eISSN: 1896-9151
ISSN: 1734-1922
Archives of Medical Science
Current issue Archive Manuscripts accepted About the journal Special issues Editorial board Abstracting and indexing Subscription Contact Instructions for authors
SCImago Journal & Country Rank
2/2019
vol. 15
 
Share:
Share:
more
 
 
abstract:
Clinical research

In patients with superficial vein thrombosis the inflammatory response is increased and related to the recanalization rate

Pavel Poredoš, Ana Spirkoska, Mateja Kaja Ježovnik

Arch Med Sci 2019; 15, 2: 393–401
Online publish date: 2019/03/04
View full text
Get citation
ENW
EndNote
BIB
JabRef, Mendeley
RIS
Papers, Reference Manager, RefWorks, Zotero
AMA
APA
Chicago
Harvard
MLA
Vancouver
 
Introduction
Little is known about pathogenetic mechanisms of superficial venous thrombosis (SVT). We aimed to investigate the systemic inflammatory response in the acute phase of SVT, the time course of inflammatory markers and involvement of inflammation in resolution of thrombus in SVT.

Material and methods
The circulatory inflammatory parameters high-sensitivity C-reactive protein (hsCRP), tumor necrosis factor α (TNF-α), interleukins 6, 8 and 10 (IL-6, IL-8, IL-10), and markers of fibrinolytic activity tissue plasminogen activator (t-PA), plasminogen activator inhibitor-1 (PAI-1) and fibrinogen were determined in 68 patients with acute SVT of lower limbs, who were allocated to two groups, dalteparin 5000 IU once daily or 10 000 IU once daily. Recanalization of occluded veins was monitored by ultrasonography at regular intervals. Blood was drawn in the acute phase and after 12 weeks.

Results
In the acute phase a majority of the measured inflammatory markers were increased, while after 12 weeks most of them significantly dropped: hsCRP: 13.6 ±11.9 vs. 7.4 ±4.4, p < 0.001; IL-6: 3.8 ±3.1 vs. 2.6 ±1.9, p = 0.007. Significant changes in endogenic fibrinolytic parameters were also observed: t-PA activity decreased (0.81 ±0.35 vs. 0.68 ±0.34, p = 0.003), while PAI-1 levels increased (5.6 ±5.1 vs. 8.8 ±8.5, p < 0.001). Levels of inflammatory markers at inclusion and after 12 weeks were related to less effective thrombus resolution: CRP: r = 0.386, p = 0.001; IL-6: r = 0.384; TNF-α: r = 0.255, p = 0.037.

Conclusions
In the acute phase of SVT, most of the circulating inflammatory markers were increased and most of their levels decreased after 12 weeks. Levels of inflammatory markers were negatively correlated with the recanalization rate.

keywords:

superficial venous thrombosis, inflammation, anticoagulants, inflammatory markers, thrombophlebitis

references:
Prandoni P, ten Cate JW. Epidemiology, risk factors, and natural history of venous thromboembolism (I). Pulmonary embolism. Blackwell Science, Berlin 1999; 2-16.
Decousus H, Quéré I, Presles E, et al.; POST (Prospective Observational Superficial Thrombophlebitis) Study Group. Superficial venous thrombosis and venous thromboembolism: a large, prospective epidemiologic study. Ann Intern Med 2010; 152: 218-24.
Aksu K, Donmez A, Keser G. Inflammation-induced thrombosis: mechanisms, disease associations and management. Curr Pharm Des 2012; 18: 1478-93.
Collen D, Hoylaerts MF. Relationship between inflammation and venous thromboembolism as studied by microparticle assessment in plasma. J Am Coll Cardiol 2005; 45: 1472-3.
Müller I, Klocke A, Alex M, et al. Intravascular tissue factor initiates coagulation via circulating microvesicles and platelets. FASEB J 2003; 17: 476-8.
Esmon CT. Inflammation and thrombosis. J Thromb Haemost 2003; 1: 1343-8.
Kearon C, Akl EA, Comerota AJ, et al. Antithrombotic therapy for VTE disease: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 2012; 141: e419S-96S.
Spirkoska A, Jezovnik MK, Poredos P. Time course and the recanalization rate of superficial vein thrombosis treated with low-molecular-weight heparin. Angiology 2015; 66: 381-6.
Kalodiki E, Stvrtinova V, Allegra C, et al. Superficial vein thrombosis: a consensus statement. Int Angiol 2012; 31: 203-16.
Jezovnik MK, Poredos P. Factors influencing the recanalisation rate of deep venous thrombosis. Int Angiol 2012; 31: 169-75.
Jezovnik MK, Poredos P, Stalc M. Impairment of the vasodilatation capability of the brachial artery in patients with idiopathic venous thrombosis. J Atheroscler Thromb 2010; 17: 1190-8.
Sprague AH, Khalil RA. Inflammatory cytokines in vascular dysfunction and vascular disease. Biochem Pharmacol 2009; 78: 539-52.
Rahman A, Kefer J, Bando M, Niles WD, Malik AB. E-selectin expression in human endothelial cells by TNF-alpha-induced oxidant generation and NF-kappaB activation. Am J Physiol 1998; 275: L533-44.
Poredos P, Jezovnik MK. In patients with idiopathic venous thrombosis, interleukin-10 is decreased and related to endothelial dysfunction. Heart Vessels 2011; 26: 596-602.
Wakefield TW, Strieter RM, Prince MR, Downing LJ, Greenfield LJ. Pathogenesis of venous thrombosis: a new insight. Cardiovasc Surg 1997; 5: 6-15.
Conde I, López JA. Classification of venous thromboembolism (VTE). Role of acute inflammatory stress in venous thromboembolism. J Thromb Haemost 2005; 3: 2573-5.
Clapp BR, Hingorani AD, Kharbanda RK, et al. Inflammation-induced endothelial dysfunction involves reduced nitric oxide bioavailability and increased oxidant stress. Cardiovasc Res 2004; 64: 172-8.
Reitsma PH, Branger J, Van Den Blink B, Weijer S, Van Der Poll T, Meijers JCM. Procoagulant protein levels are differentially increased during human endotoxemia. J Thromb Haemost 2003; 1: 1019-23.
Poredos P, Spirkoska A, Rucigaj T, et al. Do blood constituents in varicose veins differ from the systemic blood constituents? Eur J Vasc Endovasc Surg 2015; 50: 250-6.
Distler JHW, Pisetsky DS, Huber LC, Kalden JR, Gay S, Distler O. Microparticles as regulators of inflammation: novel players of cellular crosstalk in the rheumatic diseases. Arthritis Rheum 2005; 52: 3337-48.
Sustar V, Jansa R, Frank M, et al. Suppression of membrane microvesiculation: a possible anticoagulant and anti-tumor progression effect of heparin. Blood Cells Mol Dis 2009; 42: 223-7.
FEATURED PRODUCTS
Quick links
© 2019 Termedia Sp. z o.o. All rights reserved.
Developed by Bentus.
PayU - płatności internetowe