Prasol V.A., Troyan V.I., Ponomaryov A.O., Kupriyanova L.S.

Kharkiv National Medical University (Ministry of Health of Ukraine) Pathomorphology Department

Immunological peculiarities of the wall of large subcutaneous vein in patients with varicose disease

Objective: To reveal immunohistochemical peculiarities of the wall of large subcutaneous vein in patients with varicose disease.

Methods of research: Histological, immunohistochemical, morphometry, statistical analysis.

Material: The controls were 4 cases of autopsy of young male patients who died of different injuries. The study group comprised 11 patients who were operated for varicose disease. In all cases a segment of large superficial vein was investigated.

Results: Microscopy of the vein walls of the study group demonstrated protrusions with uneven thickening and consolidation of the wall. The vessel integrity was preserved. Histological survey revealed that the wall of the vein in all cases was presented by three layers: internal, medial, external. But the wall thickness was changed. Thus, in the controls this parameter was 322.67±43.12õ10‾³m, in the study group it was 490.27±18.65õ10‾³m. In contrast to the controls, the changes of myeloelastosis type were noted in the structure of the inner layer of the vein wall in the study group. Massive growth of the connective tissue as well as thickening and loosening of muscular fibers were observed in the structure of the medial and external layers of the walls in of the study group (p. 1). Immunohistological method with Coons’ technique revealed the following peculiarities of collagen formation in the walls of the veins of the investigated groups. In all observations type IV, I and III collagens were present in the connective tissue. But the changes of fluorescence intensity of these collagen types were noted.

The indices of collages fluorescence intensity for main collagen types are presented in table 1.

Table 1

Type I, III, IV collagen fluorescence intensity in the connective tissue of the vessel walls of the investigated groups (conventional units)

Group	Type I collagen	Type III collagen	Type IV collagen
Controls	2.15±0.27	3.04±0.8	2.96±0.16
Varicose disease	1.89±0.19	3.86±0.28*	2.06±0.28*

*ð<0.05 (compared to the controls)

P. 1. Massive growth of the connective tissue in the structure of the medial and external layers of the walls in of the study group. Stained with Picrofucsin to van Geeson, x200.

The data of the table suggest significant reduction of type IV and I collagens and significant increase of type III collagen amount in the connective tissue of the wall of large subcutaneous vein in patients with varicose disease (p. 2).

P. 2. Type III collagen in the structure of the medial layer of the walls in of the study group. Immunohistological method with Coons’ technique, x200.

Conclusion. The complex investigation demonstrated prevailing sclerotic changes in main components of the vein wall in patients with varicose disease which manifested by changes in the structure of the connective tissue. The revealed peculiarities of collagen formation can be a sign of connective tissue dysplasia in patients with varicose disease.