title: Prevention of excessive endothelin-1 release in sclerotherapy: in vitro and in vivo studies.
abstract: BACKGROUND
  The foam sclerotherapy technique has become one of the most commonly used treatments for superficial venous insufficiency. Despite excellent results, few visual/neurologic disturbances have been recently reported; their pathogenesis is still debated but a correlation with endothelin-1 (ET-1) release from the treated vein has been proposed.
  
  
  OBJECTIVE
  The purpose of this work was to evaluate the ET-1 release after sclerotherapy and to investigate the effects of the anti-endothelin drug aminaphtone.
  
  
  METHODS
  As in vitro sclerotherapy model, an endothelial cell culture, mimicking vascular endothelium, was pretreated with aminaphtone and exposed to detergents. Cell survival and ET-1 release were measured. In in vivo experiments, 45 rats, fed with different aminaphtone-rich diets, were subjected to sclerotherapy, and the systemic ET-1 was measured.
  
  
  RESULTS
  Aminaphtone cell exposure caused a statistically significant reduction in ET-1 release, both before and after in vitro sclerotherapy. Rats fed with aminaphtone showed a trend toward reduced mortality and a significant decrease of ET-1 release after sclerotherapy.
  
  
  CONCLUSIONS
  This is the first study in which an anti-endothelin agent was able to cause a significant reduction of ET-1 release during sclerotherapy. Although clinical studies are required, these findings might advocate the use of anti-endothelin agents in prophylaxis of neurologic or visual disturbances after sclerotherapy.
authors.affiliation: *Studio Medico Flebologico, Figline Valdarno-Florence, Italy; †Department of Pharmacy, University of Pisa, Italy; ‡Department of Surgical, Medical and Molecular pathology and Critic area, University of Pisa, Italy; §Fondazione Toscana G. Monasterio, Pisa, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Frullini
authors.forename: Eleonora
authors.initials: E
authors.lastname: Da Pozzo
authors.forename: Francesca
authors.initials: F
authors.lastname: Felice
authors.forename: Silvia
authors.initials: S
authors.lastname: Burchielli
authors.forename: Claudia
authors.initials: C
authors.lastname: Martini
authors.forename: Rossella
authors.initials: R
authors.lastname: Di Stefano
mesh_terms: D000818:Animals; D002470:Cell Survival / Q000187:drug effects; D054885:Cumulus Cells; D019587:Dietary Supplements; D019332:Endothelin-1 / Q000037:antagonists & inhibitors / Q000097:blood / Q000378:metabolism*; D006490:Hemostatics / Q000008:administration & dosage / Q000494:pharmacology*; D061307:Human Umbilical Vein Endothelial Cells / Q000187:drug effects* / Q000378:metabolism; D006801:Humans; D008297:Male; D051381:Rats; D017208:Rats, Wistar; D012597:Sclerosing Solutions / Q000494:pharmacology*; D015911:Sclerotherapy / Q000009:adverse effects; D062366:para-Aminobenzoates / Q000008:administration & dosage / Q000494:pharmacology*
chemical_list: D019332:Endothelin-1; D006490:Hemostatics; D012597:Sclerosing Solutions; D062366:para-Aminobenzoates; C016217:aminaftone