Comparison of extracellular matrix in skin and saphenous veins of from patients with varicose veins: does the skin reflect venous matrix changes?
Résumé
Varicose vein disease is a frequently occurring pathology with multifactorial causes and with a genetic component. An intense remodelling of the varicose vein wall has been described and could be at the origin of its weakness and altered elasticity. We previously described a dysregulation of collagen synthesis in cultured smooth muscle cells from the saphenous veins and in dermal fibroblasts from the skin of patients with varicose veins suggesting a systemic defect in their connective tissue. The present work describes comparative morphological and immunohistochemical data of both the skin and the saphenous veins of 8 control (undergoing coronary bypass surgery) and 8 varicose vein patients. Histological staining of glycoproteins, the elastic fiber network and of collagen bundles shows that the remodelling and the fragmentation of elastic fibers observed in varicose veins are also present in the skin of the patients. As compared to control subjects, we noted in both the veins and the skin of varicose vein patients (1) an increase in the elastic network, as quantified by image analysis ; (2) an accumulation of collagen type I, fibrillin-1 and laminin and (3) an overproduction of the matrix metalloproteinase (MMP) -1,-2 and -3, analysed by immunohistochemistry, but normal levels of other MMPs (MMP-7 and -9) and their inhibitors (TIMP-1, -2, -3). An imbalance of the extracellular matrix production/degradation was thus observed in veins as well as in the skin of the varicose vein patients and taken together, these findings show that a remodelling is present in different organs, confirming systemic alterations of connective tissues.
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