Plasma Lactoferrin as a Marker of White Cell Degranulation in Venous Disease

Abstract

Objective:

To measure plasma lactoferrin as a marker of neutrophil degranulation in groups of patients with varying severity of venous disease and compare with age- and sex-matched control subjects.

Design:

Prospective study of patients with varicose veins compared with a group of control subjects with no history or clinical findings of varicose veins.

Setting:

The Middlesex Hospital Vascular Laboratory, Mortimer Street, London WIN 8AA, UK.

Patients:

Patients referred to the Middlesex Hospital Vascular Laboratory for investigation of venous disease. Control subjects were obtained from within the laboratory and hospital staff, and from a group of Patients attending the London Foot Hospital for routine chiropody. Neither group had arterial disease nor any other illness or medication known to alter white cell activity.

Interventions:

10 ml of blood taken from an arm vein into EDTA for a neutrophil count and measurement of Plasma lactoferrin using an ELISA.

Results:

Significantly raised plasma lactoferrin was found in all four groups of patients compared with their controls (p = 0.0156 for uncomplicated varicose veins, P = 0.01 for lipodermatosclerosis, p = 0.0413 for active venous ulceration, and p = 0.0005 for healed ulcers, Mann-Whitney U-test). Differences between medians (95% confidence interval) for the four groups were 269 (62–603), 199 (60–314), 133 (44–218) and 215 (98–349) ng/ml respectively. There was no difference in the neutrophil count between the patient and control groups, and correcting plasma lactoferrin for the neutrophil count did not remove significance in any group.

Conclusions:

This study shows evidence of increased neutrophil activation as shown by increased degranulation in patients with venous disease.