Upregulation of epidermal gap junctional proteins in patients with venous disease. BJS 2018; 105: 59-67.
Published: 16th November 2017
Authors: M. Kanapathy, R. Simpson, L. Madden, C. Thrasivoulou, A. Mosahebi, D. L. Becker et al.
Leg ulceration is a feared complication of venous insufficiency. It is not known whether varicose veins predispose skin to poor wound healing. The expression pattern of gap junctional protein connexin, a known marker of poor wound healing, was investigated across various stages of venous disease.
Patients undergoing intervention for varicose veins were assessed according to the Clinical Etiologic Anatomic Pathophysiologic (CEAP) classification of varicose veins. Paired 4‐mm punch biopsies were taken from above the ankle (pathological) and above the knee (control). Tissues were stained with haematoxylin and eosin, and for connexin 43, connexin 30 and connexin 26.
Forty‐eight paired biopsies were taken (12 each for CEAP class C0, C2, C4 and C6). The pathological skin showed progressive epithelial hyperthickening, an increase in the number and depth of rete ridges, increased inflammation and loss of dermal architecture with disease progression from C4 onwards. The overall absolute connexin expression and mean connexin expression per cell in the pathological skin similarly increased across the CEAP classes from as early as C2. Increasing levels of connexin in control skin were also noted, indicating progression of the disease proximally. Connexin 43 expression showed the strongest positive correlation between pathological and control skin.
Connexins were overexpressed in patients with simple varicose veins, with a stepwise increased expression through venous eczema to ulceration. Connexin 43 is a potential biomarker for venous disease. This finding suggests that varicose veins predispose skin to poor wound healing. The overexpression of connexins, a family of gap junctional proteins, is known to cause poor healing in venous leg ulceration. It is not known whether there is any association with superficial venous disease. Here, connexin proteins were overexpressed in patients with uncomplicated varicose veins, before histological skin changes. Connexin could be a biomarker of venous disease progression.
The overexpression of connexins, a family of gap junctional proteins, is known to cause poor healing in venous leg ulceration. It is not known whether there is any association with superficial venous disease. Here, connexin proteins were overexpressed in patients with uncomplicated varicose veins, before histological skin changes. Connexin could be a biomarker of venous disease progression.Full text
You may also be interested in
Authors: S. Zommorodi, M. Bottai, R. Hultgren
Authors: A. Saratzis, N. E. M. Jaspers, B. Gwilym, O. Thomas, A. Tsui, R. Lefroy et al.
Predicting reamputation risk in patients undergoing lower extremity amputation due to the complications of peripheral artery disease and/or diabetes. BJS 2019; 106: 1026-1034.
Authors: J. M. Czerniecki, M. L. Thompson, A. J. Littman, E. J. Boyko, G. J. Landry, W. G. Henderson et al.
Health gains, costs and cost‐effectiveness of a population‐based screening programme for abdominal aortic aneurysms. BJS 2019; 106: 1043-1054.
Authors: N. Nair, G. Kvizhinadze, G. T. Jones, R. Rush, M. Khashram, J. Roake et al.
Development and validation of a gene expression test to identify hard‐to‐heal chronic venous leg ulcers. BJS 2019; 106: 1035-1042.
Authors: D. C. Bosanquet, A. J. Sanders, F. Ruge, J. Lane, C. A. Morris, W. G. Jiang et al.
Randomized clinical trial
Randomized clinical trial of endovenous laser ablation versus direct and indirect radiofrequency ablation for the treatment of great saphenous varicose veins. BJS 2019; 106: 998-1004.
Authors: S. A. S. Hamann, L. Timmer‐de Mik, W. M. Fritschy, G. R. R. Kuiters, T. E. C. Nijsten, R. R. Bos et al.
Meta‐analysis of the outcomes of treatment of internal carotid artery near occlusion. BJS 2019; 106: 665-671.
Authors: A. J. A. Meershoek, E. E. Vries, D. Veen, H. M. Ruijter, G. J. Borst, A. Garcia‐Pastor et al.
Contemporary prevalence of carotid stenosis in patients presenting with ischaemic stroke. BJS 2019; 106: 872-878.
Authors: S. F. Cheng, M. M. Brown, R. J. Simister, T. Richards
Baseline findings of the population‐based, randomized, multifaceted Danish cardiovascular screening trial (DANCAVAS) of men aged 65–74 years. BJS 2019; 106: 862-871.
Authors: J. S. Lindholt, L. M. Rasmussen, R. Søgaard, J. Lambrechtsen, F. H. Steffensen, L. Frost et al.
Randomized clinical trial
Randomized clinical trial of mechanochemical and endovenous thermal ablation of great saphenous varicose veins. BJS 2019; 106: 548-554.
Authors: S. Vähäaho, O. Mahmoud, K. Halmesmäki, A. Albäck, K. Noronen, P. Vikatmaa et al.
Meta‐analysis of long‐term survival after elective endovascular or open repair of abdominal aortic aneurysm. BJS 2019; 106: 523-533.
Authors: R. M. A. Bulder, E. Bastiaannet, J. F. Hamming, J. H. N. Lindeman
Mortality prediction following non‐traumatic amputation of the lower extremity. BJS 2019; 106: 879-888.
Authors: D. C. Norvell, M. L. Thompson, E. J. Boyko, G. Landry, A. J. Littman, W. G. Henderson et al.