Endothelial activation response to oral micronised flavonoid therapy in patients with chronic venous disease--a prospective study.
BACKGROUND
Endothelial activation is important in the pathogenesis of skin changes due to chronic venous disease (CVD). Purified micronised flavonoid fraction has been used for symptomatic treatment of CVD for a considerable period of time. The exact mode of action of these compounds remains unknown.


OBJECTIVE
To study the effects of micronised purified flavonoidic fraction (Daflon 500 mg, Servier, France) treatment on plasma markers of endothelial activation.


METHODS
Twenty patients with chronic venous disease were treated for 60 days with DAFLON 500 mg twice daily. Duplex ultrasonography and PPG was used to assess the venous disease. Blood was collected from a foot vein immediately before starting treatment and within 1 week of stopping treatment. Plasma markers of endothelial activation were measured using commercial ELISA kits.


RESULTS
Reduction in the level of ICAM-1, 32% (141 ng/ml: 73 ng/ml) and VCAM 29% (1292 ng/ml: 717 ng/ml) was seen. Reduction in plasma lactoferrin (36% decrease, 760 ng/ml: 560 ng/ml) and VW factor occurred in the C4 group only.


CONCLUSIONS
Micronised purified flavonoidic fraction treatment for 60 days seems to decrease the levels of some plasma markers of endothelial activation. This could ameliorate the dermatological effects of (CVD). This could also explain some of the pharmacological actions of these compounds. Our study demonstrates the feasibility of using soluble endothelial adhesion molecules as markers for treatment.
Shoab
S S
SS
Department of Surgery, University College London Medical School, U.K.
Porter
J
J
Scurr
J H
JH
Coleridge-Smith
P D
PD
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D004145:Diosmin / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004730:Endothelium, Vascular / Q000187:drug effects* / Q000276:immunology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005419:Flavonoids / Q000008:administration & dosage*; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D007781:Lactoferrin / Q000097:blood; D008297:Male; D008875:Middle Aged; D018375:Neutrophil Activation / Q000187:drug effects; D010147:Pain Measurement; D011446:Prospective Studies; D018616:Ultrasonography, Doppler, Duplex / Q000187:drug effects; D014648:Varicose Veins / Q000276:immunology / Q000628:therapy*; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood; D014689:Venous Insufficiency / Q000276:immunology / Q000628:therapy*; D014841:von Willebrand Factor / Q000378:metabolism
D005419:Flavonoids; D019010:Vascular Cell Adhesion Molecule-1; D014841:von Willebrand Factor; D018799:Intercellular Adhesion Molecule-1; D004145:Diosmin; D007781:Lactoferrin