Vol 27, No 1 (2021)
Review paper
Published online: 2021-06-01
The influence of compression therapy on the level of inflammatory biomarkers in patients with chronic venous disease.
1
, 2, 3, 2
, 2, 3, 2
DOI: 10.5603/AA.2021.0004
Acta Angiologica 2021;27(1):32-36.
Abstract
Chronic venous disease (CVD) is defined as any morphological and functional abnormalities of long duration manifested either by symptoms and/or signs indicating the need for investigation and/or care. The pathophysiological mechanism of CVD can be characterized by reflux, obstruction, or a combination of both, which leads to increased venous pressure.
Compression therapy remains the gold standard of the conservative treatment of CVD in all stages. The possible forms of compression therapy are elastic stocking, non-elastic and elastic bandages, and intermittent pneumatic compression. Compression bandages have been proven to improve the healing of venous ulcers, in comparison with standard care without compression therapy.
In the last years, inflammation has been shown to play an important role in the pathophysiology of CVD. The influence of the altered shear stress on the endothelial cells (EC) causes EC to release inflammatory molecules, chemokines, vasoactive agents, express selectins, and prothrombotic precursors such as ICAM-1, MCP-1, MIP 1β, VCAM, L-selectin, E-selectin, IL-1β, IL-4, IL-6, IL-8, IL-12p40, IL-13, G-CSF, GM-CSF, IFN-γ, TNF-α, MIP-1α.
Several studies were performed to investigate the influence of compression therapy on the level of various inflammatory biomarkers in patients with CVD. In these studies level of the most inflammatory molecules, such as IL-1β, IL-6, IL-8, IL-12p40, G-CSF, GM-CSF, IFN-γ, TNF-α, VEGF, MMP 3, 8, 9 and TIMP-1 decreased after the therapy.
Keywords: inflammatory biomarkerscompression therapychronic venous diseaseinflammation
References
- Eklof Bo, Perrin M, Delis KT, et al. American Venous Forum, European Venous Forum, International Union of Phlebology, American College of Phlebology, International Union of Angiology. Updated terminology of chronic venous disorders: the VEIN-TERM transatlantic interdisciplinary consensus document. J Vasc Surg. 2009; 49(2): 498–501.
- Zolotukhin IA, Seliverstov EI, Shevtsov YN, et al. Prevalence and Risk Factors for Chronic Venous Disease in the General Russian Population. Eur J Vasc Endovasc Surg. 2017; 54(6): 752–758.
- Robertson L, Evans C, Fowkes FGR. Epidemiology of chronic venous disease. Phlebology. 2008; 23(3): 103–111.
- Graham ID, Harrison MB, Nelson EA, et al. Prevalence of lower-limb ulceration: a systematic review of prevalence studies. Adv Skin Wound Care. 2003; 16(6): 305–316.
- Wittens C, Davies AH, Bækgaard N, et al. Editor's Choice - Management of Chronic Venous Disease: Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS). Eur J Vasc Endovasc Surg. 2015; 49(6): 678–737.
- Labropoulos N. Hemodynamic changes according to the CEAP classification. Phlebolymphology. 2003; 40: 130–136.
- Grudzińska E, Lekstan A, Szliszka E, et al. Cytokines Produced by Lymphocytes in the Incompetent Great Saphenous Vein. Mediators Inflamm. 2018; 2018: 7161346.
- Bergan J. Molecular mechanisms in chronic venous insufficiency. Ann Vasc Surg. 2007; 21(3): 260–266.
- Anwar MA, Shalhoub J, Lim CS, et al. The effect of pressure-induced mechanical stretch on vascular wall differential gene expression. J Vasc Res. 2012; 49(6): 463–478.
- Takase S, Bergan JJ, Schmid-Schönbein G. Expression of adhesion molecules and cytokines on saphenous veins in chronic venous insufficiency. Ann Vasc Surg. 2000; 14(5): 427–435.
- Castro-Ferreira R, Cardoso R, Leite-Moreira A, et al. The Role of Endothelial Dysfunction and Inflammation in Chronic Venous Disease. Ann Vasc Surg. 2018; 46: 380–393.
- Raffetto J. Pathophysiology of Chronic Venous Disease and Venous Ulcers. Surgical Clinics of North America. 2018; 98(2): 337–347.
- Mansilha A, Sousa J. Pathophysiological Mechanisms of Chronic Venous Disease and Implications for Venoactive Drug Therapy. Int J Mol Sci. 2018; 19(6).
- Azirar S, Appelen D, Prins MH, et al. Compression therapy for treating post-thrombotic syndrome. Cochrane Database Syst Rev. 2019; 9: CD004177.
- Shingler S, Robertson L, Boghossian S, et al. Compression stockings for the initial treatment of varicose veins in patients without venous ulceration. Cochrane Database Syst Rev. 2013(12): CD008819.
- Andreozzi GM, Cordova R, Scomparin MA, et al. Quality of Life Working Group on Vascular Medicine of SIAPAV. Effects of elastic stocking on quality of life of patients with chronic venous insufficiency. An Italian pilot study on Triveneto Region. Int Angiol. 2005; 24(4): 325–329.
- Wong IKY, Andriessen A, Charles HE, et al. Randomized controlled trial comparing treatment outcome of two compression bandaging systems and standard care without compression in patients with venous leg ulcers. J Eur Acad Dermatol Venereol. 2012; 26(1): 102–110.
- Blecken SR, Villavicencio JL, Kao TC. Comparison of elastic versus nonelastic compression in bilateral venous ulcers: a randomized trial. J Vasc Surg. 2005; 42(6): 1150–1155.
- Blair SD, Wright DD, Backhouse CM, et al. Sustained compression and healing of chronic venous ulcers. BMJ. 1988; 297(6657): 1159–1161.
- Schmid-Schönbein GW, Takase S, Bergan JJ. New advances in the understanding of the pathophysiology of chronic venous insufficiency. Angiology. 2001; 52 Suppl 1: S27–S34.
- Bergan JJ, Schmid-Schönbein GW, Smith PD, et al. Chronic venous disease. N Engl J Med. 2006; 355(5): 488–498.
- Tisato V, Zauli G, Voltan R, et al. Endothelial cells obtained from patients affected by chronic venous disease exhibit a pro-inflammatory phenotype. PLoS One. 2012; 7(6): e39543.
- Takase S, Pascarella L, Lerond L, et al. Venous hypertension, inflammation and valve remodeling. Eur J Vasc Endovasc Surg. 2004; 28(5): 484–493.
- Castro-Ferreira R, Cardoso R, Leite-Moreira A, et al. The Role of Endothelial Dysfunction and Inflammation in Chronic Venous Disease. Ann Vasc Surg. 2018; 46: 380–393.
- Jacob MP, Cazaubon M, Scemama A, et al. Plasma matrix metalloproteinase-9 as a marker of blood stasis in varicose veins. Circulation. 2002; 106(5): 535–538.
- Mannello F, Raffetto JD. Matrix metalloproteinase activity and glycosaminoglycans in chronic venous disease: the linkage among cell biology, pathology and translational research. Am J Transl Res. 2011; 3(2): 149–158.
- Mannello F, Ligi D, Canale M, et al. Omics profiles in chronic venous ulcer wound fluid: innovative applications for translational medicine. Expert Rev Mol Diagn. 2014; 14(6): 737–762.
- Kucukguven A, Khalil RA. Matrix metalloproteinases as potential targets in the venous dilation associated with varicose veins. Curr Drug Targets. 2013; 14(3): 287–324.
- Chen Y, Peng W, Raffetto JD, et al. Matrix Metalloproteinases in Remodeling of Lower Extremity Veins and Chronic Venous Disease. Prog Mol Biol Transl Sci. 2017; 147: 267–299.
- Serra R, Grande R, Butrico L, et al. Effects of a new nutraceutical substance on clinical and molecular parameters in patients with chronic venous ulceration. Int Wound J. 2016; 13(1): 88–96.
- Beidler SK, Douillet CD, Berndt DF, et al. Multiplexed analysis of matrix metalloproteinases in leg ulcer tissue of patients with chronic venous insufficiency before and after compression therapy. Wound Repair Regen. 2008; 16(5): 642–648.
- Raffetto JD, Khalil RA. Mechanisms of varicose vein formation: valve dysfunction and wall dilation. Phlebology. 2008; 23(2): 85–98.
- Beidler SK, Douillet CD, Berndt DF, et al. Inflammatory cytokine levels in chronic venous insufficiency ulcer tissue before and after compression therapy. J Vasc Surg. 2009; 49(4): 1013–1020.
- Murphy MA, Joyce WP, Condron C, et al. A reduction in serum cytokine levels parallels healing of venous ulcers in patients undergoing compression therapy. Eur J Vasc Endovasc Surg. 2002; 23(4): 349–352.
- Gohel MS, Windhaber RAJ, Tarlton JF, et al. The relationship between cytokine concentrations and wound healing in chronic venous ulceration. J Vasc Surg. 2008; 48(5): 1272–1277.
- Beidler SK, Douillet CD, Berndt DF, et al. Multiplexed analysis of matrix metalloproteinases in leg ulcer tissue of patients with chronic venous insufficiency before and after compression therapy. Wound Repair Regen. 2008; 16(5): 642–648.
- Caimi G, Ferrara F, Montana M, et al. Behaviour of the plasma concentration of gelatinases and their tissue inhibitors in subjects with venous leg ulcers. Clin Hemorheol Microcirc. 2015; 60(3): 309–316.