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Severity of venous insufficiency is related to the density of microvascular deposition of PAI-1, uPA and von Willebrand factor.
Vasa. 2004 Feb; 33(1):19-24.VASA

Abstract

BACKGROUND

Impaired microcirculation in chronic venous insufficiency leads to chronic inflammation and dystrophic changes of the skin, and finally to leg ulceration. The purpose of this study was to investigate in more detail coagulation and fibrinolytic protein response of the capillaries in skin biopsies of the lower extremity.

PATIENTS AND METHODS

From eighteen ambulant patients with venous leg ulcer(s) (n = 8) and controls (n = 10) with various degrees of venous insufficiency according to the CEAP classification, we obtained 4 mm punch biopsies. Immunohistochemical staining with tissue derived plasminogen activator (tPA), urokinase derived plasminogen activator (uPA), plasminogen activator inhibitor (PAI-1) and von Willebrand Factor (vWF) was performed and analyzed with bright field microscopy.

RESULTS

The amount of staining with vWF (p = 0.04) and uPA (p = 0.02) showed statistically significant differences, PAI-1 (p = 0.09) and tPA (p = 0.50) showed no difference between leg ulcer and control groups. A strong proliferation of capillaries with tortuous capillary loops in the papillary dermis was seen, but no statistically significant difference (M-W test, p = 0.10) was found between the groups. Comparison between CEAP classes 0-6 showed a statistically significant increased staining pattern of vWF (p = 0.06), uPA (p = 0.02) and PAI-1 (p = 0.02), but not from tPA (p = 0.30).

CONCLUSIONS

In skin biopsies of the lower extremity of patients with severe venous insufficiency increased deposition of vWF, PAI-1 and uPA were found in the capillaries. These findings point to a local imbalance in coagulation and fibrinolytic status, which might contribute to impaired microcirculation and finally to the development of venous leg ulceration.

Authors+Show Affiliations

Departments of Dermatology, Clinical Epidemiology and Medical Technology Assessment, Academic Hospital Maastricht, The Netherlands. dinanda.kolbach@epid.unimaas.nlNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15061043

Citation

Kolbach, D N., et al. "Severity of Venous Insufficiency Is Related to the Density of Microvascular Deposition of PAI-1, uPA and Von Willebrand Factor." VASA. Zeitschrift Fur Gefasskrankheiten, vol. 33, no. 1, 2004, pp. 19-24.
Kolbach DN, Hamulyák K, Prins MH, et al. Severity of venous insufficiency is related to the density of microvascular deposition of PAI-1, uPA and von Willebrand factor. Vasa. 2004;33(1):19-24.
Kolbach, D. N., Hamulyák, K., Prins, M. H., Neumann, H. A., & Cleutjens, J. P. (2004). Severity of venous insufficiency is related to the density of microvascular deposition of PAI-1, uPA and von Willebrand factor. VASA. Zeitschrift Fur Gefasskrankheiten, 33(1), 19-24.
Kolbach DN, et al. Severity of Venous Insufficiency Is Related to the Density of Microvascular Deposition of PAI-1, uPA and Von Willebrand Factor. Vasa. 2004;33(1):19-24. PubMed PMID: 15061043.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Severity of venous insufficiency is related to the density of microvascular deposition of PAI-1, uPA and von Willebrand factor. AU - Kolbach,D N, AU - Hamulyák,K, AU - Prins,M H, AU - Neumann,H A, AU - Cleutjens,J P, PY - 2004/4/6/pubmed PY - 2004/8/27/medline PY - 2004/4/6/entrez SP - 19 EP - 24 JF - VASA. Zeitschrift fur Gefasskrankheiten JO - Vasa VL - 33 IS - 1 N2 - BACKGROUND: Impaired microcirculation in chronic venous insufficiency leads to chronic inflammation and dystrophic changes of the skin, and finally to leg ulceration. The purpose of this study was to investigate in more detail coagulation and fibrinolytic protein response of the capillaries in skin biopsies of the lower extremity. PATIENTS AND METHODS: From eighteen ambulant patients with venous leg ulcer(s) (n = 8) and controls (n = 10) with various degrees of venous insufficiency according to the CEAP classification, we obtained 4 mm punch biopsies. Immunohistochemical staining with tissue derived plasminogen activator (tPA), urokinase derived plasminogen activator (uPA), plasminogen activator inhibitor (PAI-1) and von Willebrand Factor (vWF) was performed and analyzed with bright field microscopy. RESULTS: The amount of staining with vWF (p = 0.04) and uPA (p = 0.02) showed statistically significant differences, PAI-1 (p = 0.09) and tPA (p = 0.50) showed no difference between leg ulcer and control groups. A strong proliferation of capillaries with tortuous capillary loops in the papillary dermis was seen, but no statistically significant difference (M-W test, p = 0.10) was found between the groups. Comparison between CEAP classes 0-6 showed a statistically significant increased staining pattern of vWF (p = 0.06), uPA (p = 0.02) and PAI-1 (p = 0.02), but not from tPA (p = 0.30). CONCLUSIONS: In skin biopsies of the lower extremity of patients with severe venous insufficiency increased deposition of vWF, PAI-1 and uPA were found in the capillaries. These findings point to a local imbalance in coagulation and fibrinolytic status, which might contribute to impaired microcirculation and finally to the development of venous leg ulceration. SN - 0301-1526 UR - https://www.unboundmedicine.com/medline/citation/15061043/Severity_of_venous_insufficiency_is_related_to_the_density_of_microvascular_deposition_of_PAI_1_uPA_and_von_Willebrand_factor_ L2 - https://econtent.hogrefe.com/doi/10.1024/0301-1526.33.1.19?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -