Effect of pentoxifylline on cell adhesion molecules and extracellular matrix in chronic venous ulcer: a reappraisal of pathogenic mechanism

ABSTRACT

The pathogenesis of venous ulceration is unknown. It has been early proposed that the pathogenesis of venous ulceration involves formation of pericapillary fibrin cuffs. More recent hypothesis suggests that macromolecules leaking into dermis may bind or trap growth factors. The role of leukocyte and its adherece to endothelial cells by adhesion molecules in damaged tissue of venous diseas has been considered. The purpose of this study was to evaluate the role of pharmacotherapy as pentoxifylline in treatment of non complicated chronic venous ulcer. This was performed through immunohistochemical staining of tissue distribution of fibronectin [FN], transforming growth factor beta-1 [TGF beta 1] and ICAM-1 in damaged skin of 19 patients. Also, plasma level of soluble L-selectin was measured. All these parameters were estimated before and after pentoifylline administration and external compression bandage for 3 months. The results of this study demonstrated that pentoxifylline administration was associated with significant clinical improvement of the uicerative area and induced decrease of 1C AM-1 expression in skin. There were changes of TGF beta1 and fibronectin [FN] distribution from non-healed to the healed ulcer. Also there was significant rise in plasma level SL-selectin [p > 0.001] which decreased after clinical improvement. It could be concluded that the accumulation of activated leukocyte is the key event in venous leg ulcer and TGF beta1 in extracellular matrix is critical in wound healingThe pathogenesis of venous ulceration is unknown. It has been early proposed that the pathogenesis of venous ulceration involves formation of pericapillary fibrin cuffs. More recent hypothesis suggests that macromolecules leaking into dermis may bind or trap growth factors. The role of leukocyte and its adherece to endothelial cells by adhesion molecules in damaged tissue of venous diseas has been considered. The purpose of this study was to evaluate the role of pharmacotherapy as pentoxifylline in treatment of non complicated chronic venous ulcer. This was performed through immunohistochemical staining of tissue distribution of fibronectin [FN], transforming growth factor beta-1 [TGF beta 1] and ICAM-1 in damaged skin of 19 patients. Also, plasma level of soluble L-selectin was measured. All these parameters were estimated before and after pentoifylline administration and external compression bandage for 3 months