Pericapillary fibrin cuffs in venous disease. A reappraisal.
Pericapillary fibrin cuffs in venous disease. A reappraisal.
复制标题
静脉疾病中的毛细血管周围纤维蛋白袖带。
DOI：
10.1111/j.1524-4725.1997.tb00759.x
复制
发表时间：
1997
期刊：
影响因子：
--
通讯作者：
Falanga,V
中科院分区：
文献类型：
--
作者：
VandeScheur,M;Falanga,V
背景。在过去的几年中，人们提出了许多假说来解释静脉溃疡的发病机制。根据 Browse 和 Burnand 提出的早期模型，由于静脉高压和纤维蛋白原外渗而形成的毛细血管周围纤维蛋白袖口，充当氧气和营养物质扩散的屏障；最终，组织缺氧、细胞死亡和溃疡随之而来。最近的假设包括从脉管系统泄漏的大分子捕获生长因子和粘附分子的观点，以及白细胞粘附并损害微循环中的内皮细胞的观点。 目的。回顾支持或反对纤维蛋白袖带致病作用的现有证据，并希望为这个有争议的话题提供有用的视角。方法。我们回顾了静脉溃疡的不同假设以及支持和反对纤维蛋白袖带作为屏障的证据。结论。静脉溃疡可能是许多不同致病事件的结果。毛细血管周围的纤维蛋白袖带仍然是一个突出的特征，无论它们是作为屏障、内皮细胞损伤的标记，还是作为大分子渗漏和捕获的整体机制的一部分。
BACKGROUND. Over the last several years, a number of hypotheses have been proposed to explain the pathogenesis of venous ulceration. According to an early model suggested by Browse and Burnand, pericapillary fibrin cuffs, developing as a result of venous hypertension and extravasation of fibrinogen, act as barrier to the diffusion of oxygen and nutrients; ultimately, tissue anoxia, cell death, and ulceration would follow. More recent hypotheses include the idea that macromolecules leaking from the vasculature trap growth factors and adhesion molecules, and the notion that white blood cells adhere to and damage endothelial cells in the microcirculation.OBJECTIVE. To review the available evidence for or against a pathogenic role of fibrin cuffs, and hope to provide a useful perspective for this controversial topic.METHODS. We have reviewed the different hypotheses for venous ulceration and the evidence for and against fibrin cuffs acting as a barrier.CONCLUSIONS. Venous ulceration is likely to be the result of a number of distinct pathogenic events. Pericapillary fibrin cuffs remain a prominent feature, whether they act as a harrier, a marker for endothelial cell damage, or as part of an overall mechanism of macromolecular leakage and trapping.