Intense remodeling of extracellular matrix within the varicose vein: the role of gelatinases and vascular endothelial gr
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ORIGINAL ARTICLE
Intense remodeling of extracellular matrix within the varicose vein: the role of gelatinases and vascular endothelial growth factor Anna Horecka 1 & Anna Hordyjewska 1 & Jadwiga Biernacka 2 & Wojciech Dąbrowski 2 & Tomasz Zubilewicz 3 & Agnieszka Malec 4 & Irena Musik 1 & Jacek Kurzepa 1 Received: 29 April 2020 / Accepted: 19 June 2020 # The Author(s) 2020
Abstract Background Increased blood pressure in the varicose veins (VV) can contribute to the overexpression of matrix metalloproteinases (MMPs), affecting the endothelium, smooth muscle, and extracellular matrix of the vein wall. Gelatinases (MMP-2 and MMP-9), hypoxia, and inflammation occurring in the VV wall contribute to the increased expression of vascular endothelial growth factor (VEGF). Aims Our objective was to analyze the concentration of gelatinases and VEGF in the great saphenous VV wall and plasma of patients. Methods In total, 65 patients (2nd degree according to clinical state classification, etiology, anatomy, and pathophysiology— CEAP classification) aged 22 to 70 were enrolled. Control veins (n = 10) were collected from the patients who underwent coronary artery bypass graft surgery. Control plasma (n = 20) was obtained from healthy individuals. Gelatinases and VEGF levels were measured with the usage of ELISA method. Results A significant increase in MMP-9 (11.2 vs. 9.98 ng/mg of protein) and VEGF (41.06 vs. 26 ng/g of protein) concentration in VV wall compared with control veins was observed. A positive correlation between VEGF versus MMP-2 (p = 0.03, r = 0.27) was found in the VV wall. However, no correlation was found between the concentration of VEGF and MMP-9 (p = 0.4, r = 0.11) in the VV wall. In addition, no statistical differences between MMP-9, MMP-2, and VEGF levels in plasma of VV patients compared with controls were noticed. Conclusions The results of the present study confirm that VV’s patients have altered expression of MMPs and VEGF. Overexpression of MMP-9 and VEGF in the VV wall may contribute to the spreading of inflammatory process and suggests the intense remodeling of extracellular tissue within the VV wall. Keywords Gelatinases . Varicose veins . Vascular endothelial growth factor
Introduction
* Anna Horecka [email protected] 1
Department of Medical Chemistry, Medical University of Lublin, Chodźki 4A,, 20-093 Lublin, Poland
2
I Clinic of Anaesthesiology and Intensive Therapy with Clinical Paediatric Department, Medical University of Lublin, Jaczewskiego 8, 20-090 Lublin, Poland
3
Department of Vascular Surgery and Angiology, Medical University of Lublin, Staszica 17, 20-081 Lublin, Poland
4
Department of Obstetrics and Pathology of Pregnancy, Staszica 16, 20-081 Lublin, Poland
Chronic venous insufficiency (CVI) is an important medical problem in developed countries. Increased blood pressure in the varicose veins (VV) can contribute to the overexpression of selected matrix metalloproteinases (MMPs), affecting the endothelium, smooth muscle, and extracellular matrix proteins of the vein wall
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