Diminished mononuclear cell function is associated with chronic venous insufficiency

Purpose: With clinical progression of chronic venous insufficiency (CVI), dermal infiltration of mononuclear cells increases. Because these cells regulate chronic inflammatory responses and modulate wound healing, cellular dysfunction could explain alterations in wound healing with CVI. The purpose...

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Veröffentlicht in:Journal of vascular surgery 1995-11, Vol.22 (5), p.580-586
Hauptverfasser: Pappas, Peter J., Teehan, Edwin P., Fallek, Steve R., Garcia, Ambrosia, Araki, Clifford T., Back, Thomas L., Durán, Walter N., Hobson, Robert W.
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container_end_page 586
container_issue 5
container_start_page 580
container_title Journal of vascular surgery
container_volume 22
creator Pappas, Peter J.
Teehan, Edwin P.
Fallek, Steve R.
Garcia, Ambrosia
Araki, Clifford T.
Back, Thomas L.
Durán, Walter N.
Hobson, Robert W.
description Purpose: With clinical progression of chronic venous insufficiency (CVI), dermal infiltration of mononuclear cells increases. Because these cells regulate chronic inflammatory responses and modulate wound healing, cellular dysfunction could explain alterations in wound healing with CVI. The purpose of this study was to determine whether monocytes in patients with CVI are dysfunctional. Methods: Mononuclear cell function was measured as the degree of proliferation in response to a mitogenic challenge. Fifty patients were separated into four groups: group 1, 14 patients with normal limbs; group 2, 10 patients with class 2 CVI; group 3, 15 patients with active venous ulcers; group 4, 11 patients with healed venous ulcers and current evidence of lipodermatosclerosis. Duplex scanning and air plethysmography correlated with the clinical classification of CVI. Systemically circulating monocytes and lymphocytes were obtained by antecubital venipuncture from groups 1 to 4. Cells were cultured in the presence of staphylococcal enterotoxins A, B, C 1 , D, and E (mitogens) at 1, 8, 31, and 125 μg/well on the basis of previous dose-response experiments. Phytohemagglutinin (PHA), 5 μg/well, served as a control mitogen. The dose-response curves indicated that 8 μg/well elicited the greatest degree of cell proliferation. Proliferative responses at 8 μg/well were analyzed for statistical significance among groups 1 to 4. Comparisons among groups were performed by use of the nonparametric Mann Whitney U post tests and a one-tailed unpaired t test. Results were considered significant at p≤ 0.05. Results: Proliferative responses to PHA indicate that lymphocytes and monocytes from patients with CVI are not globally depressed. However, patients in group 2 did not exhibit the same degree of proliferation to PHA as did groups 1, 3, and 4. Proliferative responses between groups 2 and 1 (44.38 ± 43.9 vs 118.87 ± 27.1, p ≤ 0.05) and groups 2 and 3 (44.38 ± 43.9 vs 105.95 ± 60.99, p≤ 0.05) were significant. Challenges with staphylococcal enterotoxin A and B reveal significant diminution of proliferative responses in groups 2 (42.73 ± 11.55, p≤ 0.05) and 3 (45.57 ± 9.1, p≤ 0.05) and groups 3 (36.81 ± 6.9, p ≤ 0.05) and 4 (35.04 ± 7.5, p≤ 0.05), compared with staphylococcal enterotoxin A controls (68.68 ± 9.9) and staphylococcal enterotoxin B controls (66.25 ± 13.56), respectively. A trend of diminished mononuclear cell function with progression of CVI was observed with staphylococcal
doi_str_mv 10.1016/S0741-5214(95)70042-0
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Because these cells regulate chronic inflammatory responses and modulate wound healing, cellular dysfunction could explain alterations in wound healing with CVI. The purpose of this study was to determine whether monocytes in patients with CVI are dysfunctional. Methods: Mononuclear cell function was measured as the degree of proliferation in response to a mitogenic challenge. Fifty patients were separated into four groups: group 1, 14 patients with normal limbs; group 2, 10 patients with class 2 CVI; group 3, 15 patients with active venous ulcers; group 4, 11 patients with healed venous ulcers and current evidence of lipodermatosclerosis. Duplex scanning and air plethysmography correlated with the clinical classification of CVI. Systemically circulating monocytes and lymphocytes were obtained by antecubital venipuncture from groups 1 to 4. Cells were cultured in the presence of staphylococcal enterotoxins A, B, C 1 , D, and E (mitogens) at 1, 8, 31, and 125 μg/well on the basis of previous dose-response experiments. Phytohemagglutinin (PHA), 5 μg/well, served as a control mitogen. The dose-response curves indicated that 8 μg/well elicited the greatest degree of cell proliferation. Proliferative responses at 8 μg/well were analyzed for statistical significance among groups 1 to 4. Comparisons among groups were performed by use of the nonparametric Mann Whitney U post tests and a one-tailed unpaired t test. Results were considered significant at p≤ 0.05. Results: Proliferative responses to PHA indicate that lymphocytes and monocytes from patients with CVI are not globally depressed. However, patients in group 2 did not exhibit the same degree of proliferation to PHA as did groups 1, 3, and 4. Proliferative responses between groups 2 and 1 (44.38 ± 43.9 vs 118.87 ± 27.1, p ≤ 0.05) and groups 2 and 3 (44.38 ± 43.9 vs 105.95 ± 60.99, p≤ 0.05) were significant. Challenges with staphylococcal enterotoxin A and B reveal significant diminution of proliferative responses in groups 2 (42.73 ± 11.55, p≤ 0.05) and 3 (45.57 ± 9.1, p≤ 0.05) and groups 3 (36.81 ± 6.9, p ≤ 0.05) and 4 (35.04 ± 7.5, p≤ 0.05), compared with staphylococcal enterotoxin A controls (68.68 ± 9.9) and staphylococcal enterotoxin B controls (66.25 ± 13.56), respectively. A trend of diminished mononuclear cell function with progression of CVI was observed with staphylococcal enterotoxins B, C 1, D, and E, strongly suggesting biologic significance. Furthermore, patients with lipodermatosclerosis uniformly exhibited the poorest proliferative responses. Conclusions: Deterioration of mononuclear cell function is associated with CVI. A trend of diminishing proliferative responses with clinical disease progression is observed and suggests biologic significance. The decreased capacity for mononuclear cell proliferation in response to various challenges may manifest itself clinically as poor and prolonged wound healing. (J V ASC S URG 1995;22:580-6.)</description><identifier>ISSN: 0741-5214</identifier><identifier>EISSN: 1097-6809</identifier><identifier>DOI: 10.1016/S0741-5214(95)70042-0</identifier><identifier>PMID: 7494359</identifier><identifier>CODEN: JVSUES</identifier><language>eng</language><publisher>New York, NY: Mosby, Inc</publisher><subject>Aged ; Biological and medical sciences ; Blood and lymphatic vessels ; Cardiology. Vascular system ; Cell Division - drug effects ; Chronic Disease ; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous ; Dose-Response Relationship, Drug ; Female ; Hemodynamics ; Humans ; Leukocytes, Mononuclear - drug effects ; Leukocytes, Mononuclear - physiology ; Male ; Medical sciences ; Middle Aged ; Mitogens - pharmacology ; Monocytes - drug effects ; Monocytes - physiology ; Prospective Studies ; Statistics, Nonparametric ; Time Factors ; Varicose Ulcer - blood ; Varicose Ulcer - diagnosis ; Varicose Ulcer - physiopathology ; Venous Insufficiency - blood ; Venous Insufficiency - diagnosis ; Venous Insufficiency - physiopathology</subject><ispartof>Journal of vascular surgery, 1995-11, Vol.22 (5), p.580-586</ispartof><rights>1995 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter</rights><rights>1996 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c436t-1e0fc4f36cb3389a3b221634c80cd211cd6177067db9e9c55ff483a04eb3641d3</citedby><cites>FETCH-LOGICAL-c436t-1e0fc4f36cb3389a3b221634c80cd211cd6177067db9e9c55ff483a04eb3641d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/S0741-5214(95)70042-0$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>309,310,314,780,784,789,790,3550,23930,23931,25140,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=2913668$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/7494359$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pappas, Peter J.</creatorcontrib><creatorcontrib>Teehan, Edwin P.</creatorcontrib><creatorcontrib>Fallek, Steve R.</creatorcontrib><creatorcontrib>Garcia, Ambrosia</creatorcontrib><creatorcontrib>Araki, Clifford T.</creatorcontrib><creatorcontrib>Back, Thomas L.</creatorcontrib><creatorcontrib>Durán, Walter N.</creatorcontrib><creatorcontrib>Hobson, Robert W.</creatorcontrib><title>Diminished mononuclear cell function is associated with chronic venous insufficiency</title><title>Journal of vascular surgery</title><addtitle>J Vasc Surg</addtitle><description>Purpose: With clinical progression of chronic venous insufficiency (CVI), dermal infiltration of mononuclear cells increases. Because these cells regulate chronic inflammatory responses and modulate wound healing, cellular dysfunction could explain alterations in wound healing with CVI. The purpose of this study was to determine whether monocytes in patients with CVI are dysfunctional. Methods: Mononuclear cell function was measured as the degree of proliferation in response to a mitogenic challenge. Fifty patients were separated into four groups: group 1, 14 patients with normal limbs; group 2, 10 patients with class 2 CVI; group 3, 15 patients with active venous ulcers; group 4, 11 patients with healed venous ulcers and current evidence of lipodermatosclerosis. Duplex scanning and air plethysmography correlated with the clinical classification of CVI. Systemically circulating monocytes and lymphocytes were obtained by antecubital venipuncture from groups 1 to 4. Cells were cultured in the presence of staphylococcal enterotoxins A, B, C 1 , D, and E (mitogens) at 1, 8, 31, and 125 μg/well on the basis of previous dose-response experiments. Phytohemagglutinin (PHA), 5 μg/well, served as a control mitogen. The dose-response curves indicated that 8 μg/well elicited the greatest degree of cell proliferation. Proliferative responses at 8 μg/well were analyzed for statistical significance among groups 1 to 4. Comparisons among groups were performed by use of the nonparametric Mann Whitney U post tests and a one-tailed unpaired t test. Results were considered significant at p≤ 0.05. Results: Proliferative responses to PHA indicate that lymphocytes and monocytes from patients with CVI are not globally depressed. However, patients in group 2 did not exhibit the same degree of proliferation to PHA as did groups 1, 3, and 4. Proliferative responses between groups 2 and 1 (44.38 ± 43.9 vs 118.87 ± 27.1, p ≤ 0.05) and groups 2 and 3 (44.38 ± 43.9 vs 105.95 ± 60.99, p≤ 0.05) were significant. Challenges with staphylococcal enterotoxin A and B reveal significant diminution of proliferative responses in groups 2 (42.73 ± 11.55, p≤ 0.05) and 3 (45.57 ± 9.1, p≤ 0.05) and groups 3 (36.81 ± 6.9, p ≤ 0.05) and 4 (35.04 ± 7.5, p≤ 0.05), compared with staphylococcal enterotoxin A controls (68.68 ± 9.9) and staphylococcal enterotoxin B controls (66.25 ± 13.56), respectively. A trend of diminished mononuclear cell function with progression of CVI was observed with staphylococcal enterotoxins B, C 1, D, and E, strongly suggesting biologic significance. Furthermore, patients with lipodermatosclerosis uniformly exhibited the poorest proliferative responses. Conclusions: Deterioration of mononuclear cell function is associated with CVI. A trend of diminishing proliferative responses with clinical disease progression is observed and suggests biologic significance. The decreased capacity for mononuclear cell proliferation in response to various challenges may manifest itself clinically as poor and prolonged wound healing. (J V ASC S URG 1995;22:580-6.)</description><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Blood and lymphatic vessels</subject><subject>Cardiology. Vascular system</subject><subject>Cell Division - drug effects</subject><subject>Chronic Disease</subject><subject>Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous</subject><subject>Dose-Response Relationship, Drug</subject><subject>Female</subject><subject>Hemodynamics</subject><subject>Humans</subject><subject>Leukocytes, Mononuclear - drug effects</subject><subject>Leukocytes, Mononuclear - physiology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Mitogens - pharmacology</subject><subject>Monocytes - drug effects</subject><subject>Monocytes - physiology</subject><subject>Prospective Studies</subject><subject>Statistics, Nonparametric</subject><subject>Time Factors</subject><subject>Varicose Ulcer - blood</subject><subject>Varicose Ulcer - diagnosis</subject><subject>Varicose Ulcer - physiopathology</subject><subject>Venous Insufficiency - blood</subject><subject>Venous Insufficiency - diagnosis</subject><subject>Venous Insufficiency - physiopathology</subject><issn>0741-5214</issn><issn>1097-6809</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1995</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkM1u1TAQhS1EVS6FR6iUBUKwSLFjx45XqCp_lSqxoKwtZzLWHZTYxU6K-vbN_dHdsprFfGfm6GPsUvArwYX-9IsbJeq2EeqDbT8azlVT8xdsI7g1te64fck2J-QVe13KH86FaDtzzs6Nskq2dsPuv9BEkcoWh2pKMcUFRvS5AhzHKiwRZkqxolL5UhKQn1fuH83bCrY5RYLqEWNaSkWxLCEQEEZ4esPOgh8Lvj3OC_b729f7mx_13c_vtzfXdzUoqedaIA-ggtTQS9lZL_umEVoq6DgMjRAwaGEM12boLVpo2xBUJz1X2EutxCAv2PvD3Yec_i5YZjdR2TX3EddSzhhtOts0K9geQMiplIzBPWSafH5ygrudTbe36XaqnG3d3qbja-7y-GDpJxxOqaO-df_uuPcF_Biyj0DlhDVWSK27Fft8wHCV8UiYXdmLwoEywuyGRP8p8gzKJ5HT</recordid><startdate>19951101</startdate><enddate>19951101</enddate><creator>Pappas, Peter J.</creator><creator>Teehan, Edwin P.</creator><creator>Fallek, Steve R.</creator><creator>Garcia, Ambrosia</creator><creator>Araki, Clifford T.</creator><creator>Back, Thomas L.</creator><creator>Durán, Walter N.</creator><creator>Hobson, Robert W.</creator><general>Mosby, Inc</general><general>Elsevier</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19951101</creationdate><title>Diminished mononuclear cell function is associated with chronic venous insufficiency</title><author>Pappas, Peter J. ; Teehan, Edwin P. ; Fallek, Steve R. ; Garcia, Ambrosia ; Araki, Clifford T. ; Back, Thomas L. ; Durán, Walter N. ; Hobson, Robert W.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c436t-1e0fc4f36cb3389a3b221634c80cd211cd6177067db9e9c55ff483a04eb3641d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1995</creationdate><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Blood and lymphatic vessels</topic><topic>Cardiology. Vascular system</topic><topic>Cell Division - drug effects</topic><topic>Chronic Disease</topic><topic>Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous</topic><topic>Dose-Response Relationship, Drug</topic><topic>Female</topic><topic>Hemodynamics</topic><topic>Humans</topic><topic>Leukocytes, Mononuclear - drug effects</topic><topic>Leukocytes, Mononuclear - physiology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Mitogens - pharmacology</topic><topic>Monocytes - drug effects</topic><topic>Monocytes - physiology</topic><topic>Prospective Studies</topic><topic>Statistics, Nonparametric</topic><topic>Time Factors</topic><topic>Varicose Ulcer - blood</topic><topic>Varicose Ulcer - diagnosis</topic><topic>Varicose Ulcer - physiopathology</topic><topic>Venous Insufficiency - blood</topic><topic>Venous Insufficiency - diagnosis</topic><topic>Venous Insufficiency - physiopathology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pappas, Peter J.</creatorcontrib><creatorcontrib>Teehan, Edwin P.</creatorcontrib><creatorcontrib>Fallek, Steve R.</creatorcontrib><creatorcontrib>Garcia, Ambrosia</creatorcontrib><creatorcontrib>Araki, Clifford T.</creatorcontrib><creatorcontrib>Back, Thomas L.</creatorcontrib><creatorcontrib>Durán, Walter N.</creatorcontrib><creatorcontrib>Hobson, Robert W.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of vascular surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pappas, Peter J.</au><au>Teehan, Edwin P.</au><au>Fallek, Steve R.</au><au>Garcia, Ambrosia</au><au>Araki, Clifford T.</au><au>Back, Thomas L.</au><au>Durán, Walter N.</au><au>Hobson, Robert W.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Diminished mononuclear cell function is associated with chronic venous insufficiency</atitle><jtitle>Journal of vascular surgery</jtitle><addtitle>J Vasc Surg</addtitle><date>1995-11-01</date><risdate>1995</risdate><volume>22</volume><issue>5</issue><spage>580</spage><epage>586</epage><pages>580-586</pages><issn>0741-5214</issn><eissn>1097-6809</eissn><coden>JVSUES</coden><abstract>Purpose: With clinical progression of chronic venous insufficiency (CVI), dermal infiltration of mononuclear cells increases. Because these cells regulate chronic inflammatory responses and modulate wound healing, cellular dysfunction could explain alterations in wound healing with CVI. The purpose of this study was to determine whether monocytes in patients with CVI are dysfunctional. Methods: Mononuclear cell function was measured as the degree of proliferation in response to a mitogenic challenge. Fifty patients were separated into four groups: group 1, 14 patients with normal limbs; group 2, 10 patients with class 2 CVI; group 3, 15 patients with active venous ulcers; group 4, 11 patients with healed venous ulcers and current evidence of lipodermatosclerosis. Duplex scanning and air plethysmography correlated with the clinical classification of CVI. Systemically circulating monocytes and lymphocytes were obtained by antecubital venipuncture from groups 1 to 4. Cells were cultured in the presence of staphylococcal enterotoxins A, B, C 1 , D, and E (mitogens) at 1, 8, 31, and 125 μg/well on the basis of previous dose-response experiments. Phytohemagglutinin (PHA), 5 μg/well, served as a control mitogen. The dose-response curves indicated that 8 μg/well elicited the greatest degree of cell proliferation. Proliferative responses at 8 μg/well were analyzed for statistical significance among groups 1 to 4. Comparisons among groups were performed by use of the nonparametric Mann Whitney U post tests and a one-tailed unpaired t test. Results were considered significant at p≤ 0.05. Results: Proliferative responses to PHA indicate that lymphocytes and monocytes from patients with CVI are not globally depressed. However, patients in group 2 did not exhibit the same degree of proliferation to PHA as did groups 1, 3, and 4. Proliferative responses between groups 2 and 1 (44.38 ± 43.9 vs 118.87 ± 27.1, p ≤ 0.05) and groups 2 and 3 (44.38 ± 43.9 vs 105.95 ± 60.99, p≤ 0.05) were significant. Challenges with staphylococcal enterotoxin A and B reveal significant diminution of proliferative responses in groups 2 (42.73 ± 11.55, p≤ 0.05) and 3 (45.57 ± 9.1, p≤ 0.05) and groups 3 (36.81 ± 6.9, p ≤ 0.05) and 4 (35.04 ± 7.5, p≤ 0.05), compared with staphylococcal enterotoxin A controls (68.68 ± 9.9) and staphylococcal enterotoxin B controls (66.25 ± 13.56), respectively. A trend of diminished mononuclear cell function with progression of CVI was observed with staphylococcal enterotoxins B, C 1, D, and E, strongly suggesting biologic significance. Furthermore, patients with lipodermatosclerosis uniformly exhibited the poorest proliferative responses. Conclusions: Deterioration of mononuclear cell function is associated with CVI. A trend of diminishing proliferative responses with clinical disease progression is observed and suggests biologic significance. The decreased capacity for mononuclear cell proliferation in response to various challenges may manifest itself clinically as poor and prolonged wound healing. (J V ASC S URG 1995;22:580-6.)</abstract><cop>New York, NY</cop><pub>Mosby, Inc</pub><pmid>7494359</pmid><doi>10.1016/S0741-5214(95)70042-0</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record>
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subjects Aged
Biological and medical sciences
Blood and lymphatic vessels
Cardiology. Vascular system
Cell Division - drug effects
Chronic Disease
Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous
Dose-Response Relationship, Drug
Female
Hemodynamics
Humans
Leukocytes, Mononuclear - drug effects
Leukocytes, Mononuclear - physiology
Male
Medical sciences
Middle Aged
Mitogens - pharmacology
Monocytes - drug effects
Monocytes - physiology
Prospective Studies
Statistics, Nonparametric
Time Factors
Varicose Ulcer - blood
Varicose Ulcer - diagnosis
Varicose Ulcer - physiopathology
Venous Insufficiency - blood
Venous Insufficiency - diagnosis
Venous Insufficiency - physiopathology
title Diminished mononuclear cell function is associated with chronic venous insufficiency
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