Annals of the Russian academy of medical sciencesAnnals of the Russian academy of medical sciencesВестник Российской академии медицинских наук0869-60472414-3545"Paediatrician" Publishers LLC121310.15690/vramn1213CARDIOLOGY AND CARDIOVASCULAR SURGERY: CURRENT ISSUESАКТУАЛЬНЫЕ ВОПРОСЫ КАРДИОЛОГИИ И СЕРДЕЧНО-СОСУДИСТОЙ ХИРУРГИИResearch ArticleVaricose veins: on the verge of discovering the cause?Варикозная болезнь: на пороге открытия причины?https://orcid.org/0000-0002-6563-04713426-2981ZolotukhinIgor A.ЗолотухинИгорь Анатольевич
Russian Federation

MD, PhD, Professor

д.м.н., профессор РАН

zoloto70@bk.ruhttps://orcid.org/0000-0003-3537-74099775-1057PorembskayaOlga Ya.ПорембскаяОльга Ярославна
Russian Federation

MD, PhD

к.м.н.

porembskaya@yandex.ruhttps://phlebounion.ru/my/https://orcid.org/0000-0001-6080-46156045-9880SmetaninaMariya A.СметанинаМария Александровна
Russian Federation

PhD

к.б.н.

mariya_smetanina@niboch.nsc.ruhttps://orcid.org/0000-0001-6188-60937064-6369SazhinAleksandr V.СажинАлександр Вячеславович
Russian Federation

MD, PhD, Professor

д.м.н., член-корреспондент РАН, профессор

sazhin-av@yandex.ruhttps://orcid.org/0000-0002-8950-53684025-0533FilipenkoMaksim L.ФилипенкоМаксим Леонидович
Russian Federation

PhD

к.б.н.

max@niboch.nsc.ruhttps://orcid.org/0000-0001-8792-16948319-5682KirienkoAleksandr I.КириенкоАлександр Иванович
Russian Federation

MD, PhD, Professor

д.м.н., академик РАН, профессор

aik1910@mail.ruPirogov Russian National Research Medical UniversityРоссийский национальный исследовательский медицинский университет им. Н.И. ПироговаInstitute of Experimental MedicineИнститут химической биологии и фундаментальной медицины СО РАНInstitute of Chemical Biology and Fundamental Medicine SB RASИнститут экспериментальной медициныNorth-Western State Medical University named after I.I. MechnikovСеверо-Западный государственный медицинский университет имени И.И. МечниковаNovosibirsk State UniversityНовосибирский государственный университет110320203003202075136453009201926012020Copyright ©; 2020, "Paediatrician" Publishers LLCCopyright ©; 2020, Издательство "Педиатръ"2020"Paediatrician" Publishers LLCИздательство "Педиатръ"https://vestnikramn.spr-journal.ru/jour/about/submissionshttps://vestnikramn.spr-journal.ru/jour/article/view/1213

Varicose veins of the lower limbs are one of the most common and wide-spread pathology all around the world. What triggers the specific changes in a vein wall still remains unclear as well as what happens in the layers of the vein wall after the disease starts. The aim of the article is to analyze published data and results of researches on epidemiology, genetics, cellular and molecular mechanisms underlying varicose veins pathogenesis. It is now commonly accepted that vein wall changes in patients with varicose veins result from vein-specific inflammation. This process includes leukocytes adhesion to venous endothelium with their subsequent migration into the vein wall and surrounding tissues. Activated leukocytes express a number of molecules that lead to vein wall remodeling and dilation. Comprehensive assessment of the epidemiological data on the prevalence of varicose veins and risk factors, of the findings from genetic studies, of data on molecular-cell interactions as well as results of various surgical interventions in patients with varicose veins, shows that remodeling is a reversible process that can be stopped and reversed by different stimuli including some chemical substances. For the first time in the literature, the authors assume that varicose veins can be successfully cured pharmacologically with no surgical interventions needed.

Варикозная болезнь нижних конечностей — одно из самых распространенных заболеваний сосудистой системы человека. Этиология и патогенез болезни служат предметом активного изучения во всем мире и до настоящего времени полностью не установлены. В статье проведен анализ литературных сведений и представлены результаты собственных исследований авторов. Лежащие в основе варикозной трансформации подкожных вен процессы, которые можно объединить термином «веноспецифическое воспаление», включают каскад реакций, которые запускаются при наличии генетической предрасположенности к заболеванию и включают адгезию лейкоцитов к эндотелию, их миграцию в венозную стенку и окружающие ткани с экспрессией ряда молекул, стимулирующих перестройку гладкомышечного слоя с развитием ремоделирования венозной стенки. Комплексная оценка эпидемиологических данных о распространенности заболевания и факторах риска, генетических находок, результатов изучения молекулярно-клеточных взаимодействий, результатов наблюдений за пациентами после различных хирургических вмешательств позволила авторам сделать вывод об обратимости патологических изменений в венозной стенке при варикозной болезни в определенных условиях. Более того, основываясь на ряде экспериментальных данных о подавлении «веноспецифического воспаления» при использовании фармакологических агентов и собственных клинических наблюдениях, авторы впервые в мировой литературе делают предположение о возможности ликвидации варикозной трансформации вен фармакологическим путем.

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