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: B. M. Biccard, A. Sigamani, M. T. V. Chan, D. I. Sessler, A. Kurz, J. G. Tittley et al.
Notes: No evidence to start or stop aspirin
Authors: P. A. Coughlin, J. H. F. Rudd
Population‐based study of mortality and major amputation following lower limb revascularization. BJS 2018; 105: 1145-1154.
Authors: K. Heikkila, I. M. Loftus, D. C. Mitchell, A. S. Johal, S. Waton, D. A. Cromwell et al.
Notes: lower than previously estimated
Cost‐effectiveness of population‐based vascular disease screening and intervention in men from the Viborg Vascular (VIVA) trial.
Authors: R. Søgaard, J. S. Lindholt
Notes: Highly cost effective
Five‐year follow‐up of a randomized clinical trial comparing open surgery, foam sclerotherapy and endovenous laser ablation for great saphenous varicose veins. BJS 2018; 105: 686-691.
Authors: S. Vähäaho, K. Halmesmäki, A. Albäck, E. Saarinen, M. Venermo
Notes: More foam recurrences
Eight‐year follow‐up of a randomized clinical trial comparing ultrasound‐guided foam sclerotherapy with surgical stripping of the great saphenous vein. BJS 2018; 105: 692-698.
Authors: Y. L. Lam, J. A. Lawson, I. M. Toonder, N. H. Shadid, A. Sommer, M. Veenstra et al.
Notes: Surgery better
Value of risk scores in the decision to palliate patients with ruptured abdominal aortic aneurysm. BJS 2018; 105: 1135-1144.
Authors: M. J. Sweeting, P. Ulug, J. Roy, R. Hultgren, R. Indrakusuma, R. Balm et al.
Notes: Not much help
Follow‐up after endovascular aortic aneurysm repair can be stratified based on first postoperative imaging. BJS 2018; 105: 709-718.
Authors: H. Baderkhan, O. Haller, A. Wanhainen, M. Björck, K. Mani
Notes: Short sealing zones spell trouble
Risk of major amputation in patients with intermittent claudication undergoing early revascularization. BJS 2018; 105: 699-708.
Authors: J. Golledge, J. V. Moxon, S. Rowbotham, J. Pinchbeck, L. Yip, R. Velu et al.
Notes: Early revascularization associated with amputation
Authors: R. E. Clough, R. Spear, K. Van Calster, A. Hertault, R. Azzaoui, J. Sobocinski et al.
Notes: Encouraging results in expert hands
Authors: N. Rudarakanchana, M. P. Jenkins
Notes: Formidable challenge
Cellular and molecular imaging of the arteries in the age of precision medicine. BJS 2018; 105: 311-312.
Authors: R. O. Forsythe, D. E. Newby