Journal Article Epublish
PubMed: 40362286 DOI: 10.3390/ijms26094046
Local and Systemic Endothelial Damage in Patients with CEAP C2 Chronic Venous Insufficiency: Role of Mesoglycan.
Int J Mol Sci 26(9)
Authors: Angelo Santoliquido, Claudia Carnuccio, Luca Santoro, Angela Di Giorgio, Alessia D'Alessandro, Francesca Romana Ponziani, Flavia Angelini, Marcello Izzo, Antonio Nesci
Affiliations
- Angiology and Noninvasive Vascular Diagnostics Unit, Department of Cardiovascular Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy.
- Department of Translational Medicine and Surgery, Catholic University of the Sacred Heart, 00168 Rome, Italy.
- Digestive Disease Center (CEMAD), Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy.
- Compression Therapy Study Group (CTG), Math Tech Med Medicine & Bioscience, Research Center, University of Ferrara, 44121 Ferrara, Italy.
Abstract
Chronic venous disease (CVD) involves complex pathophysiological mechanisms, particularly an imbalance between matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs), contributing to venous remodeling and varicosities. Elevated MMP-2 and MMP-9 levels are commonly found in tissues affected by venous ulcers. Inflammation plays a central role in CVD, with higher levels of pro-inflammatory markers present in varicose veins compared to healthy ones. Syndecans, key components of the endothelial glycocalyx, are involved in inflammatory responses. Alterations in the glycocalyx structure are associated with vascular damage in both venous and arterial diseases. This study aimed to investigate inflammatory changes in CVD patients, focusing on glycocalyx damage and the therapeutic role of mesoglycan, a glycosaminoglycan-based drug. A prospective, monocentric study included 23 patients with C2 clinical-etiological-anatomical-pathological (CEAP) CVD. Serum samples were collected before and after mesoglycan treatment. Results showed significantly elevated levels of VCAM-1, MMP-2, MMP-9, SDC-1, IL-6, and IL-8 in blood from varicose veins versus the systemic circulation. Patients received 50 mg of mesoglycan orally every 12 h for 90 days. After treatment, a notable reduction in inflammatory markers was observed. These results support the hypothesis that mesoglycan may alleviate both local and systemic inflammation, providing insights into new therapeutic strategies for CVD management.
MeSH
Glycocalyx, Syndecans, Matrix Metalloproteinases, Therapeutics, Venous Insufficiency, Tissues, Varicose Veins, Veins