Estrogen And Progesterone Receptors Expression And Collagen Subtype Pattern In Normal And Varicose Saphenous Veins

AIM The presence of estrogen and progesterone receptors was investigated in the walls of normal and varicose vein. Our present study was to determine to collagen subtype pattern in the greater saphenous vein of the lower limb, obtained from 21 normal and 37 varicose subjects, and to compare affected and unaffected segments.METHODS Fixed sections from the saphenous veins of 29 normal individuals, and varicose and normal vein segments of 32 patients with varicose vein, were stained with anti-estrogen or anti- progesterone receptor antibodies. Nuclear stain density and scope were scored. The elastase pretreatment and partial pepsin digestion, type I , III& V collagens were extracted selectively by differential salt precipitation and measured quantitatively in samples obtained from normal and varicose saphenous veins.-6-RESULTS Receptors to both hormones were detected in the nuclear regions of the intima and media in females and males. In the adventitia, estrogen and the progesterone receptors were found only in nuclei of the vasa vasorum. Estrogen receptor levels were lower in non-varicose segments of varicose veins compared with normal vein. In varicose segments, estrogen receptors were more abundant than in the non-varicose parts of the same vein, especially in females. Similarly, progesterone receptor levelsin the non-varicose portions were higher in females. Significant elevations of water (p<0.05) and collagen type I (p <0.01) content in varicose veins (both affected and unaffected segments) as compared with normal saphenous veins were observed. The collagen type III and collagen type V content of varicose veins were found to be slightly reduced as compared to normal veins and consequently the C I / (CIII+CV ) ratio in varicose veins increased significantly (p<0.02) as compared to normalveins.CONCLUSION These findings may be related to the involvement of sex-hormones in varicosis. Elevation of the C I / (CIII+C V ) ratio in varicose veins may cause considerable weakening of the venous wall, further supporting the " weak wall" theory of varicose vein etiology.