Document Detail

Leukocyte activity in the microcirculation of the leg in patients with chronic venous disease.
MedLine Citation:
PMID:  9279314     Owner:  NLM     Status:  MEDLINE    
PURPOSE: It has been suggested that leukocyte trapping and activation in the microcirculation of the leg skin causes lipodermatosclerosis and ulceration in patients with chronic venous disease. Ambulatory venous hypertension is accepted as the physiologic factor that leads to ulceration. We investigated leukocyte endothelial adhesion in patients who were subjected to short-term venous hypertension.
METHODS: Two groups of patients with venous disease were studied: group 1, varicose veins with skin changes (n = 15); and group 2, varicose veins without skin changes (n = 15). Blood samples were taken from a foot vein before and after standing for 30 minutes to raise the venous pressure in the lower limb, and after lying supine again for 10 minutes. The samples were analyzed for leukocyte surface CD11b and L-selectin (CD62L) expression using a flow cytometer. Plasma-soluble L-selectin was also measured using an enzyme-linked immunosorbent assay.
RESULTS: In patients with skin changes, median neutrophil CD11b levels fell from 4.66 to 3.83 arbitrary units (p = 0.005, Wilcoxon) after 30 minutes of venous hypertension, Median monocyte CD11b levels fell from 7.65 to 5.8 arbitrary units (p = NS, Wilcoxon) after venous hypertension and then fell further to 5.43 arbitrary units (p = 0.02 vs baseline; Wilcoxon) when the venous hypertension was removed. Neutrophil and monocyte L-selectin levels also fell in response to venous hypertension, remaining low even after venous hypertension was removed. A similar pattern was seen in patients with uncomplicated varicose veins. There was a rise in soluble L-selectin in the plasma of both groups of patients after venous hypertension, reflecting leukocyte adhesion to endothelium. In the group of patients with skin changes the level of soluble L-selectin rose from 695 ng/ml to 836 ng/ml (p = 0.02, Wilcoxon), and in the group without skin changes the rise was from 700 ng/ml to 801 ng/ml (p = 0.02, Wilcoxon).
CONCLUSION: Venous hypertension results in sequestration of the more activated population of neutrophils and monocytes in the microcirculation of the leg in patients with venous disease. These cells bind to the endothelium, releasing L-selectin, and do not emerge from the limb when venous hypertension is reversed. These findings do not differ between patients with varicose veins and those with skin changes.
M Saharay; D A Shields; J B Porter; J H Scurr; P D Coleridge Smith
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of vascular surgery     Volume:  26     ISSN:  0741-5214     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  1997 Aug 
Date Detail:
Created Date:  1997-09-17     Completed Date:  1997-09-17     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  265-73     Citation Subset:  IM    
Department of Surgery, University College London Medical School, United Kingdom.
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MeSH Terms
Cell Adhesion Molecules*
Chronic Disease
Flow Cytometry
L-Selectin / blood
Leukocytes / immunology,  physiology*
Macrophage-1 Antigen / blood
Middle Aged
Monocytes / physiology
Neutrophils / physiology
Varicose Ulcer / blood*,  etiology
Varicose Veins / blood*,  complications
Reg. No./Substance:
0/Cell Adhesion Molecules; 0/Macrophage-1 Antigen; 126880-86-2/L-Selectin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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