Micronized purified flavonoid fraction for the treatment of chronic venous insufficiency, with a focus on postthrombotic syndrome: A narrative review

Li, Ke Xuan; Diendéré, Gisèle; Galanaud, Jean‐Philippe; Mahjoub, Nada; Kahn, Susan R.

doi:10.1002/rth2.12527

Cited by 8 publications

(6 citation statements)

References 70 publications

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“…The beneficial effects of different flavonoids in cardiovascular complications of diabetes have been studied in experimental models of T1D and T2D [ 18 , 23 , 25 , 44 ]. Micronized purified flavonoid fractions containing phlebotonic drugs such as diosmin and hidrosmin have been used in the treatment of chronic venous insufficiency likely because of its ability to ameliorate venous tone and contractility [ 21 , 45 ]. However, to our knowledge this is the first study evaluating in relevant preclinical models the effects of hidrosmin on the vascular dysfunction associated with hyperglycemia.…”

Section: Discussionmentioning

confidence: 99%

The Synthetic Flavonoid Hidrosmin Improves Endothelial Dysfunction and Atherosclerotic Lesions in Diabetic Mice

et al. 2022

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In diabetes, chronic hyperglycemia, dyslipidemia, inflammation and oxidative stress contribute to the progression of macro/microvascular complications. Recently, benefits of the use of flavonoids in these conditions have been established. This study investigates, in two different mouse models of diabetes, the vasculoprotective effects of the synthetic flavonoid hidrosmin on endothelial dysfunction and atherogenesis. In a type 2 diabetes model of leptin-receptor-deficient (db/db) mice, orally administered hidrosmin (600 mg/kg/day) for 16 weeks markedly improved vascular function in aorta and mesenteric arteries without affecting vascular structural properties, as assessed by wire and pressure myography. In streptozotocin-induced type 1 diabetic apolipoprotein E-deficient mice, hidrosmin treatment for 7 weeks reduced atherosclerotic plaque size and lipid content; increased markers of plaque stability; and decreased markers of inflammation, senescence and oxidative stress in aorta. Hidrosmin showed cardiovascular safety, as neither functional nor structural abnormalities were noted in diabetic hearts. Ex vivo, hidrosmin induced vascular relaxation that was blocked by nitric oxide synthase (NOS) inhibition. In vitro, hidrosmin stimulated endothelial NOS activity and NO production and downregulated hyperglycemia-induced inflammatory and oxidant genes in vascular smooth muscle cells. Our results highlight hidrosmin as a potential add-on therapy in the treatment of macrovascular complications of diabetes.

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Section: Discussionmentioning

confidence: 99%

The Synthetic Flavonoid Hidrosmin Improves Endothelial Dysfunction and Atherosclerotic Lesions in Diabetic Mice

et al. 2022

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“…Улучшение микроциркуляторного русла положительно сказывается на оксигенации тканей, что было доказано при проведении чрескожной оксиметрии у пациентов с ХВН. Было зарегистрировано увеличение скорости эритроцитов в капиллярах по сравнению с исходным уровнем, что в свою очередь уменьшило капиллярный застой и улучшило венозную микроангиопатию [32,34].…”

Section: доказательная эффективность микронизированной очищенной фрак...unclassified

“…Отличий в частоте возникновения побочных реакций в зависимости от препарата не было выявлено, и их возникновение объясняется длительной продолжительностью лечения (более 6 мес.) [34,40].…”

Section: доказательная эффективность микронизированной очищенной фрак...unclassified

Current principles of symptomatic treatment of lymphovenous insufficiency

Дунаевская

2023

Ambulatornaya khirurgiya

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This article provides a review of the current literature on the current principles of symptomatic treatment of lymphovenous insufficiency. Lymphovenous insufficiency is an urgent problem of modern phlebology, the prevalence of this pathology reaches 50% among the world population. Underlying the pathogenesis is venous hypertension, which is caused by venous valve insufficiency, venous outflow obstruction, or combined causes. The use of compression knitwear and symptomatic therapy for lymphovenous insufficiency is an important component of the treatment at the initial stages of the disease — pharmacotherapy based on the use of venoactive drugs. The most promising to date are preparations of the micronized purified flavonide fraction (MPFF) group, which consist of micronized diosmin and flavonides. The use of МОФФ drugs reduces venous hypertension by increasing venous tone, reducing venous capacity, and extensibility of the vessel wall. MPFF also improves lymph conversion by increasing the contractility of the lymphatic capillaries and has an effect on the microcirculation of the vessels of the lower extremities, having an effect on the resistance and permeability of the capillaries. Thus, the use of preparations of the micronized purified fraction of flavonides has a more pronounced effect on the etiology and pathogenesis of the disease, thereby increasing the clinical effect and leading to a more effective result in the treatment of lymphovenous insufficiency. And as presented in this review, drugs containing micronized purified flavonoid fraction are an excellent candidate to be further studied as therapeutic agents for the treatment of lymphovenous insufficiency, because the mechanism of action of the micronized purified flavonoid fraction is directly connected with its pathophysiology and high clinical efficacy.

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“…These antioxidants protect endothelial cells from hypoxia and inflammation, have affinity for venous endothelium and in clinical studies were found to reduce markers of endothelial damage and dysfunction [54][55][56][57]. Flavonoids, in particular modified variants rutoside and micronized purified flavonoid fraction (MPFF), were found to reduce symptoms in both primary CVD and PTS [58,59]. Guidelines recommend its use in treatment of primary CVD [60], and a large trial is ongoing to confirm its effectiveness on reducing symptoms of PTS (NCT03833024).…”

Section: Endothelial Dysfunctionmentioning

confidence: 99%

How to optimize the prevention of post-thrombotic syndrome: recent advances

Iding¹,

Cate‐Hoek²

2022

Polish Archives of Internal Medicine

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Post-thrombotic syndrome (PTS) is the most frequent complication of deep vein thrombosis, and it can be detrimental to the quality of life of affected patients. Once affected by this chronic condition, treatment options are very limited, so preventive therapies are paramount.Currently, the prevention of PTS is hampered by the lack of unequivocally effective therapies.However, increased pathogenic insight acquired in recent years, including the central role of residual venous obstruction, could lead to better application of existing therapies and identification of novel therapeutic targets. Plausible therapeutic agents include flavonoids and statins, while promising future agents include those that target leukocyte-endothelial interaction. Moreover, differences in PTS risk were found to be partly explained by a tendency of patients to form clots which are less susceptible to lysis. Finally, identifying patients that are expected to benefit most from certain therapies is equally valuable for the success of future preventive strategies. This requires exploration of better risk stratification through machine learning techniques.

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Micronized purified flavonoid fraction for the treatment of chronic venous insufficiency, with a focus on postthrombotic syndrome: A narrative review

Abstract: This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Cited by 8 publications

References 70 publications

The Synthetic Flavonoid Hidrosmin Improves Endothelial Dysfunction and Atherosclerotic Lesions in Diabetic Mice

The Synthetic Flavonoid Hidrosmin Improves Endothelial Dysfunction and Atherosclerotic Lesions in Diabetic Mice

Current principles of symptomatic treatment of lymphovenous insufficiency

How to optimize the prevention of post-thrombotic syndrome: recent advances

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