Articles |
From the Section of Vascular Surgery and Jobst Vascular Research Laboratory, Department of Surgery (T.W.W., A.M.K., S.K.W., R.S., L.J.G.); the Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine (R.M.S., C.A.W., M.D.B); and the Department of Pathology (S.L.K.), University of Michigan Medical Center, Ann Arbor.
Correspondence to Thomas W. Wakefield, MD, 2210D THCC, University of Michigan Medical Center, 1500 E Medical Center Dr, Ann Arbor, MI 48109-0329.
Abstract Thrombosis and inflammation are closely related.
However, the response of the vein wall to venous thrombosis has been
poorly documented. This study examines the hypothesis that venous
thrombosis is associated with an inflammatory response in the vein
wall. In a rat model of inferior vena caval thrombosis, vein wall was
temporally examined for inflammation by assessment of histopathology,
leukocyte morphometrics, and cytokine levels. Animals were killed 1
hour and 1, 3, and 6 days after thrombus induction. Our findings
demonstrated an early (day 1) neutrophil infiltration into the vein
wall followed by a later (days 3 and 6) monocyte/macrophage and
lymphocyte response. Cytokines were elevated only under conditions of
venous thrombosis. Levels of epithelial neutrophil activating
protein78 (ENA-78), tumor necrosis factor
(TNF), interleukin-6,
and JE/monocyte chemoattractant protein1 (JE/MCP-1) increased over
the 6-day period, while macrophage inflammatory protein-1
(MIP-1
)
peaked at day 3 after thrombus induction. Additionally, rats were
passively immunized with neutralizing antibodies to TNF, ENA-78,
MIP-1
, JE/MCP-1, intercellular adhesion molecule1 (ICAM-1), and
CD18 compared with control antibodies. The most effective antibody
early after thrombus induction for attenuating vein wall neutrophil
extravasation was anti-TNF (P<.01). The monocyte/macrophage
extravasation was inhibited most by antiICAM-1 followed by anti-TNF
(P<.01). These findings demonstrate that venous thrombosis
is associated with significant vein wall inflammation that is partially
inhibited by neutralizing antibodies to cytokines and adhesion
molecules.
Key Words: venous thrombosis inflammation antibodies neutrophils monocytes/macrophages
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