Effects of a new nutraceutical substance on clinical and molecular parameters in patients with chronic venous ulceration

Abstract

Pathophysiological events involved in the onset of chronic venous ulceration (CVU) are inflammation, activation of polymorphonucleates (PMNs) and secretion of proteases such as matrix metalloproteinases (MMPs), which degrade extracellular matrix (ECM) that is a support for vascular and tissutal wall. MMPs, neutrophil gelatinase-associated lipocalin (NGAL) and inflammatory cytokines are overexpressed in CVUs and they could play a central role in pathophysiological mechanisms of skin lesion and delayed wound healing. Bioflavonoids, such as diosmin and other compounds, appear to have several provessel function activities including anti-inflammatory, antioxidant and phlebotonic effects and are widely used in the treatment of chronic venous disease (CVD)-related problems. In this article, we evaluated the effects of Axaven(®) , a new nutraceutical on both clinical and molecular parameters in patients with CVUs. During the study period, 83 patients with CVUs of both sexes were enrolled and divided into two groups: group A (treated group): 25 females and 19 males (median age is 67·7 years) received standard treatment (compression therapy and surgical correction of superficial venous incompetence) + Axaven(®) once a day for 8 months as adjunctive treatment. Group B (control group): 24 females and 15 males (median age is 65·2 years) were treated only with basic treatment according to their clinical conditions. In our study, the administration of Axaven(®) in patients with CVUs was able to decrease inflammatory cytokines, MMPs and NGAL, inducing an improvement of both symptoms with an increase of the speed of wound healing.

Hemorrhoids and matrix metalloproteinases: A multicenter study on the predictive role of biomarkers

“…We used the MMP and NGAL kit described previously. [19][20][21] The results were evaluated respect to the control group.…”

“…For Western blot analysis, hemorrhoidal specimens taken at the time of hemorrhoidal operations were lysed in 2 mL of tissue protein extraction reagent as described previously. [19][20][21] Immunoblotting of protein was performed using anti-MMPs and anti-NGAL monoclonal antibodies as described. 19 Antibodies were obtained from (Thermo Scientific, Cambridge, United Kingdom).…”

“…[19][20][21] Immunoblotting of protein was performed using anti-MMPs and anti-NGAL monoclonal antibodies as described. 19 Antibodies were obtained from (Thermo Scientific, Cambridge, United Kingdom). All experiments were performed in triplicate.…”

“…55 This drug was able to decrease inflammatory cytokines, MMPs, and NGAL, inducing an improvement in both symptoms in chronic venous insufficiency. 19 …”

“…14 Matrix metalloproteinases (MMPs) are enzymes that regulate ECM composition 15 and play a role in several vascular inflammatory conditions that may be related with hemorrhoidal disease. [16][17][18][19][20][21][22][23][24][25][26][27][28][29] Fargo and Latimer documented that the degradation of the ECM with MMP may be involved in the development of hemorrhoidal disease, 30 and we showed that neutrophil gelatinaseassociated lipocalin (NGAL) modulates the activity of MMP-9 in vascular disease. 17 Therefore, to evaluate the role of MMPs and NGAL in the development of hemorrhoidal disease, we evaluated both plasma MMPs and NGAL levels and their tissue expression in patients with different stages of hemorrhoids.…”