Surg 2004; 27:259-68. [PMID: 14760594 DOI: 10.1016/j.ejvs.2003.12.015] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Loss of regulation of vascular endothelial growth factor (VEGF) production and action disturbs vascular homeostasis leading to pathology. Primary varicose veins (VVs) demonstrate aberrant production/release of VEGF. Our aim was to examine transcription of genes for VEGF (VEGF(121)/VEGF(165)) and its receptors (KDR, flt-1, s.flt-1) in VVs, in relation to underlying venous incompetence. MATERIALS AND METHODS Samples of varicose (n=83, 18 patients) or normal (n=14, five subjects) great saphenous vein were divided into segments, determined by anatomical position from the sapheno-femoral junction (SFJ). SFJ and segmental incompetence were determined from duplex scans. Gene transcripts were amplified by RT-PCR, analysed by scanning densitometry, and the levels of transcription determined by ratio to control gene GADPH-3 (GAP-3). RESULTS VEGF(121)/(165), KDR and flt-1 transcription was elevated in VVs overall (p<0.001), and in VVs with an incompetent SFJ (p<0.001), but not when the SFJ was functional; s.flt-1 was unaltered. Notably, gene transcription was unaffected by segmental position, or incompetence. Position below the SFJ correlated with increased transcription of s.flt-1 when the SFJ was incompetent (p<0.04), and s.flt-1 and VEGF(121) when the segment was incompetent (p<0.03). CONCLUSIONS SFJ incompetence is associated with altered transcription of VEGF and its receptors reflecting an aetiological mechanism or later stage of disease development. Altered VEGF(121) and s.flt-1 transcription may be an early event in varicogenesis.
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Affiliation(s)
- S J Hollingsworth
- The Academic Vascular Unit, Department of Surgery, The Royal Free and University College Medical School London, The Middlesex Hospital, Mortimer Street, London, UK
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28
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Affiliation(s)
- Chieh-Min Fan
- Massachusetts General Hospital, Department of Radiology, Boston, MA 02114, USA
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29
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Abstract
Many contributing factors are involved in the genesis of varicose disease of the lower limbs such as age, sex, heredity, sedentary life style among others. For physicians the decisive role played by heredity leaves no doubt. Few studies have, however, attempted to prove the importance of the hereditary factor on a clinical level, and no study has been conducted in molecular genetics. The impact of the hereditary factor is variably estimated and its nature is open to discussion. Despite the numerous limits of the research focusing on the hereditary aspect of varicose disease, the authors can nevertheless claim that the genetic factor definitively exists and has a great impact. There are few studies conducted among twins. The data collected in these studies point to the reality of various types of heredity. With the predominant impact of the hereditary factor, and despite the role played by environmental factors, it can be supposed that a single genetic anomaly may be the determining factor of the disease in a given family. Thus we have conducted an original study in order to identify one or several mutations predisposing to varicose disease, based on the approach called "reverse genetic" and linkage study. The study of a first family whose varicose disease segregates in an autosomal dominant manner allowed us to identify 3 potential loci, if we accept the hypothesis of 2 or 3 phenocopies. No candidate gene has been singled out in these regions in the first analysis. The study of a second family whose phenotype of the varicose disease is particularly homogeneous and segregates in an autosomal dominant manner did not confirm any of the previously identified loci, probably related to a genetic heterogeneity of the varicose disease. As a consequence, the second part of this study was devoted to determining the complete genotype of each individual within this family, in order to identify new loci of interest. A potential locus has just been identified. The third part of this research, currently being pursued, is devoted to the sequencing of potential genes. In parallel, the analysis of new large families is underway. The presentation will include an update on the hereditary and genetic aspects of varicose disease, and secondly identify the limits and difficulties of the genetic study of the families.
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Affiliation(s)
- Marc-Antoine Pistorius
- Department of Vascular Medicine, Hôtel-Dieu, place Alexis Ricordeau, 44000 Nantes, France
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30
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Yin HH, Wang SM, Wang JS, Hu ZJ, Huang XL. [Default of KIAA0353 gene in varicose great saphenous vein accompanying primary deep vein valve insufficiency]. Zhonghua Yi Xue Za Zhi 2003; 83:620-3. [PMID: 12887813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
OBJECTIVE To screen and identify the genes related to the occurrence and development of varicose great saphenous vein in the patients with primary deep vein valve insufficiency (PDVI). METHODS mRNA fluorescent differential display (FDD) technique was used to compare the different cDNA fragments originated from differentially expressed mRNAs from the venous tissues of 10 patients with varicose great saphenous vein complicated with PDVI. Ten specimens of normal venous tissue from 10 patients dying from other diseases were used as controls. The differently expressed cDNA fragments were then re-amplified and labeled with DIG to prepare probes for later Northern blotting. Positive fragments confirmed by Northern blotting were cloned into pGEM-T easy vector and sequenced using Sanger's method. Then the sequences were compared with the data in GeneBank by BLASTN software to search for their genetic origin. RESULTS Altogether 37 differentially expressed cDNA fragments were discovered from the 2 groups, among which 30 were confirmed by Northern blotting. There was a notable 540 bp-long cDNA fragment, which was only presented in the control group, sharing 99% homology with part of the mRNA sequence of human KIAA0353 gene. CONCLUSION The varicose great saphenous vein of PDVI patients is a process with the involvement of multiple genes and the default of KIAA0353 gene may play a role in the occurrence and development of varicose great saphenous vein in PDVI patients.
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Affiliation(s)
- Heng-hu Yin
- Department of Vascular Surgery, First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
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31
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Kakkos SK, Zolota VG, Peristeropoulou P, Apostolopoulou A, Geroukalos G, Tsolakis IA. Increased mast cell infiltration in familial varicose veins: pathogenetic implications? INT ANGIOL 2003; 22:43-9. [PMID: 12771855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
AIM Increased infiltration of activated mast cells has been recently implicated in the pathophysiology of varicose veins. The aim of the present study was to investigate a possible association between mast cell infiltration of primary varicose veins and clinical features, which could clarify further varicose vein pathophysiology. METHODS Seventeen patients, operated on for primary varicose veins and greater saphenous vein incompetence, participated in the study. Mast cells, distributed within the adventitia of grossly abnormal segments of the greater saphenous vein and calf varicosities removed during surgery, were identified and measured in stained tissue sections. The mast cell count, expressed as mast cells per 10 high-power fields, was subsequently associated with clinical features, including age, gender, body mass index, familial varicose veins, duration of varicose vein disease and relation to previous pregnancies, leg symptoms and findings on physical examination, clinical class and score of chronic venous insufficiency (CEAP classification). RESULTS Patients with family history of varicose veins (n=7) had a significantly increased mast cell infiltration (median, interquartile range) of the abnormal venous segments (16, 8.4) in comparison with those (n=10) without such a history (9.2, 7.3), p=0.005. Mast cell infiltration had a significant inverse association with age (r= -0.49, p=0.046), but not with the remaining clinical features. CONCLUSION Our findings support the hypothesis that the increased mast cell infiltration in varicose veins is not a consequence of venous hypertension. Furthermore, the increased mast cell infiltration in familial varicose veins implies a rather primary role and therefore the presence of a distinct pathophysiology. Further investigation testing the activity of mast cells in cases of family history might reveal another step in the pathogenic mechanism of varicose veins, leading to a more rational treatment.
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Affiliation(s)
- S K Kakkos
- University of Patras Medical School, Patras, Greece
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32
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Abstract
We present the case report of a patient with neurofibromatosis and regional dysmorphism in the superficial femoral vein. Colour coded duplex sonography revealed an incidental finding: thickening of a short portion of the vein wall with calcification. This unusual finding strongly suggests a causal relationship. Pathological processes in the arteries have often been described in patients with von Recklinghausen's disease (neurofibromatosis). Dysplastic and hyperplastic reactions of the intramural nerve tissues and the smooth muscle elements in the vascular wall have been observed. This leads to the formation of aneurysms and arteriovenous fistulas and to stenosing processes in the peripheral, visceral and cerebral arteries. However, involvement of the veins in type 1 von Recklinghausen's neurofibromatosis has only been reported in old histopathological studies of medium-sized and small vessels.
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Affiliation(s)
- F Präve
- Venenzentrum Frankfurt am Main.
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33
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Wang S, Yin H, Wang J, Hu Z, Huang X. [Screening and cloning of genes related to varicose great saphenous vein accompanying with primary deep vein valve insufficiency]. Zhonghua Wai Ke Za Zhi 2002; 40:909-11. [PMID: 12654207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
OBJECTIVE To screen the genes related to the occurrence and development of varicosis of the great saphenous vein in the patients with primary deep vein valve insufficiency. METHODS Using mRNA fluorescent differential display reverse transcriptive polymerase chain reaction (FDD-RTPCR), different genes expressed in the varicose great saphenous veins in patients with primary deep vein valve insufficiency and corresponding normal human tissues were compared. Differentially expressed cDNA fragments confirmed by Northern blot were compared and then cloned into the pGEM-Teasy vector. Positive clones were selected and sequenced. All the sequences were put into GenBank and analyzed by BLASTN software to search for their genetic origins. RESULTS Altogether 37 different cDNA fragments were obtained and 30 of which were confirmed by Northern blot. Analysis of the sequences by BLASTN software showed that C(610) fragment (NO. 18 cDNA clone) shared 96% homology with the mRNA sequence of the human Mckusick-Kaufman syndrome gene (MKKS gene). CONCLUSION C(610) fragment is highly homologous with the mRNA sequence of the human MKKS gene and is closely related to the development of varicosis of the great saphenous vein in patients with primary deep vein valve insufficiency.
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Affiliation(s)
- Shenming Wang
- Department of Vascular Surgery, First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, China
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34
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Sansilvestri-Morel P, Rupin A, Jaisson S, Fabiani JN, Verbeuren TJ, Vanhoutte PM. Synthesis of collagen is dysregulated in cultured fibroblasts derived from skin of subjects with varicose veins as it is in venous smooth muscle cells. Circulation 2002; 106:479-83. [PMID: 12135949 DOI: 10.1161/01.cir.0000022846.22923.46] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The dilatation and tortuosity observed in varicose veins provide evidence for progressive venous wall remodeling associated with abnormalities of smooth muscle cells and extracellular matrix. The present study was designed to examine if the phenotypic modulations observed in the venous smooth muscle cells of patients with varicose veins were also present in their dermal fibroblasts. METHODS AND RESULTS Collagen type I (collagen I), type III (collagen III), and type V (collagen V) were compared in dermal fibroblasts derived from the skin of control subjects and patients with varicose veins. The synthesis of collagen I, the release of its metabolites, and the expression of its mRNA were increased in fibroblasts from patients with varicose veins, whereas the synthesis of collagen III was decreased but not correlated with a decrease in mRNA expression and in metabolite release. Matrix metalloproteinases (MMP1, 2, 7, 8, 9, and 13) and their inhibitors (TIMP1 and 2) were quantified in both cell types; only the production of proMMP2 was increased in cells derived from patients with varicose veins. CONCLUSIONS These findings suggest that the synthesis of collagen I and III is dysregulated in dermal fibroblasts derived from patients with varicose veins. These results are comparable with those observed in smooth muscle cells derived from varicose veins, thus suggesting a systemic alteration of tissue remodeling in subjects with varicose veins.
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35
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36
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Yuwono HS. Diagnosis and treatment in the management of chronic venous insufficiency. Clin Hemorheol Microcirc 2001; 23:233-7. [PMID: 11321445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
Chronic venous insufficiency (CVI) is caused mainly by an alteration in the elasticity of venous walls and the dysfunction of venous valves. The diagnosis and treatment for CVI management are discussed in this paper.
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Affiliation(s)
- H S Yuwono
- Sub-Department of Vascular Surgery, Padjadjaran State University, Bandung, Indonesia.
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37
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Le Flem L, Mennen L, Aubry ML, Aiach M, Scarabin PY, Emmerich J, Alhenc-Gelas M. Thrombomodulin promoter mutations, venous thrombosis, and varicose veins. Arterioscler Thromb Vasc Biol 2001; 21:445-51. [PMID: 11231927 DOI: 10.1161/01.atv.21.3.445] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
We analyzed the distal promoter region of the thrombomodulin (TM) gene (nucleotides -300 to -2052) in subjects from the Paris Thrombosis Study (PATHROS), a French case-control study of venous thrombosis, to identify polymorphisms that might modify TM gene expression. Eight novel mutations were found in the 40 DNA samples initially screened. Two of these mutations (-1748G/C and -1208/-1209 del TT) were frequent. One rare transition (-1166G/A) might have functional consequences owing to its position. These 3 mutations were screened for in the entire study population of 327 patients and 398 controls. None of the 3 was significantly associated with thrombosis. Interestingly, the -1208/-1209 TT deletion was associated with varicose veins in the patients. This mutation was in tight linkage disequilibrium with the +1418 C/T change in the coding sequence, a known polymorphism that predicts an Ala 455 Val substitution in the sixth epidermal growth factor-like TM module, a domain previously implicated in the proliferative functions of TM. This linkage suggests that the Ala 455 Val mutation may promote changes in these functions and thus be involved in varicose vein formation.
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Affiliation(s)
- L Le Flem
- Service d'Hématologie Biologique A and Service des Maladies Vasculaires, Hôpital Européen Georges Pompidou, AP-HP, Unité INSERM 428, France
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38
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Ivanov VP, Polonikov AV, Solodilova MA, Lukashov AA. [Contents of the main erythrocyte membrane proteins in patients with primary arterial hypertension and its relationship with hereditary predisposition to cardiovascular diseases]. TERAPEVT ARKH 2001; 72:73-6. [PMID: 11076426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
AIM To study quantitative content of main erythrocyte membrane proteins in patients with primary arterial hypotension and its relationship with hereditary predisposition to cardiovascular disease. MATERIAL AND METHODS Quantitative content of main erythrocyte membrane proteins in 109 patients with primary arterial hypotension (PAH) and 124 healthy persons was measured with unidimensional polyacrylamide gel electrophoresis. Hereditary determination of PAH was studied by the clinical-genealogical method. RESULTS PAH patients showed quantitative alterations in erythrocyte membrane protein composition: increased content of alpha-spectrin, ankyrin (band 2.1), anion exchange protein (band 3) and decreased content of actin, tropomyosin and glutathione-S-transferase. Patients with aggravated heredity for PAH had higher content of beta-spectrin and ankyrin (band 2.1 and 2.2) then patients without aggravated heredity for PAH. CONCLUSION Quantitative alterations of membrane proteins in patients with PAH could significantly modify the structure of cytoskeleton and result in modification of the enzyme activity of transmembrane proteins (ATPases) regulating cation transport across erythrocyte membrane. Moreover, aggravated heredity for PAH predisposes to high content of cytoskeletal proteins (beta-spectrin, 2.1 and 2.2 ankyrin) which could form more compact structure of erythrocyte membrane and limit cation influx into cytoplasma.
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39
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López-Cepero Andrada JM, López Silva M, Ferré Alamo A, Salado Fuentes M, Benítez Roldán A. [Familial colonic varices: report of two cases]. Gastroenterol Hepatol 2000; 23:341-3. [PMID: 11002536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Idiopathic or familial colonic varices are an infrequent cause of gastrointestinal hemorrhage. It seems that congenital vascular abnormalities are involved in its etiopathogenesis. We present two cases in the same family. The disease first presented as intermittent episodes of rectorrhagia. In one case varices of the small intestine were detected by radiology. Both cases were given conservative treatment and we believe that surgery should be limited to selected cases and always after a careful observation period.
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40
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Baldursson B, Syrjänen S, Beitner H. Expression of p21WAF1/CIP1, p53, bcl-2 and Ki-67 in venous leg ulcers with and without squamous cell carcinoma. Acta Derm Venereol 2000; 80:251-5. [PMID: 11028856 DOI: 10.1080/000155500750012117] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
In order to gain understanding of the cellular mechanisms of malignant transformation in chronic venous leg ulcers, we analysed by immunohistochemistry the presence of p21, p53, bcl-2 and Ki-67 in ulcers with and without squamous cell carcinoma. The material consisted of 41 archived histopathological samples from 33 patients with chronic venous leg ulcers and 28 samples from 21 patients suffering from squamous cell carcinoma in chronic venous leg ulcers. All samples derived from the chronic ulcers were negative for p53, p21 and bcl-2. Cells positive for Ki-67 were seen in certain ulcer areas. In the cancers, 14 samples showed immunopositivity for p53 and 22 samples were positive for p21, with expression mainly in the suprabasal layer. Expression of p21 seemed independent of p53. None of the samples was bcl-2-positive. Ki-67 was positive with basal expression in 16/28 of the tumour samples, 15 of which also expressed p21. There was no perilesional p53 or p21 activity in the cancer samples. The results regarding perilesional expression are different from those reported in UV-induced squamous cell carcinomas and probably reflect a different carcinogen.
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Affiliation(s)
- B Baldursson
- Department of Dermatology, Gävle Hospital, Sweden.
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41
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Affiliation(s)
- M Kori
- The Gastroenterology Unit and The Department of Pediatrics, Kaplan Hospital, Rehovot, Israel
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42
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Jeanneret C, Labs KH, Aschwanden M, Bollinger A, Hoffmann U, Jäger K. Physiological reflux and venous diameter change in the proximal lower limb veins during a standardised Valsalva manoeuvre. Eur J Vasc Endovasc Surg 1999; 17:398-403. [PMID: 10329523 DOI: 10.1053/ejvs.1998.0797] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVES the aim of this study was to provide normal values for venous diameter at rest, and venous diameter and physiologic venous reflux during a standardised Valsalva manoeuvre. The impact of the patient's sex, body mass index (BMI), and family history was investigated. MATERIAL AND METHODS eighty legs of 40 healthy volunteers were investigated in a supine position. The median age was 28 years (range 20-66 years). The common femoral vein (CFV), the proximal superficial femoral vein (SFV) and the proximal long saphenous vein (LSV) were investigated by duplex sonography. The following parameters were assessed: resting diameter (VDrest) and maximum diameter (VDmax) as well as reflux time (tr) during the Valsalva manoeuvre. The Valsalva manoeuvre was elicited by a forceful expiration into a tube system. The standard values used were a pressure of 30 mmHg, established within 0.5 seconds (s) and maintained over a time period of at least 3 s. RESULTS mean VDrest and VDmax were 8.3+/-2.2 and 11.1+/-2.8 mm in the CFV, 5.9+/-1. 3 and 7.2+/-1.6 mm in the SFV and 3.5+/-0.9 and 4.3+/-1.4 mm in the LSV. Mean values for tr were 0.61+/-0.63 s in the CFV, 0.25+/-0.26 s in the SFV and 0.28+/-0.40 s in the LSV. A BMI >22.5 kg/m2 was associated with statistically significant larger values for VDrest and tr. If adjusted for BMI, tr in the SFV and the LSV did not differ by sex. For healthy subjects with first-degree relatives suffering from varicose veins (n=19), mean VDrest in the SFV as well as VD in the LSV was significantly larger (p=0.02, 0.05, respectively). Coefficients of variation for repeated measurements (VDrest, VDmax, tr) in the same segment varied between 3.3% and 16. 4% for the three investigated sites. CONCLUSIONS normal values for VDrest and VDmax as well as reflux time during a standardised Valsalva manouevre were assessed in the proximal lower limb veins. The influences of BMI, sex and family history were investigated. The described standardised Valsalva manoeuvre led to highly reproducible results and can be recommended for further research projects or as a routine procedure for the assessment of venous reflux.
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Affiliation(s)
- C Jeanneret
- Division of Angiology, University of Basel Medical School, 4031 Basel, Switzerland
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43
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Bernardini D, Barthet M, Castellani P, Sahel J, Gauthier A, Botta-Fridlund D. [Familial varices of the colon. Report of four cases]. Gastroenterol Clin Biol 1998; 22:827-30. [PMID: 9854209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
We report four cases of ileo-colonic varices in one family. This congenital disease is uncommon with only 21 cases described in the literature. Recurrent digestive tract bleeding is the most common manifestation, but varices can be asymptomatic. Digestive endoscopy leads to the diagnosis. The diagnosis of familial colonic varices can be considered when colonic varices occur in several members of a family with no evident cause, particularly portal hypertension or venous thrombosis. No treatment is usually necessary except when major or recurrent bleeding indicates surgical resection. These malformations are classified as vascular ectasia in the subgroup of cavernous haemangiomas.
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Affiliation(s)
- D Bernardini
- Service d'Hépato-Gastroentérologie, Hôpital de la Conception, Marseille
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44
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Guo Q, Guo C. [Genetic analysis of varicose vein of lower extremities]. Zhonghua Yi Xue Yi Chuan Xue Za Zhi 1998; 15:221-3. [PMID: 9691130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To make a hereditary analysis of varicose vein of lower extremities(VVLE), including hereditary pattern, sex ratio and the transmitted expression male and female of varicose vein of lower extremities. METHODS The ascertainment probability was estimated according to Weinberg's proband method. The value of segregation ratio P and proportion of sporadic cases X were estimated by the maximum likelihood score method. The calculations were performed using computer program of segregation analysis. The VVLE cases were random samples from inpatients and outpatients of the authors' hospital from 1991 to 1996. RESULTS There were 68 pedigrees including 80 nuclear families in 3 different mating types:UAU, UAA and AAA. UAU, UAA and AAA were analysed together. UAA and UAU (multiplex families) were analysed respectively. All the values were compatible with autosomal dominant inheritance of incomplete penetrance; the penetrance frequencies were 91.94%, 78.14% and 69. 92% respectively. The proportion of X was 24.32%. The UAU was compatible with autosomal recessive inheritance; the proportion of sporadic cases was 36.75%. CONCLUSION VVLE is compatible with autosomal dominant and recessive inheritance. The sex ratio of male:female is 2.39:1. The transmission is possible from male and female to male and female both.
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Affiliation(s)
- Q Guo
- Provincial Hospital of Shandong, Jinan, Shandong, 250021 P. R. China. chenhong
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Sverdlova AM, Bubnova NA, Baranovskaya SS, Vasina VI, Avitisjan AO, Schwartz EI. Prevalence of the methylenetetrahydrofolate reductase (MTHFR) C677T mutation in patients with varicose veins of lower limbs. Mol Genet Metab 1998; 63:35-6. [PMID: 9538515 DOI: 10.1006/mgme.1997.2638] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Abstract
Most cases of KTW syndrome are sporadic. However, in a few, other family members have some clinical manifestations of the syndrome, and an autosomal dominant mode of inheritance has been suggested. In this paper we present a family with an affected child who has large skin hemangiomata, overgrowth of the right leg, and severe heart defects. Her mother has a large capillary hemangioma on the left side of back and has developed severe varicosities in both lower extremities. The maternal grandmother developed severe varicosities in her legs at a young age. The clinical signs found in the mother and maternal grandmother represent a milder phenotype and might be explained as variable expressivity of the syndrome. The family tree supports autosomal dominant inheritance.
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Affiliation(s)
- J M Ceballos-Quintal
- Centro de Investigaciones Regionales Dr. Hideyo Noguchi, Laboratorio de Genética, Universidad Autónoma de Yucatán, México
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47
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Scappaticci S, Capra E, Cortinovis M, Cortinovis R, Arbustini E, Diegoli M, Fraccaro M. Cytogenetic studies in venous tissue from patients with varicose veins. Cancer Genet Cytogenet 1994; 75:26-30. [PMID: 8039160 DOI: 10.1016/0165-4608(94)90211-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Cytogenetic investigation of primary cell cultures from fragments of varicose veins of seven patients with familial varicosity and seven patients with the sporadic type revealed the presence of metaphases with structural abnormalities, clonal trisomies of chromosomes 7, 12, and 18, and monosomy of chromosome 14 only in cases with the familial type, while the sporadic cases had no similar chromosome aberrations. The immunophenotypical results are consistent with fibroblast lineage of the cultured cells. These results suggest that karyotypic variations in familial varicose vein tissue cultures could in some way be associated either with the genotypic constitution responsible for the familial type or a longer duration of disease on average than those with sporadic varicosities.
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Affiliation(s)
- S Scappaticci
- Biologia Generale e Genetica Medica, Università di Pavia, Italy
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48
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Affiliation(s)
- M M el-Dosoky
- Department of Radiology, Academic Medical Center, Amsterdam, Netherlands
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49
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Cornu-Thenard A, Boivin P, Baud JM, De Vincenzi I, Carpentier PH. Importance of the familial factor in varicose disease. Clinical study of 134 families. J Dermatol Surg Oncol 1994; 20:318-26. [PMID: 8176043 DOI: 10.1111/j.1524-4725.1994.tb01631.x] [Citation(s) in RCA: 102] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND The role of heredity in the development of varicose veins of the lower limbs has been raised many times in the literature. When evaluating this role, most authors only question the patients, without examining their relatives. As shown in other papers, the subjectivity of this type of data throws doubt on the results. OBJECTIVE This problem was evaluated by means of a prospective study based on clinical examination of all immediate family members. METHODS In the case-control study, the female or male patients had to satisfy the following criteria: 1. Varicose veins in their legs. 2. Age between 30 and 40 years (meaning that, in most cases, their parents were still alive). 3. No history of deep vein thrombosis. To limit the influence of certain confusing factors (diet, life-style), the control group was composed of the patients' spouses, who were not suffering from varicose veins. The parents of the cases and the parents of the controls were also examined. For each case-control couple and for the four parents, we recorded the history of venous disease, the life-style, and the results of clinical examination, including the results of palpation and percussion of the various varicose vein territories. RESULTS One hundred and thirty-four families were examined: 67 patients and their parents and 67 controls and their parents. A total of 402 subjects were examined. The results demonstrated a prominent role of heredity in the development of varicose veins (P < .001). The risk of developing varicose veins for the children was 90% when both parents suffered from this disease, 25% for males and 62% for females when one parent was affected, and 20% when neither parent was affected.
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Affiliation(s)
- A Cornu-Thenard
- Service de Cardiologie, Hôpital Saint-Antoine, Paris, France
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50
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Binaghi F, Cannas F, Fronteddu PF, Pitzus F. [Relation between changes in the microcirculation in the capillaries supplying the toenails and the degree of chronic venous insufficiency]. Minerva Cardioangiol 1994; 42:163-8. [PMID: 8058182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Chronic venous insufficiency (CVI) is characterised by stasis which may lead to an imbalance in the cutaneous microcirculation resulting in a wide spectrum of complications. The use of capillaroscopy on the toenail folds of patients with CVI allows the morphological and microhemorrheological aspects of microcirculatory disorders to be studied. The aim of this study was to clarify the correlation between the extent of abnormalities of the nutritional capillary and the degree of severity of CVI according to Widmer's classification. Capillaroscopy of the toenail fold was used to study 100 patients suffering from essential varicose disease (EVD) and post-thrombotic syndrome (PTS) with CVI of various degrees, giving a total of 110 limbs grouped as follows: 30 limbs at stage 0; 49 at stage 1; 20 at stage 2 and 12 at stage 3. In addition, a further 30 limbs of normal subject without a family history of varicose disease were included in the study. All patients and control subjects were examined clinically and using ultrasound c.w. Doppler and eco-color-Doppler of the lower limbs. The results highlighted a progressive deterioration of the capillaroscopic conditions in relation to the severity of CVI. In particular, during stage 1 microcirculatory alterations found in patients with primary varicose syndromes appeared to be more severe than those with PTS. This apparent contradiction may be attributed to the unique topography of this hemodynamic disorders since the subpapillary circulation in EVD is topographically in direct continuity with the site of venous hypertension.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- F Binaghi
- Istituto di Clinica Medica, Università degli Studi di Cagliari
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