Features of the influence of micronized purified flavonoid fraction on remodeling of the venous wall during hypodynamia in the experiment
https://doi.org/10.21518/akh2025-025
Abstract
Introduction. The issue of protecting venous wall remodeling in individuals with reduced physical activity remains relevant and requires study.
Aim. To study the effect of micronized purified flavonoid fraction (MPFF) on venous wall remodeling during hypodynamia in an experiment.
Materials and methods. The experiment was performed on 15 sexually mature mongrel male dogs. The 1st group (control) included 5 dogs, in which the normal anatomy of the medial saphenous vein was studied. In the remaining groups, a model of varicose veins of the lower extremities was created. To create conditions of hypodynamia, walking the dogs was excluded. 5 dogs of the 2nd group (hypodynamia) did not receive pharmacological support. 5 dogs of the 3rd group (hypodynamia + MPFF) received MPFF orally with food for 30 days once a day at a dose of 23.5 mg/kg of body weight, equivalent to the daily dose for a human weighing 70 kg. All animals underwent a staged duplex study followed by morphological study of the medial saphenous vein.
Results. In both experimental groups, clinical and morphological signs of varicose veins were established. The 2nd group was characterized by pronounced atrophic processes in the smooth muscle and connective tissue components with disruption of the histoarchitecture, a decrease in wall thickness (p < 0.005), with a significant expansion of the lumen (p < 0.005) and lymphohistiocytic infiltration of the outer shell. The 3rd group was also characterized by atrophic changes. However, ectasia of the vein lumen was not established in all sections (p < 0.005). First of all, this fact is associated with the preservation of the muscular layer of the vein, probably due to the absence of inflammatory changes in the form oflymphohistiocytic infiltration.
Conclusion. The use of MPFF preparations reduced venous wall hypotrophy during hypodynamia in a chronic experiment. This effect requires further study in clinical trials for possible extrapolation to the prevention of varicose disease in risk groups. Lymphohistiocytic infiltration of the outer wall of the vein also requires further study.
About the Authors
D. A. YevsyukovRussian Federation
Dmitriy A. Yevsyukov, Surgeon, Assistant of the Department of Surgical Diseases and Urology of Continuing Professional Education,
12, Lenin St., Omsk, 644043
Yu. T. Tsukanov
Russian Federation
Yurii T. Tsukanov, Dr. Sci. (Med.), Professor of the Department of Surgical Diseases and Urology of Continuing Professional Education,
12, Lenin St., Omsk, 644043
A. N. Kuzovkin
Russian Federation
Aleksandr N. Kuzovkin, Pathologist, Head of the Pathological Anatomy Department,
73, 5th Kordnaya St., Omsk, 644018
V. P. Dorofeeva
Russian Federation
Vera P. Dorofeeva, Cand. Sci. (Med.), Associate Professor of the Department of Diagnostics, Internal Non-Communicable Diseases, Pharmacology, Surgery and Obstetrics,
1, Institutskaya Square, Omsk, 644008
A. Yu. Tsukanov
Russian Federation
Anton Yu. Tsukanov, Dr. Sci. (Med.), Professor , Head of the Department of Surgical Diseases and Urology of Continuing Professional Education,
12, Lenin St., Omsk, 644043
M. Kh. Alikberov
Russian Federation
Murat K. Alikberov, Cand. Sci. (Med.), Assistant of the Department of Dentistry,
12, Lenin St., Omsk, 644043
I. O. Snitko
Russian Federation
Ilya O. Snitko, Cand. Sci. (Med.), Senior Lecturer of the Department of Diagnostics, Internal Non-Communicable Diseases, Pharmacology, Surgery and Obstetrics,
1, Institutskaya Square, Omsk, 644008
I. E. Vinnik
Russian Federation
Ilya E. Vinnik, Pathologist,
73, 5th Kordnaya St., Omsk, 644018
References
1. Bogachev VYu, Rosukhovski DA, Borsuk DA, Shonov OA, Manjikian HP, Lobastov KV et al. Russian clinical practice guidelines for the management of c1 clinical class of chronic venous disorders (reticular veins and telangiectasias). Ambulatornaya Khirurgiya. 2020;(3-4):140–206. (In Russ.) https://doi.org/10.21518/18/1995-1477-2020-3-4-140-206.
2. Joseph N, B A, Faizan Thouseef M, Devi M U, Abna A, Juneja I. A multicenter review of epidemiology and management of varicose veins for national guidance. Ann Med Surg. 2016;8:21–27. https://doi.org/10.1016/j.amsu.2016.04.024.
3. Chen CL, Guo HR. Varicose veins in hairdressers and associated risk factors: a cross-sectional study. BMC Public Health. 2014;28(14):885. https://doi.org/10.1186/1471-2458-14-885.
4. Tsukanov IuT, Tsukanov AIu, Vasilevich VV, Bazhenov VN, Pritykina TV, Mozgovo SI. Comparative study of vein’s morphology, tissue hormones and metabolite levels in the interstitial tissue of patients with varicose syndrome. Flebologiya. 2008;2(1):14–20. (In Russ.) Available at: https://elibrary.ru/ndydxd.
5. Евсюков ДА, Цуканов АЮ, Цуканов ЮТ, Дорофеева ВП, Кузовкин АН, Снитко ИО, Винник ИЕ. Влияние физической нагрузки на развитие варикоза в хроническом эксперименте у животных. В: Шайдаков ЕВ (ред.). 16-й Санкт Санкт-Петербургский Венозный форум. Актуальные вопросы флебологии: сборник тезисов. Санкт-Петербург, 29 ноября – 1 декабря 2023 г. СПб.; 2023. С. 23–24. Режим доступа: https://venousforumspb.org/wp-content/uploads/СПб-Венозный-Форум_сборник-тезисов-2023.pdf.
6. Bogachev VYu, Boldin BV, Turkin PYu. Perioperative use of micronized purified flavonoid fraction in endovascular treatment of varicose veins. Angiology and Vascular Surgery. 2019;25(2):88–95. (In Russ.) https://doi.org/10.33529/ANGIO2019214.
7. Tsoukanov YuT, Tsoukanov AYu, Nikolaychuk A. Great saphenous vein transitory reflux in patients with symptoms related to chronic venous disorders, but without visible signs (C0s), and its correction with MPFF treatment. Phlebolymphology. 2015;22(1):18–24. Available at: https://diosmin.vn/wp-content/uploads/2021/06/4.NC-Yu.-T.-Tsoukanov.pdf.
8. Ilyukhin EA, Kurginyan KhM, Kovalenko KE, Norvardyan AM, Abukhamdan AS, Gevorgyan AA, Kartoev IR. Impact of Micronized Purified Flavonoid Fraction on Venous Symptoms After Endovenous Laser Ablation: a Randomized Controlled Trial DEMO. Flebologiya. 2024;18(2):122–131. (In Russ.) https://doi.org/10.17116/flebo202418021122.
9. Buzlama AV, Verlina AA, Kuznetsov AYu, Aleksenko EA. Comparative evaluation of effect of phlebotropic agents on vascular wall permeability in preclinical studies. Ambulatornaya Khirurgiya. 2023;20(2):150–158. (In Russ.) https://doi.org/10.21518/akh2023-042.
10. Горбунова НА. Регламентация экспериментов на животных – этика, законодательства, альтернативы. М.; 1998. 18 с.
11. Цуканов АЮ, Цуканов ЮТ, Евсюков ДА, Новиков АА, Дорофеева ВП. Способ моделирования варикозной болезни вен нижних конечностей у собак. Патент RU 2823139 C1, 18.07.2024. Режим доступа: https://patents.google.com/patent/RU2823139C1/ru.
12. Shekunova EV, Kovaleva MA, Makarova MN, Makarov VG. Dose Selection in Preclinical Studies: Cross-Species Dose Conversion. The Bulletin of the Scientific Centre for Expert Evaluation of Medicinal Products. Regulatory Research and Medicine Evaluation. 2020;10(1):19–28. (In Russ.) https://doi.org/10.30895/1991-2919-2020-10-1-19-28.
13. Pozdnyakov DI, Shabanova NB, Gerashchenko AD, Sarkisyan KK. Comparative evaluation of the effectiveness of phlebotonic gels. Ambulatornaya Khirurgiya. 2022;19(2):119–126. (In Russ.) https://doi.org/10.21518/1995-1477-2022-19-2-119-126.
14. Bogachev V, Boldin B, Turkin P, Samenkov A, Dzhenina O. Micronized purified flavonoid fraction-based conservative treatment of chronic venous disease in a real-world setting. Future Cardiol. 2022;18(10):777–785. https://doi.org/10.2217/fca-2022-0026.
15. Khryshchanovich VY, Nebylitsin YS, Kosinets VA. Efficacy of Micronized Purified Flavonoid Fraction-Based Venoactive Therapy After Endovenous Mechanochemical Obliteration: Prospective Comparative Study. Drugs Real World Outcomes. 2021;8(3):349–358. https://doi.org/10.1007/s40801-021-00249-4.
16. Nicolaides AN. The Benefits of Micronized Purified Flavonoid Fraction (MPFF) Throughout the Progression of Chronic Venous Disease. Adv Ther. 2020;37(Suppl. 1):1–5. https://doi.org/10.1007/s12325-019-01218-8.
17. Cui HJ, Wu YF. The Effects of Different Dosages on Micronized Purified Flavonoid Fraction’s Treatment of Lower Limb Chronic Venous Disease: A Meta-Analysis. J Endovasc Ther. 2024;15266028241262700. https://doi.org/10.1177/15266028241262700.
18. Tsukanov YuT, Tsukanov AYu. Diagnosis and treatment of situational great saphenous vein reflux in daily medical practice. Plebolymphology. 2017;24(3):144–151. Available at: https://www.phlebolymphology.org/diagnosis-and-treatment-of-situational-greatsaphenous-vein-reflux-in-daily-medical-practice/.
19. Ulloa JH. Micronized Purified Flavonoid Fraction (MPFF) for Patients Suffering from Chronic Venous Disease: A Review of New Evidence. Adv Ther. 2019;36(Suppl. 1):20–25. https://doi.org/10.1007/s12325-019-0884-4.
20. das Graças C de Souza M, Cyrino FZ, de Carvalho JJ, Blanc-Guillemaud V, Bouskela E. Protective effects of micronized purified flavonoid fraction (MPFF) on a novel experimental model of chronic venous hypertension. Eur J Vasc Endovasc Surg. 2018;55(5):694–702. https://doi.org/10.1016/j.ejvs.2018.02.009.
21. Bergan J. Molecular mechanisms in chronic venous insufficiency. Ann Vasc Surg. 2007;21(3):260–266. https://doi.org/10.1016/j.avsg.2007.03.011.
22. Hahn TL, Unthank JL, Lalka SG. Increased hindlimb leukocyte concentration in a chronic rodent model of venoushypertension. J Surg Res. 1999;81(1):38–41. https://doi.org/10.1006/jsre.1998.5518.
23. Labropoulos N. How Does Chronic Venous Disease Progress from the First Symptoms to the Advanced Stages? A Review. Adv Ther. 2019;36(Suppl. 1):13–19. https://doi.org/10.1007/s12325-019-0885-3
24. Tsukanov YuT, Tsukanov AYu, Sheglov AYu, Mozgovoi SI. Morphological aspects of varicose lesions oflower half of the body. Vestnik of Saint Petersburg University. Medicine. 2006;(3):50–61 (In Russ.) Available at: https://elibrary.ru/rtsjal.
25. Sayer GL, Smith PD. Immunocytochemical characterisation of the inflammatory cell infiltrate of varicose veins. Eur J Vasc Endovasc Surg. 2004;28(5):479–483. https://doi.org/10.1016/j.ejvs.2004.07.023.
26. Сапелкин СВ. Некоторые вопросы патогенеза и клинической симптоматики при хронической венозной недостаточности. Ангиология Therapy After Endovenous Mechanochemical Obliteration: Prospective Comparative Study. Drugs Real World Outcomes. 2021;8(3):349–358. https://doi.org/10.1007/s40801-021-00249-4.
27. Nicolaides AN. The Benefits of Micronized Purified Flavonoid Fraction (MPFF) Throughout the Progression of Chronic Venous Disease. Adv Ther. 2020;37(Suppl. 1):1–5. https://doi.org/10.1007/s12325-019-01218-8.
28. Cui HJ, Wu YF. The Effects of Different Dosages on Micronized Purified Flavonoid Fraction’s Treatment of Lower Limb Chronic Venous Disease: A Meta-Analysis. J Endovasc Ther. 2024;15266028241262700. https://doi.org/10.1177/15266028241262700.
29. Tsukanov YuT, Tsukanov AYu. Diagnosis and treatment of situational great saphenous vein reflux in daily medical practice. Plebolymphology. 2017;24(3):144–151. Available at: https://www.phlebolymphology.org/diagnosis-and-treatment-of-situational-greatsaphenous-vein-reflux-in-daily-medical-practice/.
30. Ulloa JH. Micronized Purified Flavonoid Fraction (MPFF) for Patients Suffering from Chronic Venous Disease: A Review of New Evidence. Adv Ther. 2019;36(Suppl. 1):20–25. https://doi.org/10.1007/s12325-019-0884-4.
31. das Graças C de Souza M, Cyrino FZ, de Carvalho JJ, Blanc-Guillemaud V, Bouskela E. Protective effects of micronized purified flavonoid fraction (MPFF) on a novel experimental model of chronic venous hypertension. Eur J Vasc Endovasc Surg. 2018;55(5):694–702. https://doi.org/10.1016/j.ejvs.2018.02.009.
32. Bergan J. Molecular mechanisms in chronic venous insufficiency. Ann Vasc Surg. 2007;21(3):260–266. https://doi.org/10.1016/j.avsg.2007.03.011.
33. Hahn TL, Unthank JL, Lalka SG. Increased hindlimb leukocyte concentration in a chronic rodent model of venoushypertension. J Surg Res. 1999;81(1):38–41. https://doi.org/10.1006/jsre.1998.5518.
34. Labropoulos N. How Does Chronic Venous Disease Progress from the First Symptoms to the Advanced Stages? A Review. Adv Ther. 2019;36(Suppl. 1):13–19. https://doi.org/10.1007/s12325-019-0885-3
35. Tsukanov YuT, Tsukanov AYu, Sheglov AYu, Mozgovoi SI. Morphological aspects of varicose lesions oflower half of the body. Vestnik of Saint Petersburg University. Medicine. 2006;(3):50–61 (In Russ.) Available at: https://elibrary.ru/rtsjal.
36. Sayer GL, Smith PD. Immunocytochemical characterisation of the inflammatory cell infiltrate of varicose veins. Eur J Vasc Endovasc Surg. 2004;28(5):479–483. https://doi.org/10.1016/j.ejvs.2004.07.023.
37. Sapelkin SV. Selected issues of pathogenesis and clinical symptomatology of chronic venous insufficiency. Angiology and Vascular Surgery. 2005;11(3):130–135. (In Russ.) Available at: https://elibrary.ru/pfrnpj.
38. Думпе ЭП, Ухов ЮИ, Швальб ПГ. Физиология и патология венозного кровообращения нижних конечностей. М.: Медицина; 1982. 168 с.
39. Швальб ПГ, Ухов ЮИ. Патология венозного возврата из нижних конечностей. Рязань; 2009. 152 с.
Review
For citations:
Yevsyukov D.A., Tsukanov Yu.T., Kuzovkin A.N., Dorofeeva V.P., Tsukanov A.Yu., Alikberov M.Kh., Snitko I.O., Vinnik I.E. Features of the influence of micronized purified flavonoid fraction on remodeling of the venous wall during hypodynamia in the experiment. Ambulatornaya khirurgiya = Ambulatory Surgery (Russia). 2025;22(1):102-109. (In Russ.) https://doi.org/10.21518/akh2025-025

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International.