Endothelin-1 concentrations in the internal jugular and azygous veins in multiple sclerosis patients: the results of a pilot study

Abstract

Objectives: In this pilot study we examined the potent vasoconstrictor, endothelin-1, in the blood of multiple sclerosis patients in the context of chronic cerebrospinal venous insufficiency hypothesis. For this purpose we measured endothelin-1 concentrations in blood samples that were obtained during selective catheterisation of the main veins draining the central nervous system: the internal jugular veins and the azygous vein. Material and methods:We measured endothelin-1 concentrations in peripheral blood in nine multiple sclerosis patients and five healthy controls. In multiple sclerosis patients this peptide was also evaluated in blood samples obtained from the internal jugular veins and azygous vein. Also, in five patients peripheral endothelin-1 levels were measured one and seven days after angioplasty for stenosed internal jugular veins. Results: We found similar concentrations of endothelin-1 in peripheral blood in multiple sclerosis patients and healthy controls, a higher endothelin-1 level in the upper part of right internal jugular veins, and unchanged concentrations of this peptide in peripheral blood following angioplasty. Conclusions: Considering the pilot nature of our trial and the small number of the patients and controls assessed, our findings should be interpreted with caution, but they may represent a useful framework for further research in this field. However, our study shows that it is unlikely that endothelin-1 circulating in the blood is responsible for the symptoms of multiple sclerosis.

Hypercapnia and hypoxaemia due to impaired venous blood draining and significant improvement after endovascular treatment in patients with chronic cerebrospinal venous insufficiency

“…It is also likely that local stasis of blood in abnormal extracranial veins could be responsible. Also, it was possible that hypercapnia and hypoxaemia in blood samples drawn from the internal jugular veins were partially caused by asymmetric venous outflow from the brain [16,19,20]. Still, the studies utilising perfusion MRI have shown that MS patients exhibit significant hypoperfusion of the brain [1][2][3][4][5].…”