Varicose Veins: Protocols & Research

Abstract:
The herb Lythrum salicaria L. (Lythraceae) is used in traditional medicine to treat diseases with an inflammatory background, such as haemorrhoidal disease, dysentery, chronic intestinal catarrh, eczema, varicose veins, periodontosis and gingivitis. Because these diseases are closely associated with an excessive inflammatory response of stimulated neutrophils, the influence of aqueous extract and isolated C-glucosidic ellagitannins (dimeric salicarinins A, B and C, vescalagin, castalagin) on their pro-inflammatory functions was examined. Lythrum salicaria aqueous extract was shown to modulate lipopolysaccharide (LPS)-triggered production of IL-8 (at 20 μg/mL, 16.6 ± 4.2 % inhibition) but had no influence on MMP-9 production. It was active towards cytochalasin A/f-MLP- stimulated elastase release (at 20 μg/mL, 21.5 ± 3.9 % inhibition), myeloperoxidase release (at 1 μg/mL, 26.5 ± 5.4 % inhibition) and f-MLP- and PMA-induced reactive oxygen species production (at 20 μg/mL, 67.0 ± 3.9 and 66.5 ± 1.9 % inhibition, respectively). The extract was also shown to inhibit expression of integrin CD11b on the neutrophil surface without influencing selectin CD62L shedding. Dose-dependent inhibition of hyaluronidase activity was observed with IC50 = 10.1 ± 1.2 μg/mL. The main C-glucosidic ellagitannins were shown to be responsible for all these activities with more significant participation attributable to dimeric salicarinins A, B, C. This study has demonstrated potent activity of aqueous extract on stimulated neutrophils; this enhanced response is known to cause pathological changes in skin and mucosa tissues. These observations support and explain the traditional use of the herb Lythrum salicaria to treat certain diseases with an inflammatory background. C-glucosidic ellagitannins, especially dimeric salicarinins, are the factors responsible for these effects.

Department of Pharmacognosy and Molecular Basis of Phytotherapy, Faculty of Pharmacy, Medical University of Warsaw, ul. Banacha 1, 02-097 Warsaw, Poland

Dermatol Ther. 2003;16(2):106-13. Review

Abstract:
Plant-based therapeutic preparations are cyclically returning to complement dermatologic therapy. They serve as therapeutic alternatives, safer choices, or in some cases, as the only effective treatment. Folk medicine tradition provides different indicators for use than the medical disease model. Advantages of multiple synergistic components of crude extracts are discussed, as well as herbs already used in dermatology. Bitter digestive stimulants are used for vitiligo. Bioflavinoids from buckwheat and horse chestnut are used for varicose veins, and silymarin is used for liver protection. Gotu kola and sarsaparilla are used for inflammatory skin conditions. Oregon grape root has synergistic antibacterial, anti-inflammatory, and bile-stimulating properties which make the crude extract useful in acne. Philosophical differences in herbology compared to medicine exist in the application of science toward improving elimination and strengthening the host as opposed to destroying the vector or manifestation of the disease.

Phytother Res. 2010 Feb;24(2):277-82. doi: 10.1002/ptr.2931. Comparative Study; Randomized Controlled Trial

Abstract:
Venous leg ulcers represent a significant public health problem that will increase as the population ages. Numerous herbs and their extracts are potentially conducive to wound healing, including the ability to serve as an antimicrobial, antifungal, astringent, etc. A total of 32 patients with venous leg ulcers were randomized into two groups: a group with herbal therapy treatment (PT) (17 patients) and a control group (C) (15 patients). The investigation focused on five controls of parameter changes important for ulcer healing and the control of microbiological flora. Within-treatment analysis of the PT group showed that, following herbal therapy treatment, there was a significant decrease in the scores of surface leg ulcer and venous leg ulcer after week 7 of treatment (p < 0.05). In group C following topical antibiotic treatment there was no significant decrease in the surface leg ulcer. Comparing the results of decreased venous leg ulcer surface of the) PT group with the C group showed a significant difference at p < 0.05 after week 7 of treatment. The number of different types of isolated bacterial species decreased significantly (p < 0.05) after the use of herbal preparations. The results of this pilot study demonstrate the healing and antimicrobiological effects of herbal therapy on non-infected venous leg ulcer.

J Ethnopharmacol. 2010 Aug 19;131(1):63-9. doi: 10.1016/j.jep.2010.06.001. Epub 2010 Jun 8. Comparative Study; Research Support, Non-U.S. Gov't

Abstract
AIM OF THE STUDY:
Lythrum salicaria L. belongs to the small Lythraceae family of 22 genera, which range in habit from herbs to shrubs and trees found with worldwide distribution (Heywood, 1993). The generic name of Lythrum derived from Greek "luthron"--blood, possibly referring to the color of the flowers or to the one of its herbal use as an astringent to stop bleeding (Thompson et al., 1987; Mountain, 1994; Pawlaczyk and Pacula, 2002). The flowering parts and the flowering branch tips are used in traditional medicine and pharmaceuticals internally in a form of decoctions or as extracts for treatment of diarrhea, chronic intestinal catarrhs, hemorrhoids and eczema, or externally to treat varicose veins, venous insufficiency and gums (Mantle et al., 2000; Rauha et al., 2000). The aim of this study was to isolate the plant glycoconjugate from flowering parts of Lythrum salicaria, and to verify its influence on blood coagulation process.
MATERIALS AND METHODS:
From the air-dried flowering parts of this plant a water-soluble glycoconjugate has been isolated by hot alkaline extraction followed by neutralization and purification by multi-steps extraction with organic solvents, dialysis and concentration. The plant isolate was tested in vitro on anticoagulant activity on human plasma, and on Wistar rats blood system in vivo as well as ex vivo.
RESULTS:
A dark brown isolate was obtained in the yield of 8% of starting material (w/w) as a macromolecular compound with M(w) approximately 12,500. Chemical analysis revealed the presence of carbohydrates (30%), phenolics (1g contained 1.2mM of gallic acid equivalent) and proteins (0.8%). The result of compositional analyses of carbohydrate part revealed the predominance of uronic acids (approximately 66%), galactose (approximately 12%), rhamnose (approximately 10%) and arabinose (approximately 9%) residues indicating thus the presence of pectic type of polymers, i.e. galacturonan and/or rhamnogalacturonan associated with arabinogalactan in Lythrum glycoconjugate. In vitro and ex vivo experiments showed complete inhibition of plasma clot formation, however, the application of Lythrum glycoconjugate in vivo showed controversial effect on animal blood system in comparison with in vitro ones, i.e. pro-coagulant activity.
CONCLUSION:
The in vivo results give a scientific explanation for the traditional use of Lythrum salicaria as a styptic agent. It seems that pro-coagulant activity of this complex could be probably connected with the other factors in blood circulation system, like platelets.

J Am Coll Nutr. 2017 May-Jun;36(4):268-272. doi: 10.1080/07315724.2016.1269622. Epub 2017 Apr 26.

Abstract:
J Am Coll Nutr. 2017 May-Jun;36(4):268-272. doi: 10.1080/07315724.2016.1269622. Epub 2017 Apr 26.
Modulatory Effects of a Nutraceutical Supplement on Saos-2 Cells Reveal Its Phlebotonic Activity.
Ammendola S1, Loreto MD2, d'Abusco AS3.
Author information
Abstract
OBJECTIVE:
Herbal extract compositions are largely used to manage vein diseases. We prepared a new composition of herbs, named FLEBO OK™, that, when administered as a nutraceutical to patients affected by peripheral vascular diseases, was able to improve their health conditions. We analyzed the effects of this nutraceutical composition on in vitro cultured cells with the aim to obtain information about its mechanisms of action.
METHODS:
A culture of human osteoblast cell line Saos-2 was stimulated with tumor necrosis factor (TNF)-α or interleukin (IL)-1β to induce the expression of some chemokines and matrix metalloproteases (MMPs). This cell culture was then exposed to the prepared composition and the amount of expression of the genes coding for the monocyte chemotactic protein (MCP)-1, IL-8, IL-1β, MMP-2, MMP-3, MMP-9 proteins was measured by real-time polymerase chain reaction (RT-PCR). The experiments were repeated exposing the cells to the same amount of the well-known micronized purified flavonoid fraction. Moreover, we describe the effects of the administration of nutraceutical composition to 20 patients affected by peripheral vascular diseases and 20 healthy individuals.
RESULTS:
The RT-PCR analyses showed that the new composition induces the expression of MMP-3 and MMP-9 and downregulates MMP-2 in cell cultures stimulated with IL-1β, whereas it induces the expression of IL-8 and represses the expression of IL-1β and MCP-1 in cell cultures stimulated with TNF-α. The induction of the expression of MMP-3 and the downregulation of MCP-1 might result in an antiplatelet activity that was not observed for the micronized purified flavonoid fraction. Interviewed patients reported an improvement in their conditions after 1 month of FLEBO OK treatment.
CONCLUSION:
These findings could provide a hypothesis for the high efficiency of the identified nutraceutical composition to management of peripheral vascular diseases.
KEYWORDS:
Phlebotonic; metalloproteases; nutraceuticals; osteoblasts; proinflammatory chemokine

Med Cutan Ibero Lat Am. 1990;18(1):63-6. English Abstract

Abstract:
Abstract
Oil rose of mosqueta (Rosa aff. Rubiginosa L.) is a concentrated solution in linoleic (41%) and linolenic acid (39%), that offers benefit therapeutic effects in the wound healing. Ten patients affected of leg ulcers and post-surgical wounds were treated by 26% oil concentrated rose of mosqueta with very notable improvement on its healing compared with the control group. Due to the lack of side effects, we believe rose of mosqueta oil is very usefull to these conditions. Mechanism of actions and others indications are discussed.

Wound Repair Regen. 2010 Mar-Apr;18(2):168-79. Research Support, Non-U.S. Gov't

Abstract
A new flax dressing product was developed based on three components (fibers, oil emulsion, and seedcake extract) from genetically engineered flax plants that were obtained by plant transformation using three genes controlling the synthesis of antioxidative compounds from the phenylpropanoid pathway. Simultaneous flax explant transformation with three genes coding for chalcone synthase, chalcone isomerase, and dihydroflavonol reductase resulted in an accumulation of phenolic acids in the fibers, polyunsaturated fatty acids in the oil, and lignans in the seedcake. The fibers, oil, and seedcake from transgenic flax contained a broad spectrum of antioxidative compounds. They were tested for cytotoxicity, and none were found to have a negative effect on the growth and morphology of Balb/3T3 cells. In this preliminary report, we present pilot data on the effects of using linen dressing treatment on its own or in combination with oil emulsion and/or seedcake extract on chronic wound healing. After a 12-week study, we concluded that an application of a modified flax-dressing (linen) bandage might yield a more rapid rate of healing and reduce the wound exudes and wound size. In several cases, wound healing was completed during the period of investigation. Interestingly and importantly, the patients reported that the new bandage made from modified flax diminished the pain accompanying chronic venous ulceration. Further study is required to determine any definitive effects of flax bandage on wound healing. This is the first pilot study report suggesting the benefits of a flax-based dressing on wound healing.

Varicose veins are caused by poorly functioning valves in the veins, and decreased elasticity of the vein wall, allowing pooling of blood within the veins, and their subsequent enlargement. Varicose veins affect up to 40% of adults, and are more common in obese people, and in women who have had more than two pregnancies.

Abstract
Hemorrhoids and varicose veins are common conditions seen by general practitioners. Both conditions have several treatment modalities for the physician to choose from. Varicose veins are treated with mechanical compression stockings. There are several over-the-counter topical agents available for hemorrhoids. Conservative therapies for both conditions include diet, lifestyle changes, and hydrotherapy which require a high degree of patient compliance to be effective. When conservative hemorrhoid therapy is ineffective, many physicians may choose other non-surgical modalities: injection sclerotherapy, cryotherapy, manual dilation of the anus, infrared photocoagulation, bipolar diathermy, direct current electrocoagulation, or rubber band ligation. Injection sclerotherapy is the non-surgical treatment for primary varicose veins. Non-surgical modalities require physicians to be specially trained, own specialized equipment, and assume associated risks. If a non-surgical approach fails, the patient is often referred to a surgeon. The costly and uncomfortable nature of treatment options often lead a patient to postpone evaluation until aggressive intervention is necessary. Oral dietary supplementation is an attractive addition to the traditional treatment of hemorrhoids and varicose veins. The loss of vascular integrity is associated with the pathogenesis of both hemorrhoids and varicose veins. Several botanical extracts have been shown to improve microcirculation, capillary flow, and vascular tone, and to strengthen the connective tissue of the perivascular amorphous substrate. Oral supplementation with Aesculus hippocastanum, Ruscus aculeatus, Centella asiatica, Hamamelis virginiana, and bioflavonoids may prevent time-consuming, painful, and expensive complications of varicose veins and hemorrhoids.