Features of Expression of Growth Mediators and Matrix Metalloproteinases at the Local Level in Patients With Lower Limb Varicose Veins, Clinical Class C4 - C6

Abstract

The purpose of the research was to study the features of the expression of growth mediators and matrix metalloproteinases in patients with lower limb varicose veins, clinical classes C4-C6. The study included 98 patients. The control group consisted of 102 healthy donors. The levels of VEGF, PDGF, matrix metalloproteinases (MMP-2, MMP-9), superoxide dismutase, and prolidase were studied. The average value of VEGF in pathologically altered vein (PAV) wall samples was 40.1 ± 6.2 ng/g of protein and was statistically significantly higher - 1.7 times compared with the same value in persons from CG 2 (23.0 ± 5.9 ng/g protein, p=0.001). Patients with lower limb varicose veins (LLVV) showed an inverse correlation between VEGF levels and SOD activity in blood plasma and PAV (r=-0.52; p=0.002 and r=-0.59; p=0.001, respectively). An increase in the level of PDGF correlated with an increase in the oxidative stress index (OSI) in the blood plasma and the PAV wall (r=0.59; p=0.022 and r=0.61; p<0.001). In patients with LLVV, a high level of MMP-9 inversely correlated with the total oxidant capacity (TAC) in blood plasma and in the varicose vein wall (r=-0.48; p<0.001 and r=-0.52; p=0.012). In patients with LLVV, there were statistically significant relationships between prolidase activity and OSI and TAC values ​​in the PAV wall (r=0.62; p=0.003 and r=-0.59; p<0.001). It has been established that VEGF, PDGF, MMPs play a key role in the LLVV pathogenesis; the dynamics of these indicators can be used to predict the effectiveness of surgical treatment and the risk of recurrence.

Correction of the Metabolomic Profile and Redox Potential in Patients With Lower Limb Varicose Veins (Class C4 - C6) in the Postoperative Period

“…The fibrinolytic and lipolytic properties of sulodexide are already known and have become the basis for its use in the treatment of vascular diseases (peripheral arterial disease, chronic lower limb ischemia, post-thrombotic syndrome, venous thromboembolism, diabetic microangiopathy) [11]. However, the modulating effects of sulodexide on oxidative stress have been demonstrated only in experimental studies (decrease, modulation of growth factors, decrease in the expression of matrix metalloproteinases, inflammation reduction, antiangiogenic effects and protection of endothelial cells) [12,13].…”