Evaluation of the smooth muscle cell component and apoptosis in the varicose vein wall

This study was designed to evaluate the role of the smooth muscle cell and the apoptosis in the pathogenesis of the varicose vein. Segments of saphenous vein were obtained from healthy subjects and from tho se with varicose veins. The vein specimens were subdivided according to sub ject age (younger or older than 50 years) and according to the varicose vei n source (distal or proximal). Morphological, ultrastructural, eel prolifer ation (anti-PCNA method) and cell death (TUNEL method) analysis were perfor med. The walls of healthy, control vein specimens acquired a more collagenous an d papilomatous appearance with age. A slight increase in the number of TUNE L-positive cells was also observed in specimens from older subjects. The pr oportion of apoptotic cells was much greater in the varicose veins than in control specimens. Most cellular alterations were seen in proximal varicose segments obtained from young subjects. These specimens showed hypertrophic areas with a high degree of cellularity (both in the media and in the thic kened intima). The highest proportion of apoptotic cells and collagenisatio n were also observed in these areas. The enhanced number of apoptotic cells in varicose veins observed mainly in proximal/young vein specimens could b e responsible, at least in part, for the acceleration of the final fibroscl erotic process characteristic of the varicose vein wall.