Immunocytochemical Characterisation of the Inflammatory Cell Infiltrate of Varicose Veins

Abstract

Objectives To characterise the inflammatory cell infiltrate in varicose vein wall, and its relationship to the valve complex. Design A comparative study of the distribution of inflammatory cells in normal and varicose vein. Materials Specimens of proximal human long saphenous vein were obtained from patients with duplex Doppler confirmed long saphenous vein reflux ( n=14). Control vein was obtained from patients undergoing coronary artery bypass without clinical evidence of venous insufficiency ( n=6). Longitudinal 7 μm frozen sections of vein, displaying valve, were prepared. Methods Using immunohistochemistry, T-lymphocytes (CD3), macrophage/monocytes (CD68), neutrophils (CD15s) and mast cells (anti-mast cell tryptase) were identified. The number of cells per unit length vein were counted using light microscopy. Results There were significantly more mast cells and macrophage/monocytes in varicose vein as compared to control. There was a non-significant trend towards more T-lymphocytes in varicose vein. Few neutrophils were present in varicose or normal vein. The distribution of inflammatory cells with respect to the valve was not found to be significant. Conclusions Varicose veins display a greater inflammatory cell infiltrate than normal vein. The key role of macrophage/monocytes and mast cells in tissue damage and remodelling should stimulate further research into whether they play a significant role in the development of chronic venous insufficiency.