Effects of compression therapy and antibiotics on lymphatic flow and chronic venous leg ulceration

Cariati, Andrea; Piromalli, Elisa; Cariati, Paola

doi:10.1007/s00403-012-1220-x

Cited by 3 publications

(7 citation statements)

References 5 publications

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“…Few investigators only have analysed enzyme activities or gene expression, whereas MMP concentrations in supernatants of cell cultures have been analysed in most of the studies. A decrease in MMP concentrations as a consequence of antibiotic treatment could be demonstrated in patients with orthopaedic infections treated with ß-lactams [111,112] and daptomycin [113], as well as pulmonary diseases treated with clarithromycin and azithromycin [114,115]; doxycycline reduced MMP concentrations in patients with CF, COPD, and tuberculosis [116][117][118][119], chronic wounds [120][121][122][123][124][125][126][127][128], abdominal aortic aneurysm [129][130][131][132], ophthalmological diseases [133,134], and in patients with acute lung injury following cardiac bypass [135]. Marketing authorizations have been granted for treatment of rosacea and periodontal diseases with sub-antimicrobial doses of doxycycline due to MMP inhibition [136][137][138][139][140][141][142].…”

Section: Antibiotics Inhibit Metallo-matrix-proteinasesmentioning

confidence: 99%

Selective toxicity of antibacterial agents—still a valid concept or do we miss chances and ignore risks?

Dalhoff

2020

Infection

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Background Selective toxicity antibacteribiotics is considered to be due to interactions with targets either being unique to bacteria or being characterized by a dichotomy between pro- and eukaryotic pathways with high affinities of agents to bacterial- rather than eukaryotic targets. However, the theory of selective toxicity oversimplifies the complex modes of action of antibiotics in pro- and eukaryotes. Methods and objective This review summarizes data describing multiple modes of action of antibiotics in eukaryotes. Results Aminoglycosides, macrolides, oxazolidinones, chloramphenicol, clindamycin, tetracyclines, glycylcyclines, fluoroquinolones, rifampicin, bedaquillin, ß-lactams inhibited mitochondrial translation either due to binding to mitosomes, inhibition of mitochondrial RNA-polymerase-, topoisomerase 2ß-, ATP-synthesis, transporter activities. Oxazolidinones, tetracyclines, vancomycin, ß-lactams, bacitracin, isoniazid, nitroxoline inhibited matrix-metalloproteinases (MMP) due to chelation with zinc and calcium, whereas fluoroquinols fluoroquinolones and chloramphenicol chelated with these cations, too, but increased MMP activities. MMP-inhibition supported clinical efficacies of ß-lactams and daptomycin in skin-infections, and of macrolides, tetracyclines in respiratory-diseases. Chelation may have contributed to neuroprotection by ß-lactams and fluoroquinolones. Aminoglycosides, macrolides, chloramphenicol, oxazolidins oxazolidinones, tetracyclines caused read-through of premature stop codons. Several additional targets for antibiotics in human cells have been identified like interaction of fluoroquinolones with DNA damage repair in eukaryotes, or inhibition of mucin overproduction by oxazolidinones. Conclusion The effects of antibiotics on eukaryotes are due to identical mechanisms as their antibacterial activities because of structural and functional homologies of pro- and eukaryotic targets, so that the effects of antibiotics on mammals are integral parts of their overall mechanisms of action.

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Section: Antibiotics Inhibit Metallo-matrix-proteinasesmentioning

confidence: 99%

Selective toxicity of antibacterial agents—still a valid concept or do we miss chances and ignore risks?

Dalhoff

2020

Infection

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“…In fact, venous and lymphatic systems work together to drain blood and interstitial fluids from the limb and, in case of post-thrombotic syndrome we were able to demonstrate, using lymphoscintigraphy, that the formation of venous ulcer is related to an impairment of the lymph flow and that, on the contrary the healing of the ulceration is related with and improvement of the lower limb lymphatic flow (3). Elastic compression therapy, anticoagulation and mobilization enhance lymphatic drainage and improve healing rates (3)(4)(5). Psychosocial and physiological risk factors could include together with venous abnormalities, decreased mobility, fixed ankle joint, nutri-tion, ulcer duration, location and dimensions, wound exudation, wound infection and compression treatment (1) also the role of lymphatic drainage (3,4).…”

Section: Lower Limb Lymphatic Flow and Venous Leg Ulcers Formation Anmentioning

confidence: 99%

“…Elastic compression therapy, anticoagulation and mobilization enhance lymphatic drainage and improve healing rates (3)(4)(5). Psychosocial and physiological risk factors could include together with venous abnormalities, decreased mobility, fixed ankle joint, nutri-tion, ulcer duration, location and dimensions, wound exudation, wound infection and compression treatment (1) also the role of lymphatic drainage (3,4). In fact, a reduction in the lymphatic flow of the affected limb at lymphoscintigraphy is a negative predictive factor for wound healing, on the contrary an improvement of the lymph flow at lymphoscintigraphy is a positive predictive factor for wound closure (3,4).…”

Section: Lower Limb Lymphatic Flow and Venous Leg Ulcers Formation Anmentioning

confidence: 99%

“…Psychosocial and physiological risk factors could include together with venous abnormalities, decreased mobility, fixed ankle joint, nutri-tion, ulcer duration, location and dimensions, wound exudation, wound infection and compression treatment (1) also the role of lymphatic drainage (3,4). In fact, a reduction in the lymphatic flow of the affected limb at lymphoscintigraphy is a negative predictive factor for wound healing, on the contrary an improvement of the lymph flow at lymphoscintigraphy is a positive predictive factor for wound closure (3,4). In conclusion, lymphoscintigraphy could be an additive method of investigation to understand the mechanism of formation and healing of venous ulcers and it could be used, during the follow-up of these patients, to identify the progresses of a determinate treatment of the venous ulcers because when ulcer start to heal the lymph flow improves.…”

Section: Lower Limb Lymphatic Flow and Venous Leg Ulcers Formation Anmentioning

confidence: 99%

“…While our review confirms Cariati's (2010) findings that elastic compression therapy and mobilisation enhance healing rates and possibly lymphatic drainage, we found no evidence in the literature to support anticoagulation as an enhancement for lymphatic drainage. However, two RCTs involving 300 mg daily of enteric-coated Aspirin have been studied in small samples of 20 and 51 participants with venous leg ulcers (4,5). A significant reduction in ulcer surface area (4) and in healing time for those on Aspirin (5) was noted.…”

Section: Lower Limb Lymphatic Flow and Venous Leg Ulcers Formation Anmentioning

confidence: 99%

See 2 more Smart Citations

Lower limb lymphatic flow and venous leg ulcers formation and healing

Cariati

Piromalli

2015

Int J Clin Pract

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The effects of gravity and compression on interstitial fluid transport in the lower limb

Baish

Padera

Munn

2022

Sci Rep

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Edema in the limbs can arise from pathologies such as elevated capillary pressures due to failure of venous valves, elevated capillary permeability from local inflammation, and insufficient fluid clearance by the lymphatic system. The most common treatments include elevation of the limb, compression wraps and manual lymphatic drainage therapy. To better understand these clinical situations, we have developed a comprehensive model of the solid and fluid mechanics of a lower limb that includes the effects of gravity. The local fluid balance in the interstitial space includes a source from the capillaries, a sink due to lymphatic clearance, and movement through the interstitial space due to both gravity and gradients in interstitial fluid pressure (IFP). From dimensional analysis and numerical solutions of the governing equations we have identified several parameter groups that determine the essential length and time scales involved. We find that gravity can have dramatic effects on the fluid balance in the limb with the possibility that a positive feedback loop can develop that facilitates chronic edema. This process involves localized tissue swelling which increases the hydraulic conductivity, thus allowing the movement of interstitial fluid vertically throughout the limb due to gravity and causing further swelling. The presence of a compression wrap can interrupt this feedback loop. We find that only by modeling the complex interplay between the solid and fluid mechanics can we adequately investigate edema development and treatment in a gravity dependent limb.

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Effects of compression therapy and antibiotics on lymphatic flow and chronic venous leg ulceration

Cited by 3 publications

References 5 publications

Selective toxicity of antibacterial agents—still a valid concept or do we miss chances and ignore risks?

Selective toxicity of antibacterial agents—still a valid concept or do we miss chances and ignore risks?

Lower limb lymphatic flow and venous leg ulcers formation and healing

The effects of gravity and compression on interstitial fluid transport in the lower limb

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