Abstract Number: PB1970
Meeting: ISTH 2020 Congress
Background: Varicose vein (VV) disease affects millions of people causing fatigue, aching pain, itching, and bleeding. In severe cases, patients with VV develop venous leg ulcers (VLU), even in the absence of deep venous thrombosis. VLU are chronic and often refractory in the long term, despite better healing rates with endovenous ablation (EVA). Inflammation may predispose VV patients to develop VLU.
Aims: In this study, we evaluated inflammatory mediator profiles from serum and vein segments from patients with VV.
Methods: Vein segments were obtained from patients undergoing microphlebectomy for VV and were digested enzymatically. Additionally, serum from within refluxing VV was obtained during EVA and percutaneous sclerotherapy. Infrared thermography was utilized to assess skin temperature over refluxing and competent leg veins. Protein-level inflammatory mediators from VV and serum were analyzed using multiplex analysis, and individual mediators were compared among groups using Students t-test.
Results: Temperatures over refluxing veins were higher by 3 degrees Celsius than those over competent leg veins (p< 0.03).VV vein segments (N=5) expressed significantly lower concentrations of IL-1b (p< 0.02), IP-10 (p< 0.003), MCP-1 (p< 0.0003), MIP-1b (p=0.0003), and TNF-a (p< 0.01) when compared to serum (n=14). In contrast, IL-15 was expressed at significantly higher levels within the vein wall compared to serum (p< 0.0001).
Conclusions: Inflammation may play a critical role in varicose vein disease, prompting advancement to ulceration. Refluxing veins have higher surrounding skin temperature, confirming an inflammatory process occurring at the vein wall. Unlike other inflammatory mediators which were present either at similar or higher levels in serum, IL-15 was present at significantly higher levels within the vein wall than in serum. As a positive modulator of NK cell function and cytotoxicity, IL-15 may represent a local inflammatory response in the vein wall, and may be a target to attenuate progression to VLU in the future.
To cite this abstract in AMA style:Sachdev U, Vodovotz L, Barclay D, Yin J, Zamora R, Vodovotz Y. Differential Expression of Inflammatory Mediators in Venous Tissue and Serum Suggest Natural Killer (NK) Cell-mediated Responses in Chronic Venous Insufficiency [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/differential-expression-of-inflammatory-mediators-in-venous-tissue-and-serum-suggest-natural-killer-nk-cell-mediated-responses-in-chronic-venous-insufficiency/. Accessed November 30, 2020.
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