Lower Limb Neutrophil Oxygen Radical Production is Increased in Venous Hypertension

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Abstract
Objective: To investigate neutrophil free radical production in patients with venous hypertension. Patients: Thirteen legs in patients with venous ulceration were compared with seven legs in patients suffering from lipodermatosclerosis (LDS) only and nine normal controls. Design: Leg and arm venous blood samples were obtained from each patient after a period of 30 min of leg dependency followed by elevation to the horizontal for a further 5 min. Neutrophils were isolated and free radical production assessed by luminol-dependen t chemiluminescence following stimulation with the chemotactic peptide FMLP. Results: The ratio of leg to arm luminescence was significantly higher in patients with venous ulceration (median 1.61; 95% confidence interval (CI) 1.20–3.05; p=0.0002) and those with LDS (median 1.36; 95% CI 1.05–2.01; p=0.0036) when compared with the controls (median 0.97; 95% CI 0.70–1.12). Conclusions: Neutrophil free radical production is increased in the legs of patients with venous hypertension and may be implicated in the underlying pathogenesis of this disease.