Histopathological changes and expression of adhesion molecules and laminin in varicose veins

Although varicose disease is a common pathology, etiologic factors predisposing to dilatation, elongation and tortuosity of the saphenous vein are not yet well understood. The aim of our study was to investigate morphological changes, laminin and adhesion molecules expression in the great saphenous vein.

Material obtained from 26 patients was analyzed using light microscopy, immunohistology and electron microscopy. Patients were divided into two age groups (group I, aged between 26 and 35 years and group 11, 36-45 years).

In most patients veins were stretched out with highly varying wall thickness. The vein wall three-layered structure composed of intima, media and adventitia was changed in 78% of the cases. In most specimens endothelium was either damaged or missing. In such areas possible thrombus formation sites were observed characterized by erythrocyte accumulation. In media and adventitia smooth muscle cells were destroyed or showed altered morphology, the amount of connective tissue was increased together with irregular organization of collagen fibers and disruption of the elastic network around smooth muscle cell bundles. Laminin, intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) expression was increased in varicose veins wall, especially in the second group of patients (p<0.05). In addition, ICAM-1 and VCAM-1 expression was more pronounced in the wall of varicose veins of female than male patients (p < 0.05).

We conclude that morphological alterations in varicose veins become more pronounced with advancing age, and laminin, ICAM-1 and VCAM-1 expression is related to the severity of damage and age of the patient.