CAN OXIDANT, ANTIOXIDANT, AND ADHESION MOLECULES LEVELS PREDICT PROGNOSIS IN PATIENTS WITH VARICOSE VEINS?

A. Sharaf El-Din, Hesham; A. Atwa, Mohamed; Abo-Hashem, Ekbal; Abdel Latif, Mohamed; El-Shabrawy, Iman

doi:10.21608/ejsur.2003.374692

CAN OXIDANT, ANTIOXIDANT, AND ADHESION MOLECULES LEVELS PREDICT PROGNOSIS IN PATIENTS WITH VARICOSE VEINS?

Document Type : Original Article

Authors

¹ Vascular Surgery, Faculty of Medicine, Mansoura University.

² Clinical Pathology, Faculty of Medicine, Mansoura University.

³ Biochemistry Departments, Faculty of Medicine, Mansoura University.

10.21608/ejsur.2003.374692

Abstract

Background: Varicose veins represent a worldwide problem. Physiologic changes and clinical signs of chronic venous
insufficiency (CVI) are not static but progress from simple varicose veins to skin ulceration. Failure of local antioxidant
scavenging systems in the face of overwhelming production of oxidants is central to the injury associated with oxidative
process.
Aim of the work: The aim of the present work was to study the effects of varicose veins on levels of some antioxidant (GPx), oxidant (MDA) and adhesion molecules (VCAM-1).
Patients and methods: This study was conducted on 40 patients with varicose veins aged 35±10 years in addition to 20
healthy controls. The patients were divided into two groups: group I:20 patients with varicose veins without skin changes, and group II:20 patients with varicose veins with skin changes (pigmentation & ulceration). Blood samples were obtained
from peripheral veins for patients and controls and calf varix of lower limb veins of patients. One month after surgery, blood samples were obtained from patients in group I (n=20) and group II (n=20). Serum malondialdehyde (MDA) was estimated by a procedure depending on the acid catalyzed thermal decomposition of lipid peroxide to MDA which reacts with thiobarbituric acid to form a colored adduct. Glutathione peroxidase (GPx) was assayed by spectrophotometric
determination of NAD (P) H oxidation of blood hemolysate. Vascular cell adhesion molecule (VCAM-1) was measured by
Elisa technique.
Results: MDA and VCAM-1 were significantly increased while GPx was significantly decreased in peripheral blood in groups I and II in comparison to control group. Moreover, results of blood from calf varix of lower limb showed significant increase of MDA and VCAM-1 and significant decrease of GPx in group II in comparison to results of blood from peripheral veins.
One month after surgery, MDA, VCAM-I and GPx showed no significant change in group I in comparison to control while in patients in group II, MDA and VCAM-1 were still significantly increased and GPx was significantly decreased in comparison to control. On the other hand, MDA and VCAM-1 were significantly decreased and GPx was significantly increased after surgery in comparison to before surgery.
Conclusion: In patients with varicose veins, MDA and VACM-1 were significantly increased while GPx was significantly
decreased especially in the presence of pigmentation and ulceration. So, early treatment is recommended since unopposed free radical production may be important in the pathogenesis of venous ulceration and cutaneous complications.

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