Compression stockings attenuate the expression of proteins associated with vascular damage in human varicose veins

J Vasc Surg Venous Lymphat Disord . 2021 Mar;9(2):428-434. doi: 10.1016/j.jvsv.2020.05.020. Epub 2020 Jul 15.

Fecha de la publicación: 15/07/2020

Autor: Guillermo Moñux (1), Mariano de la Serna-Soto (2), Ferrán Plá-Sanchez (3), José J Zamorano-León (4), Antonio Segura (5), Rodrigo Rial (1), Gala Freixer (2), Khaoula Zekri-Nechar (2), Carlos Hugo-Martínez (2), Javier Serrano (3), Antonio López-Farré (6)

Palabras clave: Compression stocking, Endothelium, Inflammation, Thrombosis, Varicose veins

PMID

PMID: 32679199
DOI: 10.1016/j.jvsv.2020.05.020

Affiliations

¹Department of Angiology and Vascular Surgery, Hospital Universitario HM Torrelodones, Madrid, Spain.

²Department of Medicine, School of Medicine, Universidad Complutense, Madrid, Spain.

³Vascular Surgery Department, Hospital Clínico San Carlos, Madrid, Spain.

⁴Department of Public Health and Maternal and Child Health, School of Medicine, Universidad Complutense, Madrid, Spain.

⁵Health Science Institute, Talavera de la Reina, Toledo, Spain.

⁶Department of Medicine, School of Medicine, Universidad Complutense, Madrid, Spain. Electronic address: ajlf@telefonica.net.

Abstract

Objective: The objective of this study was to analyze whether compression stocking therapy in the human varicose vein wall may change the levels of biomarkers associated with vein insufficiency.

Methods: Dilated collateral varicose vein samples were obtained from patients showing chronic venous disease (class 2 of the Clinical, Etiology, Anatomy, and Pathophysiology classification). Before elective surgery, 12 patients underwent compression stocking therapy (for 1 month) and 9 patients did not (control group). Expression levels of biomarkers associated with endothelial functionality (nitric oxide synthase 3), inflammation (interleukin-6, interleukin-10), oxidative stress (Gp91^phox subunit of NADPH oxidase), and coagulation (factor Xa) were determined. P-selectin, an inflammatory and thrombosis-related biomarker, was also measured.

Results: Compression stockings increased the content of nitric oxide synthase 3 (control, 16.48 [16.04-17.40] AU; compression, 83.71 [67.70-91.85] AU; P < .001) in the varicose vein wall that was accompanied by reduction of both interleukin-6 levels (control, 38.72 [33.48-48.52] pg/μg protein; compression, 14.49 [11.05-17.41] pg/μg protein; P = .001) and the expression of Gp91^phox subunit of NADPH oxidase (control, 63.24 [53.79-77.03] AU; compression, 36.85 [35.66-52.27] AU; P < .010). P-selectin (control, 77.37 [61.86-85.00] AU; compression, 54.31 [49.60-67.50] AU; P = .017) and factor Xa (control, 90.78 [75.02-100.00] AU; compression, 14.50 [13.77-36.20] AU; P < .001) were also reduced in the varicose vein wall of compression stocking-treated patients. However, P-selectin lost its statistical significance after adjustment by dyslipidemia.

Conclusions: In the varicose vein wall, compression stocking therapy improved the content levels of biomarkers associated with endothelial functionality, inflammation, oxidative stress, and coagulation.