Abstract
The development of the limbs in patients with congenital segmental defects is associated with defects in the vascular system of the same segment. In this case, vascular endothelial growth factors that participate in physiological angiogenesis may have effect on bone tissue formation in ontogenesis and participate in endochondral ossification. In this regard, the aim of the study was to compare the quantitative changes in growth factors (VEGF) and the contractile properties of arterioles under conditions of discrete distraction for congenital pathology of the lower leg bones. Materials and methods Subjects of the study were 12 patients with congenital pseudarthrosis of the lower leg (ICD-10 Q 74.0). Their serum was analyzed using an enzyme immunoassay. Microcirculation in the calf skin was examined by laser flowmetry (BLF21, Transonic Systems Inc., USA). We used the findings obtained from the study of blood serum in 103 somatically healthy people for control. Results Significant imbalance in serum concentrations of endothelial factors and their receptors was detected in the subjects with congenital pathology. As a result of surgical treatment, the imbalance of secretion of vascular growth factors and their receptors increased. Vasodilator effect in the precapillary vessels in the zone of the operated segment in patients with congenital pathology was not revealed by surgical intervention.
Highlights
It is known that congenital segmental limb defects are associated with disorders of the vascular system of the same segment in all patients [1, 2]
There was a significant imbalance in serum vascular (KKrest) by 17 %, KKpeak and peak capillary blood endothelial growth factors and their receptors (Table 2) flow index – 2 times lower; half-recovery time after in patients with congenital segmental tibial pathology. ischemic test and duration of reactive hyperemia by
The concentration of vascular endothelial growth factors (VEGF), VEGF-A and VEGF-R2 5-6 times (Table 3, Figures 1 and 2). This indicates receptor at the preoperative stage was significantly a significant decrease in the reserve capacity of the higher than the values of the reference group, while capillary bed, dysfunction of the endothelium of the VEGF-R3 receptor concentration was more than the vessels of the precapillary link
Summary
It is known that congenital segmental limb defects are associated with disorders of the vascular system of the same segment in all patients [1, 2]. Concomitant arterial hypoplasia is caused by dysplasia of the vascular wall in disorder of its basal (sympathetic) tone [4]. Vascular growth factors (VEGF) play a major part in embryonic vasculo- and angiogenesis [5], physiological angiogenesis [6, 7, 8, 9, 10], have an effect on bone tissue formation in ontogenesis [11], and participate in the transformation of the cartilage into bone (enchondral ossification) [12] in distraction regenerate [13]. A number of studies show that VEGF can have an effect on the contractility of the vascular wall [18] by inducing NO-dependent relaxation in the arteries [19, 20, 21] or activating the production of prostacyclin by VEGF interacting with flk-1/KDR (VEGF-R2), one of the most powerful vasodilator agents [22]. Vasodilatation of resistive vessels with an increase in arteriovenous shunting is one of the mechanisms that trigger tissue hyperemia and, as a result, increased pressure in venules with stimulation of angiogenesis [23, 24]
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