Efficacy of the treatment with prostaglandin E-1 in venous ulcers of the lower limbs

Milio, G; Minà, Chiara; Cospite, Valentina; Almasio, Piero Luigi; Novo, Salvatore

doi:10.1016/j.jvs.2005.03.040

Cited by 32 publications

(22 citation statements)

References 39 publications

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“…An intravenous treatment with prostaglandin E 1 was tested in VLUs and demonstrated reduced time to healing, improved complete healing rate, and improvement in other outcomes pertinent to chronic venous disorders, such as edema and venous symptoms. [464][465][466] The constraint of intravenous infusion (3 hours daily for 6 weeks), however, makes this therapy difficult to recommend. The discovery of the involvement of leukocytes in the pathophysiologic mechanism of VLUs has opened another pathway for successful investigations.…”

Section: [Best Practice]mentioning

confidence: 99%

Management of venous leg ulcers: Clinical practice guidelines of the Society for Vascular Surgery® and the American Venous Forum

O’Donnell¹,

Passman²,

Marston³

et al. 2014

Journal of Vascular Surgery

570

450

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Section: [Best Practice]mentioning

confidence: 99%

Management of venous leg ulcers: Clinical practice guidelines of the Society for Vascular Surgery® and the American Venous Forum

O’Donnell¹,

Passman²,

Marston³

et al. 2014

Journal of Vascular Surgery

570

450

View full text Add to dashboard Cite

“…In a randomized trial, infusion of prostaglandin E1 vs. placebo for 20 days demonstrated that all the venous ulcers were healed at 4 months, and a significant decrease in ulcer area were observed at 80 days. It was concluded that prostaglandin E1 may be beneficial in venous ulcer healing, possibly by improving the alterations in the microcirculation and hypoxemia associated with venous ulcer formation [103].…”

Section: Management Of Varicose Veinsmentioning

confidence: 99%

Matrix Metalloproteinases in Venous Tissue Remodeling and Varicose Vein Formation

Raffetto¹,

Khalil²

2008

CVP

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Matrix metalloproteinases (MMPs) play a major role in extracellular matrix (ECM) turnover under both physiological and pathological conditions. Studies on venous tissues from experimental animals and humans identified several MMP subtypes, and showed significant changes in the expression and activity of specific MMPs during vein wall remodeling. Also, significant research has focused on the role of MMPs in chronic venous disease (CVD) and varicose vein formation in the lower extremities and their progression to thrombophlebitis and venous leg ulcer. Several hypotheses have been forwarded regarding the pathophysiological mechanisms underlying the relation between MMPs and the formation, progression and complications of varicose veins. The effects of MMPs on ECM degradation could result in significant venous tissue remodeling and degenerative and structural changes in the vein wall, leading to venous dilation and valve dysfunction. MMPs may also induce early changes in the endothelium and venous smooth muscle function in the absence of significant ECM degradation or structural changes in the vein wall. In addition, evidence suggests increased activity of MMPs in the advanced stages of chronic venous insufficiency (CVI) associated with skin changes and leg ulceration as well as in the wound fluid environment. Several pharmacological therapies and surgical strategies are being utilized in the management of varicose veins, with variable success and recurrence rates. Inhibition of MMPs may represent a novel therapeutic intervention to limit the progression of varicose veins to CVI and leg ulceration.

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“…Prostaglandins that inhibit platelet aggregation, leukocyte activation and capillary permeability and promote venodilation and fibrinolysis can be useful. In a randomized trial, infusion of prostaglandin E1 vs. placebo for 20 days showed healed venous ulcers at 4 months, and a decrease in ulcer area at 80 days, suggesting beneficial effects in venous ulcer healing, possibly by improving the microcirculation and reducing the hypoxemia associated with venous ulcer [320]. …”

Section: Introductionmentioning

confidence: 99%

Matrix Metalloproteinases as Potential Targets in the Venous Dilation Associated with Varicose Veins

Khalil¹

2013

Current Drug Targets

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Varicose veins (VVs) are a common venous disease of the lower extremity characterized by incompetent valves, venous reflux, and dilated and tortuous veins. If untreated, VVs could lead to venous thrombosis, thrombophlebitis and chronic venous leg ulcers. Various genetic, hormonal and environmental factors may lead to structural changes in the vein valves and make them incompetent, leading to venous reflux, increased venous pressure and vein wall dilation. Prolonged increases in venous pressure and vein wall tension are thought to increase the expression/activity of matrix metalloproteinases (MMPs). Members of the MMPs family include collagenases, gelatinases, stromelysins, matrilysins, membrane-type MMPs and others. MMPs are known to degrade various components of the extracellular matrix (ECM). MMPs may also affect the endothelium and vascular smooth muscle, causing changes in the vein relaxation and contraction mechanisms. ECs injury also triggers leukocyte infiltration, activation and inflammation, which lead to further vein wall damage. The vein wall dilation and valve dysfunction, and the MMP activation and superimposed inflammation and fibrosis would lead to progressive venous dilation and VVs formation. Surgical ablation is an effective treatment for VVs, but may be associated with high recurrence rate, and other less invasive approaches that target the cause of the disease are needed. MMP inhibitors including endogenous tissue inhibitors (TIMPs) and pharmacological inhibitors such as zinc chelators, doxycycline, batimastat and marimastat, have been used as diagnostic and therapeutic tools in cancer, autoimmune and cardiovascular disease. However, MMP inhibitors may have side effects especially on the musculoskeletal system. With the advent of new genetic and pharmacological tools, specific MMP inhibitors with fewer undesirable effects could be useful to retard the progression and prevent the recurrence of VVs.

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Efficacy of the treatment with prostaglandin E-1 in venous ulcers of the lower limbs

Abstract: This study demonstrates the effectiveness of PGE-1 in reducing the healing time of venous ulcers, suggesting that venous ulcers should also be considered ischemic.

Cited by 32 publications

References 39 publications

Management of venous leg ulcers: Clinical practice guidelines of the Society for Vascular Surgery® and the American Venous Forum

Management of venous leg ulcers: Clinical practice guidelines of the Society for Vascular Surgery® and the American Venous Forum

Matrix Metalloproteinases in Venous Tissue Remodeling and Varicose Vein Formation

Matrix Metalloproteinases as Potential Targets in the Venous Dilation Associated with Varicose Veins

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