INTRODUCTION: Venous
abnormalities have been associated with different neurological
conditions, and the presence of a vascular involvement inmultiple
sclerosis (MS) has long been anticipated. In view of the recent debate
regarding the existence of cerebral venous outflow impairment in MS due
to abnormalities of the azygos or internal jugular veins (IJVs), we have
studied the morphological and biological features of IJVs in MS
patients.
METHODS: We examined (a) IJVs specimens
from MS patients who underwent surgical reconstruction of the IJV and
specimens of the great saphenous vein used for surgical reconstruction,
(b) different vein specimens from an MS patient dead of an unrelated
cause, and (c) autoptical and surgical IJV specimens from patients
without MS. Collagen deposition was assessed by means of Sirius red
staining followed by polarized light examination. The expression of
collagen type I and III, cytoskeletal proteins (α-smooth muscle actin
and smooth muscle myosin heavy chains), and inflammatory markers (CD3
and CD68) was investigated.
RESULTS: The
extracranial veins of MS patients showed focal thickenings of the wall
characterized by a prevailing yellow-green birefringence (corresponding
to thin, loosely packed collagen fibres) correlated to a higher
expression of type III collagen. No differences in cytoskeletal protein
and inflammatory marker expression were observed.
DISCUSSION: The
IJVs of MS patients presenting a focal thickening of the vein wall are
characterized by the prevalence of loosely packed type III collagen
fibers in the adventitia.
This
is another example of studies driven by the advent of CCSVI and
suggests some thickening of the vein wall, but there were no mention of
any valve problems. I am sure if one was look at the arteries they
would be narrowed by atherosclerosis also.
Does it inform us more about CSVI and its treatment? I am not so sure.
This is the closest post to CCSVI so far this month and again there is nothing in the CCSVI monthly slot, so that could be two months in a row.