Estrogen Receptors and Chronic Venous Disease

Objective/Background: Chronic venous disease (CVD) is a common and relevant problem affecting Western people. The role of estrogens and their receptors in the venous wall seems to support the major prevalence of CVD in women. The effects of the estrogens are mediated by three estrogen receptors (ERs): ER alpha, ER beta, and G protein-coupled ER (GPER). The expression of ERs in the vessel walls of varicose veins is evaluated. Methods: In this prospective study, patients of both sexes, with CVD and varicose veins undergoing open venous surgery procedures, were enrolled in order to obtain vein samples. To obtain control samples of healthy veins, patients of both sexes without CVD undergoing coronary artery bypass grafting with autologous saphenous vein were recruited (control group). Samples were processed in order to evaluate gene expression. Results: Forty patients with CVD (10 men [25%], 30 women [75%], mean age 54.3 years [median 52 years, range 33-74 years]) Were enrolled. Five patients without CVD (three men, two women [aged 61-73 years]) were enrolled as the control group. A significant increase of tissue expression of ER alpha, ER beta and GPER in patients with CVD was recorded (p < .01), which was also related to the severity of venous disease. Conclusion: ERs seem to play a role in CVD; in this study, the expression of ERs correlated with the severity of the disease, and their expression was correlated with the clinical stage. (C) 2016 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.