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Tilson MD. Autoimmunity in the Abdominal Aortic Aneurysm and its Association with Smoking. AORTA : OFFICIAL JOURNAL OF THE AORTIC INSTITUTE AT YALE-NEW HAVEN HOSPITAL 2018; 5:159-167. [PMID: 29766007 DOI: 10.12945/j.aorta.2017.17.693] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 12/05/2017] [Indexed: 11/18/2022]
Abstract
Smoking increases the risk of abdominal aortic aneurysm (AAA) in both humans and mice, although the underlying mechanisms are not completely understood. An adventitial aortic antigen, AAAP-40, has been partially sequenced. It has motifs with similarities to all three fibrinogen chains and appears to be connected in evolution to a large family of proteins called fibrinogen-related proteins. Fibrinogen may undergo non-enzymatic nitration, which may result from exposure to nitric oxide in cigarette smoke. Nitration of proteins renders them more immunogenic. It has recently been reported that anti-fibrinogen antibody promotes AAA development in mice. Also, anti-fibrinogen antibodies are present in patients with AAA. These matters are reviewed in the overall context of autoimmunity in AAA. The evidence suggests that smoking amplifies an auto-immune reaction that is critical to the pathogenesis of AAA.
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Affiliation(s)
- M David Tilson
- Department of Surgery, College of Physicians and Surgeons, Columbia University, New York, New York, USA
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McDowell MM, Zhao Y, Kellner CP, Barton SM, Sussman E, Claassen J, Ducruet AF, Connolly ES. Demographic and clinical predictors of multiple intracranial aneurysms in patients with subarachnoid hemorrhage. J Neurosurg 2018; 128:961-968. [DOI: 10.3171/2017.1.jns162785] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVEPathophysiological differences that underlie the development and subsequent growth of multiple aneurysms may exist. In this study, the authors assessed the factors associated with the occurrence of multiple aneurysms in patients presenting with aneurysmal subarachnoid hemorrhage (SAH).METHODSConsecutive patients presenting with aneurysmal SAH between 1996 and 2012 were prospectively enrolled in the Subarachnoid Hemorrhage Outcome Project. Patients harboring 1, 2, or 3 or more aneurysms were stratified into groups, and the clinical and radiological characteristics of each group were compared using multivariate logistic regression.RESULTSOf 1277 patients with ruptured intracranial aneurysms, 890 had 1 aneurysm, 267 had 2 aneurysms, and 120 had 3 or more aneurysms. On multinomial regression using the single-aneurysm cohort as base case, risk factors for patients presenting with 2 aneurysms were female sex (relative risk ratio [RRR] 1.80, p < 0.001), higher body mass index (BMI) (RRR 1.02, p = 0.003), more years of smoking (RRR = 1.01, p = 0.004), and black race (RRR 1.83, p = 0.001). The risk factors for patients presenting with 3 or more aneurysms were female sex (RRR 3.10, p < 0.001), higher BMI (RRR 1.03, p < 0.001), aneurysm in the posterior circulation (RRR 2.59, p < 0.001), and black race (RRR 2.15, p = 0.001). Female sex, longer smoking history, aneurysms in the posterior circulation, BMI, and black race were independently associated with the development of multiple aneurysms in our adjusted multivariate multinomial model.CONCLUSIONSSignificant demographic and clinical differences are found between patients presenting with single and multiple aneurysms in the setting of aneurysmal SAH. These predictors of multiple aneurysms likely reflect a predisposition toward inflammation and endothelial injury.
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Affiliation(s)
| | - Yin Zhao
- 1Department of Neurological Surgery, University of Pittsburgh, Pennsylvania
| | | | | | - Eric Sussman
- 3Department of Neurological Surgery, Stanford University, Stanford, California
| | - Jan Claassen
- 4Division of Neurocritical Care, Columbia University, New York, New York; and
| | - Andrew F. Ducruet
- 1Department of Neurological Surgery, University of Pittsburgh, Pennsylvania
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The Society for Vascular Surgery practice guidelines on the care of patients with an abdominal aortic aneurysm. J Vasc Surg 2018; 67:2-77.e2. [DOI: 10.1016/j.jvs.2017.10.044] [Citation(s) in RCA: 1150] [Impact Index Per Article: 191.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Villard C, Hultgren R. Abdominal aortic aneurysm: Sex differences. Maturitas 2017; 109:63-69. [PMID: 29452784 DOI: 10.1016/j.maturitas.2017.12.012] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 12/11/2017] [Accepted: 12/12/2017] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Abdominal aortic aneurysm (AAA) predominantly affects an elderly male population. Even so, AAA appears more detrimental in women, who experience a higher risk of aneurysm rupture and a worse outcome after surgery than men. Why women are privileged from yet are worse off once affected has been attributed to an effect of sex hormones. This review summarizes the knowledge of sex differences in AAA and addresses the changes in the aneurysm wall from a gender perspective. METHOD Standard reporting guidelines set by the PRISMA Group were followed to identify studies examining AAA from a gender perspective. Relevant reports were identified using two electronic databases: PubMed and Web of Science. The systematic search was performed in two stages: firstly, using the terms AAA and gender/sex/women; and secondly, adding the terms "elastin", "collagen" and "vascular smooth muscle cells", in order to filter the search for studies relevant to our focus on the aneurysm wall. CONCLUSION Current studies support the theory that sex has an effect on aneurysm formation, yet are inconclusive about whether or not aneurysm formation is dependent on female/male sex hormones or a lack thereof. The studies in women are scarce and out of those most reports primarily address other end-points, which limit their ability to illuminate an effect of sex on aneurysm formation. The complexity of the human menstrual cycle and menopausal transition are difficult to mimic in animal models, which limit their applicability to AAA formation in humans.
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Affiliation(s)
- Christina Villard
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
| | - Rebecka Hultgren
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden; Department of Vascular Surgery, Karolinska University Hospital, Stockholm, Sweden
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Perivascular Adipose Tissue Angiotensin II Type 1 Receptor Promotes Vascular Inflammation and Aneurysm Formation. Hypertension 2017; 70:780-789. [DOI: 10.1161/hypertensionaha.117.09512] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 04/20/2017] [Accepted: 07/10/2017] [Indexed: 01/01/2023]
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Yu AR, Hasjim B, Yu LE, Gabriel C, Anshus A, Lee JB, Louthan MJ, Kim EC, Lee K, Tse C, Keown T, Lahham S, Alvarado M, Bunch S, Gari A, Fox JC. Comparison of ultrasound-measured properties of the common carotid artery to tobacco smoke exposure in a cohort of Indonesian patients. World J Emerg Med 2017; 8:177-183. [PMID: 28680513 DOI: 10.5847/wjem.j.1920-8642.2017.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND The purpose of this study was to use point-of-care ultrasound (POCUS) to investigate the relationship between tobacco smoke exposure and the characteristics of the common carotid artery (CCA). The effect of both primary and secondary smoking on CCA properties was evaluated. METHODS We performed a prospective cross-sectional study across 20 primary care clinics in Bandung, West Java, Indonesia in July 2016. Point of care ultrasound was performed on a convenience sample of Indonesian patients presenting to clinic. The CCA wall stiffness and carotid intima-media thickness (CIMT) were measured during diastole and systole. These measurements were correlated with smoke exposure and cardiovascular disease. RESULTS We enrolled 663 patients in the study, with 426 patients enrolled in the smoking category and 237 patients enrolled in the second-hand smoke category. There was an overall positive correlation with the measured lifestyle factors and the ultrasound-measured variables in the group of individuals who smoked. For all variables, age seemed to contribute the most out of all of the lifestyle factors for the positive changes in CIMT and CCA wall stiffness. CONCLUSION Our data yielded correlations between CCA properties and cardiovascular risk, as well as between CIMT and arterial stiffness. We were also able to demonstrate an increase in thickness of the CIMT in patients who have been exposed by tobacco through the use of ultrasound. Further large scale studies comparing patients with multiple cardiac risk factors need to be performed to confirm the utility of ultrasound findings of cardiovascular disease and stroke.
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Affiliation(s)
- Allen R Yu
- School of Medicine, University of California, Irvine, USA
| | - Bima Hasjim
- School of Medicine, University of California, Irvine, USA
| | - Luke E Yu
- School of Medicine, University of California, Irvine, USA
| | | | | | - Jonathan B Lee
- School of Medicine, University of California, Irvine, USA
| | | | - Esther C Kim
- School of Medicine, University of California, Irvine, USA
| | - Katrina Lee
- School of Medicine, University of California, Irvine, USA
| | - Christina Tse
- School of Medicine, University of California, Irvine, USA
| | - Thomas Keown
- School of Medicine, University of California, Irvine, USA
| | - Shadi Lahham
- Department of Emergency Medicine, University of California, Irvine, USA
| | - Maili Alvarado
- Department of Emergency Medicine, University of California, Irvine, USA
| | - Steven Bunch
- Department of Emergency Medicine, University of California, Irvine, USA
| | - Abdulatif Gari
- Department of Emergency Medicine, University of California, Irvine, USA
| | - J Christian Fox
- School of Medicine, University of California, Irvine, USA.,Department of Emergency Medicine, University of California, Irvine, USA
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Fagerberg B, Borné Y, Sallsten G, Smith JG, Acosta S, Persson M, Melander O, Forsgard N, Gottsäter A, Hedblad B, Barregard L, Engström G. Circulating cadmium concentration and risk of aortic aneurysms: A nested case-control study within the Malmö Diet and Cancer cohort. Atherosclerosis 2017; 261:37-43. [DOI: 10.1016/j.atherosclerosis.2017.04.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 03/13/2017] [Accepted: 04/07/2017] [Indexed: 12/31/2022]
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Risk Factor Modification Behaviors of Practicing Vascular Surgeons. Ann Vasc Surg 2017; 46:90-96. [PMID: 28572029 DOI: 10.1016/j.avsg.2017.05.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 05/04/2017] [Accepted: 05/11/2017] [Indexed: 11/24/2022]
Abstract
BACKGROUND National smoking rates have declined; however, it remains the primary modifiable risk factor for nearly all vascular disease. While vascular surgeons have the availability to treat patients via medical or surgical/endovascular means, involvement in risk factor modification may be lacking. This study seeks to understand vascular surgeons' involvement in tobacco cessation and risk factor modification and to determine if practice variables had any effect on provision of these services to vascular surgery patients. METHODS Anonymous electronic surveys examining tobacco cessation and risk factor modification were sent to the Vascular & Endovascular Surgery Society members (n = 633). Influence of time from training, practice type (dichotomized into academic and nonacademic vascular surgeons), hospital size, region, and workload was assessed, and data were analyzed by univariate contingency tables. RESULTS A total of 149 (24%) surveys were completed. While the majority of respondents ask patient's smoking status (97%), assess willingness to quit (84%), and advise patients to quit (95%), only 34% prescribe medications to assist in cessation, 7% see patients in tobacco cessation follow-up, and 3% verify cessation with cotinine levels or carbon monoxide monitoring. Surgeons who prescribed medications for cessation are more likely to assess patient's willingness to quit, prescribe/advise nicotine replacement, or prescribe initial statin or other lipid-lowering medications. There was no difference in perceived education received during training in risk factor modification, but only 26% of respondents thought they were well trained. Comparing academic to private practice vascular surgeons, there was no difference in cessation techniques used; however, academic surgeons were less likely to perform endovascular procedures for claudication in patients who continued to smoke (29% vs. 46%, P = 0.03) and more likely to prescribe an initial antihyperlipid medication (65% vs. 39%, P = 0.0018). CONCLUSIONS Tobacco dependence remains a critical issue for vascular surgery patients; however, there is wide variation in cessation techniques used. The majority of vascular surgeons are not well versed in cessation techniques and risk factor modification, and thus, efforts should be made to provide this education in vascular surgery training programs.
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Tsialtas D, Bolognesi MG, Volpi R, Bolognesi R. Atherosclerotic vascular diseases have really the same risk factors? Comparison between large abdominal aortic aneurysm and obstructive non-coronary arterial disease. Vascular 2017; 25:629-634. [PMID: 28509621 DOI: 10.1177/1708538117708474] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives The purpose of this study was to investigate whether there are differences among clinical conditions and traditional atherosclerotic risk factors between patients with large abdominal aortic aneurysm and those with occlusive non-coronary arterial disease. Methods We clinically examined 519 patients with asymptomatic abdominal aortic aneurysm and 672 with severe obstructive arterial diseases before surgical repair. Results In patients with abdominal aortic aneurysm, we identified a clear predominance of males ( p < 0.001), more alcohol consumers ( p < 0.05), higher values of diastolic blood pressure ( p < 0.05), higher values of serum creatinine ( p < 0.005), more hyperuricemic patients ( p < 0.005) and less diabetics ( p < 0.001). In patients with occlusive atherosclerotic vasculopathies, we observed more smokers ( p < 0.05), higher systolic blood pressure and more hypertensives ( p < 0.05 respectively) and a prevalence of hypertriglyceridemia ( p < 0.05). Conclusions Patients with abdominal aortic aneurysm were mostly males with diastolic hypertension, impaired renal function and less diabetics, while patients with occlusive arteriopathy were more smokers, hypertensives and more hypertriglyceridemics.
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Affiliation(s)
- Dimitri Tsialtas
- Dipartimento di Medicina Interna e, Scienze Biomediche, Sezione di Cardiologia, Università degli Studi di Parma, Parma, Italy
| | - Maria Giulia Bolognesi
- Dipartimento di Medicina Interna e, Scienze Biomediche, Sezione di Cardiologia, Università degli Studi di Parma, Parma, Italy
| | - Riccardo Volpi
- Dipartimento di Medicina Interna e, Scienze Biomediche, Sezione di Cardiologia, Università degli Studi di Parma, Parma, Italy
| | - Roberto Bolognesi
- Dipartimento di Medicina Interna e, Scienze Biomediche, Sezione di Cardiologia, Università degli Studi di Parma, Parma, Italy
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Tobacco use is not associated with groin hernia repair, a population-based study. Hernia 2017; 21:517-523. [PMID: 28497407 PMCID: PMC5517591 DOI: 10.1007/s10029-017-1617-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2016] [Accepted: 04/14/2017] [Indexed: 12/16/2022]
Abstract
Purpose The pathogenesis of groin hernia is not fully understood and some suggested risk factors are debatable. This population-based study evaluates the association between groin hernia repair and tobacco use. Method An observational study based on register linkage between the Swedish Hernia Register and the Västerbotten Intervention Program (VIP). All primary groin hernia repairs performed from 2001 to 2013 in the county of Västerbotten, Sweden, were included. Results VIP provided data on the use of tobacco in 102,857 individuals. Neither smoking nor the use of snus, increased the risk for requiring a groin hernia repair. On the contrary, heavy smoking decreased the risk for men, HR 0.75 (95% CI 0.58–0.96), as did having a BMI over 30 kg/m2 HR (men) 0.33 (95% CI 0.27–0.40). Conclusion Tobacco use is not a risk factor for requiring a groin hernia repair, whereas having a low BMI significantly increases the risk.
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Abstract
Abdominal aortic aneurysm (AAA) is a life-threatening disease associated with high morbidity, and high mortality in the event of aortic rupture. Major advances in open surgical and endovascular repair of AAA have been achieved during the past 2 decades. However, drug-based therapies are still lacking, highlighting a real need for better understanding of the molecular and cellular mechanisms involved in AAA formation and progression. The main pathological features of AAA include extracellular matrix remodelling associated with degeneration and loss of vascular smooth muscle cells and accumulation and activation of inflammatory cells. The inflammatory process has a crucial role in AAA and substantially influences many determinants of aortic wall remodelling. In this Review, we focus specifically on the involvement of monocytes and macrophages, summarizing current knowledge on the roles, origin, and functions of these cells in AAA development and its complications. Furthermore, we show and propose that distinct monocyte and macrophage subsets have critical and differential roles in initiation, progression, and healing of the aneurysmal process. On the basis of experimental and clinical studies, we review potential translational applications to detect, assess, and image macrophage subsets in AAA, and discuss the relevance of these applications for clinical practice.
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Rabkin SW. The Role Matrix Metalloproteinases in the Production of Aortic Aneurysm. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2017; 147:239-265. [PMID: 28413030 DOI: 10.1016/bs.pmbts.2017.02.002] [Citation(s) in RCA: 124] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Matrix metalloproteinases (MMPs) have been implicated in the pathogenesis of aortic aneurysm because the histology of thoracic aortic aneurysm (TAA) and abdominal aortic aneurysm (AAA) is characterized by the loss of smooth muscle cells in the aortic media and the destruction of extracellular matrix (ECM). Furthermore, AAA have evidence of inflammation and the cellular elements involved in inflammation such as macrophages can produce and/or activate MMPs This chapter focuses on human aortic aneurysm that are not due to specific known genetic causes because this type of aneurysm is the more common type. This chapter will also focus on MMP protein expression rather than on genetic data which may not necessarily translate to increased MMP protein expression. There are supporting data that certain MMPs are increased in the aortic wall. For TAA, it is most notably MMP-1, -9, -12, and -14 and MMP-2 when a bicuspid aortic valve is present. For AAA, it is MMP-1, -2, -3, -9, -12, and -13. The data are weaker or insufficient for the other MMPs. Several studies of gene polymorphisms support MMP-9 for TAA and MMP-3 for AAA as potentially important factors. The signaling pathways in the aorta that can lead to MMP activation include JNK, JAK/stat, osteopontin, and AMP-activated protein kinase alpha2. Substrates in the human vasculature for MMP-3, MMP-9, or MMP-14 include collagen, elastin, ECM glycoprotein, and proteoglycans. Confirmed and potential substrates for MMPs, maintain aortic size and function so that a reduction in their content relative to other components of the aortic wall may produce a failure to maintain aortic size leading to dilatation and aneurysm formation.
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Shen YH, LeMaire SA. Molecular pathogenesis of genetic and sporadic aortic aneurysms and dissections. Curr Probl Surg 2017; 54:95-155. [PMID: 28521856 DOI: 10.1067/j.cpsurg.2017.01.001] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 01/16/2017] [Indexed: 12/20/2022]
Affiliation(s)
- Ying H Shen
- Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX; Department of Cardiovascular Surgery, Texas Heart Institute, Houston, TX; Cardiovascular Research Institute, Baylor College of Medicine, Houston, TX.
| | - Scott A LeMaire
- Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX; Department of Cardiovascular Surgery, Texas Heart Institute, Houston, TX; Cardiovascular Research Institute, Baylor College of Medicine, Houston, TX; Department of Molecular Physiology and Biophysics, Baylor College of Medicine, Houston, TX.
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Crkvenac Gregorek A, Gornik KC, Polancec DS, Dabelic S. Association of 1166A>C AT1R, -1562C>T MMP-9, ACE I/D, and CCR5Δ32 Polymorphisms with Abdominal Aortic Aneurysm in Croatian Patients. Genet Test Mol Biomarkers 2016; 20:616-623. [DOI: 10.1089/gtmb.2016.0158] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Affiliation(s)
- Andrea Crkvenac Gregorek
- Division of Vascular Surgery, Clinical Department of Surgery, University Hospital Center Zagreb, Zagreb, Croatia
| | - Kristina Crkvenac Gornik
- Division of Cytogenetics, Clinical Department for Laboratory Diagnostics, University Hospital Center Zagreb, Zagreb, Croatia
| | | | - Sanja Dabelic
- Department of Biochemistry and Molecular Biology, Faculty of Pharmacy and Biochemistry, University of Zagreb, Zagreb, Croatia
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Gordon P, Flanagan P. Smoking: A risk factor for vascular disease. JOURNAL OF VASCULAR NURSING 2016; 34:79-86. [DOI: 10.1016/j.jvn.2016.04.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 04/04/2016] [Accepted: 04/04/2016] [Indexed: 01/05/2023]
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Busch A, Holm A, Wagner N, Ergün S, Rosenfeld M, Otto C, Baur J, Kellersmann R, Lorenz U. Extra- and Intraluminal Elastase Induce Morphologically Distinct Abdominal Aortic Aneurysms in Mice and Thus Represent Specific Subtypes of Human Disease. J Vasc Res 2016; 53:49-57. [DOI: 10.1159/000447263] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 05/28/2016] [Indexed: 11/19/2022] Open
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Folkesson M, Sadowska N, Vikingsson S, Karlsson M, Carlhäll CJ, Länne T, Wågsäter D, Jensen L. Differences in cardiovascular toxicities associated with cigarette smoking and snuff use revealed using novel zebrafish models. Biol Open 2016; 5:970-8. [PMID: 27334697 PMCID: PMC4958274 DOI: 10.1242/bio.018812] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Tobacco use is strongly associated with cardiovascular disease and the only avoidable risk factor associated with development of aortic aneurysm. While smoking is the most common form of tobacco use, snuff and other oral tobacco products are gaining popularity, but research on potentially toxic effects of oral tobacco use has not kept pace with the increase in its use. Here, we demonstrate that cigarette smoke and snuff extracts are highly toxic to developing zebrafish embryos. Exposure to such extracts led to a palette of toxic effects including early embryonic mortality, developmental delay, cerebral hemorrhages, defects in lymphatics development and ventricular function, and aneurysm development. Both cigarette smoke and snuff were more toxic than pure nicotine, indicating that other compounds in these products are also associated with toxicity. While some toxicities were found following exposure to both types of tobacco product, other toxicities, including developmental delay and aneurysm development, were specifically observed in the snuff extract group, whereas cerebral hemorrhages were only found in the group exposed to cigarette smoke extract. These findings deepen our understanding of the pathogenic effects of cigarette smoking and snuff use on the cardiovascular system and illustrate the benefits of using zebrafish to study mechanisms involved in aneurysm development.
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Affiliation(s)
- Maggie Folkesson
- Division of Drug Research, Department of Medical and Health Sciences, Linköping University, 581 85 Linköping, Sweden
| | - Natalia Sadowska
- Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Linköping University, 581 85 Linköping, Sweden
| | - Svante Vikingsson
- Division of Drug Research, Department of Medical and Health Sciences, Linköping University, 581 85 Linköping, Sweden
| | - Matts Karlsson
- Division of Applied Thermodynamics and Fluid Mechanics, Department of Management and Engineering, Linköping University, 581 83 Linköping, Sweden
| | - Carl-Johan Carlhäll
- Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Linköping University, 581 85 Linköping, Sweden
| | - Toste Länne
- Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Linköping University, 581 85 Linköping, Sweden
| | - Dick Wågsäter
- Division of Drug Research, Department of Medical and Health Sciences, Linköping University, 581 85 Linköping, Sweden
| | - Lasse Jensen
- Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Linköping University, 581 85 Linköping, Sweden
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Lahoz C, Gracia CE, García LR, Montoya SB, Hernando ÁB, Heredero ÁF, Tembra MS, Velasco MB, Guijarro C, Ruiz EB, Pintó X, de Ceniga MV, Moñux Ducajú G. [Not Available]. CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE ARTERIOSCLEROSIS 2016; 28 Suppl 1:1-49. [PMID: 27107212 DOI: 10.1016/s0214-9168(16)30026-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- Carlos Lahoz
- Unidad de Lípidos y Riesgo Vascular, Servicio de Medicina Interna, Hospital Carlos III, Madrid, España.
| | - Carlos Esteban Gracia
- Servicio de Angiología y Cirugía Vascular, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España
| | | | - Sergi Bellmunt Montoya
- Servicio de Angiología y Cirugía Vascular, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | - Ángel Brea Hernando
- Unidad de Lípidos, Servicio de Medicina Interna, Hospital San Pedro, Logroño, España
| | | | - Manuel Suárez Tembra
- Unidad de Lípidos y Riesgo Cardiovascular, Servicio de Medicina Interna, Hospital San Rafael, A Coruña, España
| | - Marta Botas Velasco
- Servicio de Angiología y Cirugía Vascular, Hospital de Cabueñes, Gijón, España
| | - Carlos Guijarro
- Consulta de Riesgo Vascular, Unidad de Medicina Interna, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
| | - Esther Bravo Ruiz
- Servicio de Angiología y Cirugía Vascular, Hospital Universitario de Basurto, Bilbao, España
| | - Xavier Pintó
- Unidad de Riesgo Vascular, Servicio de Medicina Interna, Hospital Universitario de Bellvitge, L' Hospitalet de Llobregat, Barcelona, España
| | - Melina Vega de Ceniga
- Servicio de Angiología y Cirugía Vascular, Hospital de Galdakao-Usansolo, Vizcaya, España
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Kuivaniemi H, Ryer EJ, Elmore JR, Tromp G. Understanding the pathogenesis of abdominal aortic aneurysms. Expert Rev Cardiovasc Ther 2016; 13:975-87. [PMID: 26308600 DOI: 10.1586/14779072.2015.1074861] [Citation(s) in RCA: 228] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
An aortic aneurysm is a dilatation in which the aortic diameter is ≥3.0 cm. If left untreated, the aortic wall continues to weaken and becomes unable to withstand the forces of the luminal blood pressure resulting in progressive dilatation and rupture, a catastrophic event associated with a mortality of 50-80%. Smoking and positive family history are important risk factors for the development of abdominal aortic aneurysms (AAA). Several genetic risk factors have also been identified. On the histological level, visible hallmarks of AAA pathogenesis include inflammation, smooth muscle cell apoptosis, extracellular matrix degradation and oxidative stress. We expect that large genetic, genomic, epigenetic, proteomic and metabolomic studies will be undertaken by international consortia to identify additional risk factors and biomarkers, and to enhance our understanding of the pathobiology of AAA. Collaboration between different research groups will be important in overcoming the challenges to develop pharmacological treatments for AAA.
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Affiliation(s)
- Helena Kuivaniemi
- a 1 Sigfried and Janet Weis Center for Research, Geisinger Health System, Danville, PA 17822, USA
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Busch A, Busch M, Scholz CJ, Kellersmann R, Otto C, Chernogubova E, Maegdefessel L, Zernecke A, Lorenz U. Aneurysm miRNA Signature Differs, Depending on Disease Localization and Morphology. Int J Mol Sci 2016; 17:ijms17010081. [PMID: 26771601 PMCID: PMC4730325 DOI: 10.3390/ijms17010081] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 12/18/2015] [Accepted: 01/04/2016] [Indexed: 12/27/2022] Open
Abstract
Limited comprehension of aneurysm pathology has led to inconclusive results from clinical trials. miRNAs are key regulators of post-translational gene modification and are useful tools in elucidating key features of aneurysm pathogenesis in distinct entities of abdominal and popliteal aneurysms. Here, surgically harvested specimens from 19 abdominal aortic aneurysm (AAA) and 8 popliteal artery aneurysm (PAA) patients were analyzed for miRNA expression and histologically classified regarding extracellular matrix (ECM) remodeling and inflammation. DIANA-based computational target prediction and pathway enrichment analysis verified our results, as well as previous ones. miRNA-362, -19b-1, -194, -769, -21 and -550 were significantly down-regulated in AAA samples depending on degree of inflammation. Similar or inverse regulation was found for miR-769, 19b-1 and miR-550, -21, whereas miR-194 and -362 were unaltered in PAA. In situ hybridization verified higher expression of miR-550 and -21 in PAA compared to AAA and computational analysis for target genes and pathway enrichment affirmed signal transduction, cell-cell-interaction and cell degradation pathways, in line with previous results. Despite the vague role of miRNAs for potential diagnostic and treatment purposes, the number of candidates from tissue signature studies is increasing. Tissue morphology influences subsequent research, yet comparison of distinct entities of aneurysm disease can unravel core pathways.
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Affiliation(s)
- Albert Busch
- Department for General, Visceral, Vascular & Paediatric Surgery, University Hospital of Würzburg, Würzburg 97080, Germany.
| | - Martin Busch
- Rudolf Virchow-Center, University of Würzburg, Würzburg 97080, Germany.
| | - Claus-Jürgen Scholz
- IZKF Laboratory for Microarray Applications, University Hospital Würzburg, Würzburg 97080, Germany.
| | - Richard Kellersmann
- Department for General, Visceral, Vascular & Paediatric Surgery, University Hospital of Würzburg, Würzburg 97080, Germany.
| | - Christoph Otto
- Department for General, Visceral, Vascular & Paediatric Surgery, University Hospital of Würzburg, Würzburg 97080, Germany.
| | - Ekaterina Chernogubova
- Department of Medicine, Center for Molecular Medicine (L8:03), Karolinska Institute, Stockholm 12065, Sweden.
| | - Lars Maegdefessel
- Department of Medicine, Center for Molecular Medicine (L8:03), Karolinska Institute, Stockholm 12065, Sweden.
| | - Alma Zernecke
- Institute of Experimental Biomedicine, University Hospital Würzburg, Würzburg 97080, Germany.
| | - Udo Lorenz
- Department for General, Visceral, Vascular & Paediatric Surgery, University Hospital of Würzburg, Würzburg 97080, Germany.
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72
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Gidding SS, Rana JS, Prendergast C, McGill H, Carr JJ, Liu K, Colangelo LA, Loria CM, Lima J, Terry JG, Reis JP, McMahan CA. Pathobiological Determinants of Atherosclerosis in Youth (PDAY) Risk Score in Young Adults Predicts Coronary Artery and Abdominal Aorta Calcium in Middle Age: The CARDIA Study. Circulation 2016; 133:139-46. [PMID: 27028434 PMCID: PMC4817359 DOI: 10.1161/circulationaha.115.018042] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 10/23/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND We explored whether, the Pathobiological Determinants of Atherosclerosis in Youth (PDAY) coronary and abdominal risk scores measured at 18 to 30 years of age and changes in these scores would more strongly predict coronary artery calcium (CAC) and abdominal aortic calcium (AAC) assessed 25 years later, than scores measured 25 years later. METHODS AND RESULTS In the Coronary Artery Risk Development in Young Adults (CARDIA) study, 3008 participants had measurements of risk score components at 5-year intervals beginning at 18 to 30 years of age. CAC and AAC were assessed at 43 to 55 years of age. Odds ratios (ORs) for the presence and extent of CAC/AAC per/point higher score and c-statistics for predicting CAC/AAC were calculated. The prevalence of CAC was 28% and AAC was 53%. For each 1 point higher PDAY score, the odds of CAC were higher using baseline scores than year 25 scores (OR, 1.29; 95% confidence interval [CI], 1.25-1.33 versus OR, 1.12; 95% CI, 1.11-1.14). For AAC, ORs at years 0 and 25 were similar (OR, 1.29; 95% CI, 1.24-1.34 versus OR, 1.22; 95% CI, 1.19-1.26). C-statistic for CAC prediction was higher at year 0 than year 25 (0.731 versus 0.705) but similar at years 0 and 25 for AAC (0.665 versus 0.670). ORs for CAC were highest at baseline, and, for AAC, ORs were highest at year 10. Including change in PDAY scores with baseline scores improved prediction. CONCLUSIONS Atherosclerosis risk and change in risk assessed in young adulthood years before subclinical atherosclerosis imaging provide strong prediction of future subclinical atherosclerosis. CAC and AAC reflect chronic risk exposure in addition to risk measured at the time of study.
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Affiliation(s)
- Samuel S Gidding
- From Nemours Cardiac Center, A. I. DuPont Hospital for Children, Wilmington, DE (S.S.G.); Divisions of Cardiology and Research, Kaiser Permanente Northern California, Oakland, (J.S.R.); Department of Medicine, University of California, San Francisco (J.S.R.); Division of Pediatric Cardiology, Vanderbilt University, Nashville, TN (C.P.); Department of Pathology, University of Texas Health Sciences Center, San Antonio (H.M., C.A.M.); Department of Radiology and Vanderbilt Translational and Clinical Cardiovascular Research Center (VTRACC), Vanderbilt University, Nashville, TN (J.J.C., J.G.T.); Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (K.L., L.A.C.); Division of Cardiovascular Science, National Heart Lung and Blood Institute, Bethesda, MD (C.M.L., J.P.R.); and Department of Internal Medicine, Johns Hopkins University Hospital, Baltimore, MD (J.L.).
| | - Jamal S Rana
- From Nemours Cardiac Center, A. I. DuPont Hospital for Children, Wilmington, DE (S.S.G.); Divisions of Cardiology and Research, Kaiser Permanente Northern California, Oakland, (J.S.R.); Department of Medicine, University of California, San Francisco (J.S.R.); Division of Pediatric Cardiology, Vanderbilt University, Nashville, TN (C.P.); Department of Pathology, University of Texas Health Sciences Center, San Antonio (H.M., C.A.M.); Department of Radiology and Vanderbilt Translational and Clinical Cardiovascular Research Center (VTRACC), Vanderbilt University, Nashville, TN (J.J.C., J.G.T.); Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (K.L., L.A.C.); Division of Cardiovascular Science, National Heart Lung and Blood Institute, Bethesda, MD (C.M.L., J.P.R.); and Department of Internal Medicine, Johns Hopkins University Hospital, Baltimore, MD (J.L.)
| | - Christopher Prendergast
- From Nemours Cardiac Center, A. I. DuPont Hospital for Children, Wilmington, DE (S.S.G.); Divisions of Cardiology and Research, Kaiser Permanente Northern California, Oakland, (J.S.R.); Department of Medicine, University of California, San Francisco (J.S.R.); Division of Pediatric Cardiology, Vanderbilt University, Nashville, TN (C.P.); Department of Pathology, University of Texas Health Sciences Center, San Antonio (H.M., C.A.M.); Department of Radiology and Vanderbilt Translational and Clinical Cardiovascular Research Center (VTRACC), Vanderbilt University, Nashville, TN (J.J.C., J.G.T.); Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (K.L., L.A.C.); Division of Cardiovascular Science, National Heart Lung and Blood Institute, Bethesda, MD (C.M.L., J.P.R.); and Department of Internal Medicine, Johns Hopkins University Hospital, Baltimore, MD (J.L.)
| | - Henry McGill
- From Nemours Cardiac Center, A. I. DuPont Hospital for Children, Wilmington, DE (S.S.G.); Divisions of Cardiology and Research, Kaiser Permanente Northern California, Oakland, (J.S.R.); Department of Medicine, University of California, San Francisco (J.S.R.); Division of Pediatric Cardiology, Vanderbilt University, Nashville, TN (C.P.); Department of Pathology, University of Texas Health Sciences Center, San Antonio (H.M., C.A.M.); Department of Radiology and Vanderbilt Translational and Clinical Cardiovascular Research Center (VTRACC), Vanderbilt University, Nashville, TN (J.J.C., J.G.T.); Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (K.L., L.A.C.); Division of Cardiovascular Science, National Heart Lung and Blood Institute, Bethesda, MD (C.M.L., J.P.R.); and Department of Internal Medicine, Johns Hopkins University Hospital, Baltimore, MD (J.L.)
| | - J Jeffery Carr
- From Nemours Cardiac Center, A. I. DuPont Hospital for Children, Wilmington, DE (S.S.G.); Divisions of Cardiology and Research, Kaiser Permanente Northern California, Oakland, (J.S.R.); Department of Medicine, University of California, San Francisco (J.S.R.); Division of Pediatric Cardiology, Vanderbilt University, Nashville, TN (C.P.); Department of Pathology, University of Texas Health Sciences Center, San Antonio (H.M., C.A.M.); Department of Radiology and Vanderbilt Translational and Clinical Cardiovascular Research Center (VTRACC), Vanderbilt University, Nashville, TN (J.J.C., J.G.T.); Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (K.L., L.A.C.); Division of Cardiovascular Science, National Heart Lung and Blood Institute, Bethesda, MD (C.M.L., J.P.R.); and Department of Internal Medicine, Johns Hopkins University Hospital, Baltimore, MD (J.L.)
| | - Kiang Liu
- From Nemours Cardiac Center, A. I. DuPont Hospital for Children, Wilmington, DE (S.S.G.); Divisions of Cardiology and Research, Kaiser Permanente Northern California, Oakland, (J.S.R.); Department of Medicine, University of California, San Francisco (J.S.R.); Division of Pediatric Cardiology, Vanderbilt University, Nashville, TN (C.P.); Department of Pathology, University of Texas Health Sciences Center, San Antonio (H.M., C.A.M.); Department of Radiology and Vanderbilt Translational and Clinical Cardiovascular Research Center (VTRACC), Vanderbilt University, Nashville, TN (J.J.C., J.G.T.); Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (K.L., L.A.C.); Division of Cardiovascular Science, National Heart Lung and Blood Institute, Bethesda, MD (C.M.L., J.P.R.); and Department of Internal Medicine, Johns Hopkins University Hospital, Baltimore, MD (J.L.)
| | - Laura A Colangelo
- From Nemours Cardiac Center, A. I. DuPont Hospital for Children, Wilmington, DE (S.S.G.); Divisions of Cardiology and Research, Kaiser Permanente Northern California, Oakland, (J.S.R.); Department of Medicine, University of California, San Francisco (J.S.R.); Division of Pediatric Cardiology, Vanderbilt University, Nashville, TN (C.P.); Department of Pathology, University of Texas Health Sciences Center, San Antonio (H.M., C.A.M.); Department of Radiology and Vanderbilt Translational and Clinical Cardiovascular Research Center (VTRACC), Vanderbilt University, Nashville, TN (J.J.C., J.G.T.); Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (K.L., L.A.C.); Division of Cardiovascular Science, National Heart Lung and Blood Institute, Bethesda, MD (C.M.L., J.P.R.); and Department of Internal Medicine, Johns Hopkins University Hospital, Baltimore, MD (J.L.)
| | - Catherine M Loria
- From Nemours Cardiac Center, A. I. DuPont Hospital for Children, Wilmington, DE (S.S.G.); Divisions of Cardiology and Research, Kaiser Permanente Northern California, Oakland, (J.S.R.); Department of Medicine, University of California, San Francisco (J.S.R.); Division of Pediatric Cardiology, Vanderbilt University, Nashville, TN (C.P.); Department of Pathology, University of Texas Health Sciences Center, San Antonio (H.M., C.A.M.); Department of Radiology and Vanderbilt Translational and Clinical Cardiovascular Research Center (VTRACC), Vanderbilt University, Nashville, TN (J.J.C., J.G.T.); Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (K.L., L.A.C.); Division of Cardiovascular Science, National Heart Lung and Blood Institute, Bethesda, MD (C.M.L., J.P.R.); and Department of Internal Medicine, Johns Hopkins University Hospital, Baltimore, MD (J.L.)
| | - Joao Lima
- From Nemours Cardiac Center, A. I. DuPont Hospital for Children, Wilmington, DE (S.S.G.); Divisions of Cardiology and Research, Kaiser Permanente Northern California, Oakland, (J.S.R.); Department of Medicine, University of California, San Francisco (J.S.R.); Division of Pediatric Cardiology, Vanderbilt University, Nashville, TN (C.P.); Department of Pathology, University of Texas Health Sciences Center, San Antonio (H.M., C.A.M.); Department of Radiology and Vanderbilt Translational and Clinical Cardiovascular Research Center (VTRACC), Vanderbilt University, Nashville, TN (J.J.C., J.G.T.); Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (K.L., L.A.C.); Division of Cardiovascular Science, National Heart Lung and Blood Institute, Bethesda, MD (C.M.L., J.P.R.); and Department of Internal Medicine, Johns Hopkins University Hospital, Baltimore, MD (J.L.)
| | - James G Terry
- From Nemours Cardiac Center, A. I. DuPont Hospital for Children, Wilmington, DE (S.S.G.); Divisions of Cardiology and Research, Kaiser Permanente Northern California, Oakland, (J.S.R.); Department of Medicine, University of California, San Francisco (J.S.R.); Division of Pediatric Cardiology, Vanderbilt University, Nashville, TN (C.P.); Department of Pathology, University of Texas Health Sciences Center, San Antonio (H.M., C.A.M.); Department of Radiology and Vanderbilt Translational and Clinical Cardiovascular Research Center (VTRACC), Vanderbilt University, Nashville, TN (J.J.C., J.G.T.); Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (K.L., L.A.C.); Division of Cardiovascular Science, National Heart Lung and Blood Institute, Bethesda, MD (C.M.L., J.P.R.); and Department of Internal Medicine, Johns Hopkins University Hospital, Baltimore, MD (J.L.)
| | - Jared P Reis
- From Nemours Cardiac Center, A. I. DuPont Hospital for Children, Wilmington, DE (S.S.G.); Divisions of Cardiology and Research, Kaiser Permanente Northern California, Oakland, (J.S.R.); Department of Medicine, University of California, San Francisco (J.S.R.); Division of Pediatric Cardiology, Vanderbilt University, Nashville, TN (C.P.); Department of Pathology, University of Texas Health Sciences Center, San Antonio (H.M., C.A.M.); Department of Radiology and Vanderbilt Translational and Clinical Cardiovascular Research Center (VTRACC), Vanderbilt University, Nashville, TN (J.J.C., J.G.T.); Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (K.L., L.A.C.); Division of Cardiovascular Science, National Heart Lung and Blood Institute, Bethesda, MD (C.M.L., J.P.R.); and Department of Internal Medicine, Johns Hopkins University Hospital, Baltimore, MD (J.L.)
| | - C Alex McMahan
- From Nemours Cardiac Center, A. I. DuPont Hospital for Children, Wilmington, DE (S.S.G.); Divisions of Cardiology and Research, Kaiser Permanente Northern California, Oakland, (J.S.R.); Department of Medicine, University of California, San Francisco (J.S.R.); Division of Pediatric Cardiology, Vanderbilt University, Nashville, TN (C.P.); Department of Pathology, University of Texas Health Sciences Center, San Antonio (H.M., C.A.M.); Department of Radiology and Vanderbilt Translational and Clinical Cardiovascular Research Center (VTRACC), Vanderbilt University, Nashville, TN (J.J.C., J.G.T.); Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (K.L., L.A.C.); Division of Cardiovascular Science, National Heart Lung and Blood Institute, Bethesda, MD (C.M.L., J.P.R.); and Department of Internal Medicine, Johns Hopkins University Hospital, Baltimore, MD (J.L.)
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Pafili K, Gouni-Berthold I, Papanas N, Mikhailidis DP. Abdominal aortic aneurysms and diabetes mellitus. J Diabetes Complications 2015; 29:1330-6. [PMID: 26440573 DOI: 10.1016/j.jdiacomp.2015.08.011] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Revised: 08/16/2015] [Accepted: 08/17/2015] [Indexed: 11/16/2022]
Abstract
There is accumulating evidence that risk profiles differ between coronary artery disease and abdominal aortic aneurysms (AAAs). However, diabetes mellitus (DM) appears to be negatively associated with AAA formation. The underlying mechanisms for this negative relationship are far from defined, but may include: increased arterial wall matrix formation via advanced glycation end products; suppression of plasmin and reduction of levels and activity of matrix metalloproteinases (MMP)-2 and 9; diminished aortic wall macrophage infiltration, elastolysis and neovascularization. In addition, the effect of pharmacological agents used for the treatment of patients with DM on AAA formation has been studied with rather controversial results. Statins, angiotensin converting enzyme inhibitors, angiotensin receptor blockers, fenofibrate, antibiotics and some hypoglycemic agents are beginning to be appreciated for a potential modest protection from AAAs, but further studies are needed.
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Affiliation(s)
- Kalliopi Pafili
- Diabetes Clinic, Second Department of Internal Medicine, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Ioanna Gouni-Berthold
- Center for Endocrinology, Diabetes and Preventive Medicine, University of Cologne, Cologne, Germany
| | - Nikolaos Papanas
- Diabetes Clinic, Second Department of Internal Medicine, Medical School, Democritus University of Thrace, Alexandroupolis, Greece.
| | - Dimitri P Mikhailidis
- Department of Clinical Biochemistry (Vascular Disease Prevention Clinics), Royal Free Hospital campus, University College London Medical School, University College London (UCL), London NW3 2QG, UK
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74
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Lu H, Howatt DA, Balakrishnan A, Moorleghen JJ, Rateri DL, Cassis LA, Daugherty A. Subcutaneous Angiotensin II Infusion using Osmotic Pumps Induces Aortic Aneurysms in Mice. J Vis Exp 2015. [PMID: 26436287 PMCID: PMC4692630 DOI: 10.3791/53191] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Osmotic pumps continuously deliver compounds at a constant rate into small animals. This article introduces a standard protocol used to induce aortic aneurysms via subcutaneous infusion of angiotensin II (AngII) from implanted osmotic pumps. This protocol includes calculation of AngII amount and dissolution, osmotic pump filling, implantation of osmotic pumps subcutaneously, observation after pump implantation, and harvest of aortas to visualize aortic aneurysms in mice. Subcutaneous infusion of AngII through osmotic pumps following this protocol is a reliable and reproducible technique to induce both abdominal and thoracic aortic aneurysms in mice. Infusion durations range from a few days to several months based on the purpose of the study. AngII 1,000 ng/kg/min is sufficient to provide maximal effects on abdominal aortic aneurysmal formation in male hypercholesterolemic mouse models such as apolipoprotein E deficient or low-density lipoprotein receptor deficient mice. Incidence of abdominal aortic aneurysms induced by AngII infusion via osmotic pumps is 5-10 times lower in female hypercholesterolemic mice and also lower in both genders of normocholesterolemic mice. In contrast, AngII-induced thoracic aortic aneurysms in mice are not hypercholesterolemia or gender-dependent. Importantly, multiple features of this mouse model recapitulate those of human aortic aneurysms.
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Affiliation(s)
| | | | | | | | - Debra L Rateri
- Saha Cardiovascular Research Center, University of Kentucky
| | - Lisa A Cassis
- Department of Pharmacology and Nutritional Sciences, University of Kentucky
| | - Alan Daugherty
- Saha Cardiovascular Research Center, University of Kentucky;
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75
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The potential role of DNA methylation in the pathogenesis of abdominal aortic aneurysm. Atherosclerosis 2015; 241:121-9. [DOI: 10.1016/j.atherosclerosis.2015.05.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Revised: 04/20/2015] [Accepted: 05/03/2015] [Indexed: 12/18/2022]
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76
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Affiliation(s)
- Ziad Mallat
- From the Department of Medicine, Division of Cardiovascular Medicine, University of Cambridge, Cambridge, United Kingdom; and Institut National de la Santé et de la Recherche Médicale, U970, Paris, France.
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77
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Falk E. Vaccination Against Atherosclerosis and Abdominal Aortic Aneurysm∗. J Am Coll Cardiol 2015; 65:557-9. [DOI: 10.1016/j.jacc.2014.09.093] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2014] [Revised: 09/24/2014] [Accepted: 09/30/2014] [Indexed: 01/31/2023]
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78
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Botas Velasco M, Vallina-Victorero Vázquez M, Calvín Álvarez P, del Canto Peruyera P, Álvarez Salgado A, Álvarez Fernández L. ¿Existe algún factor de riesgo predictivo de mortalidad a corto plazo en pacientes de alto riesgo intervenidos de aneurismas de aorta abdominal mediante endoprótesis? ANGIOLOGIA 2015. [DOI: 10.1016/j.angio.2014.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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79
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Tulamo R, Niemelä M. Smoking and Cerebral Aneurysms—Potential Pathobiologic Mechanisms. World Neurosurg 2014; 82:e79-80. [PMID: 24680734 DOI: 10.1016/j.wneu.2014.03.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Accepted: 03/11/2014] [Indexed: 11/17/2022]
Affiliation(s)
- Riikka Tulamo
- Neurosurgery Research Group, Biomedicum Helsinki, Helsinki, Finland
| | - Mika Niemelä
- Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland.
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80
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Dilmé JF, Bellmunt S, Camacho M, Solà-Villà D, Romero JM, Escudero JR, Vila L. Influence of cardiovascular risk factors on levels of matrix metalloproteinases 2 and 9 in human abdominal aortic aneurysms. Eur J Vasc Endovasc Surg 2014; 48:374-81. [PMID: 24980077 DOI: 10.1016/j.ejvs.2014.05.023] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Accepted: 05/27/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To evaluate the influence of cardiovascular risk factors on levels of matrix metalloproteinases (MMP) 2 and 9 in human abdominal aortic aneurysms (AAA). METHODS Aortic samples were collected from patients who underwent AAA repair (n = 89). Patients were stratified according to the maximum transverse aorta diameter: small diameter (<55 mm), moderate diameter (55-69.9 mm) and large diameter (≥70 mm). Aortic walls were studied using real-time PCR and immunohistochemistry. MMP-2, MMP-9, α-actin, CD45, and CD68 transcript levels were determined relative to β-actin. Quantitative data were expressed as median (IQ-range). RESULTS No differences were found in MMP-2 expression between the patient groups, which was mainly associated with vascular smooth muscle cells (VSMC); however, MMP-9 displayed the maximum level in the moderate-diameter group, associated with infiltrating macrophages. Current smoking (CS) and renal insufficiency (RI) significantly increased local levels of MMP-2 (CS 349.5 [219.5-414.1] vs. no-CS 184.4 [100.0-320.5]; p < .008; RI 286.8 [189.6-410.8] vs. no-RI 177.3 [99.3-326.9]; p = .047). Nevertheless, after stepwise linear regression analysis only CS remained as an independent variable predicting local levels of MMP-2 (p = .002). No risk factors influenced local levels of MMP-9. CONCLUSIONS The results show that local levels of MMP-2, an important factor for AAA development, were increased in current smoking AAA patients. MMP-2 was mainly associated with VSMC. It is suggested that MMP-2 could contribute significantly to the increased AAA growth rate observed in current smoking patients. These findings support inclusion of smokers in screening for aneurysmal disease, and emphasize the need for more aggressive monitoring of aneurysmal disease outside the surgical range in patients who smoke at the time of diagnosis and in those who continue to smoke during follow-up.
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Affiliation(s)
- J-F Dilmé
- Angiology, Vascular Biology and Inflammation Laboratory, Institute of Biomedical Research (II-B Sant Pau), Barcelona, Spain; Vascular Surgery Department, Institute of Biomedical Research (II-B Sant Pau), Barcelona, Spain
| | - S Bellmunt
- Angiology, Vascular Biology and Inflammation Laboratory, Institute of Biomedical Research (II-B Sant Pau), Barcelona, Spain; Vascular Surgery Department, Institute of Biomedical Research (II-B Sant Pau), Barcelona, Spain
| | - M Camacho
- Angiology, Vascular Biology and Inflammation Laboratory, Institute of Biomedical Research (II-B Sant Pau), Barcelona, Spain.
| | - D Solà-Villà
- Autonomous University of Barcelona, Institute of Biomedical Research (II-B Sant Pau), Barcelona, Spain
| | - J-M Romero
- Angiology, Vascular Biology and Inflammation Laboratory, Institute of Biomedical Research (II-B Sant Pau), Barcelona, Spain; Vascular Surgery Department, Institute of Biomedical Research (II-B Sant Pau), Barcelona, Spain
| | - J-R Escudero
- Angiology, Vascular Biology and Inflammation Laboratory, Institute of Biomedical Research (II-B Sant Pau), Barcelona, Spain; Vascular Surgery Department, Institute of Biomedical Research (II-B Sant Pau), Barcelona, Spain
| | - L Vila
- Angiology, Vascular Biology and Inflammation Laboratory, Institute of Biomedical Research (II-B Sant Pau), Barcelona, Spain
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81
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Marsico F, Giugliano G, Ruggiero D, Parente A, Paolillo S, Guercio LD, Esposito G, Trimarco B, Filardi PP. Prevalence and severity of asymptomatic coronary and carotid artery disease in patients with abdominal aortic aneurysm. Angiology 2014; 66:360-4. [PMID: 24965380 DOI: 10.1177/0003319714540319] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We evaluated the prevalence and severity of occult coronary artery disease (CAD) and cerebrovascular disease (CeVD) in patients with abdominal aortic aneurysm (AAA). We studied 100 consecutive patients with no history of CAD, normal electrocardiogram, normal systolic function, and no angina or dyspnea. All patients underwent carotid Doppler study and invasive coronary angiography. Significant CAD was observed in 61% of patients. In all, 51% of patients with significant CAD showed either left main (n = 7), 3-vessel (n = 17), or proximal left anterior descending (n = 7) CAD, corresponding to 31% of the total cohort. Cerebrovascular disease was detected in 53% of patients, and in 38% of them was significant (peak systolic flow velocity ≥125 <230 cm/s). In 36% of patients with CeVD either left main (n = 5), 3-vessel (n = 11), or proximal left anterior descending (n = 3) CAD was observed. Severe asymptomatic CAD is prevalent in AAA, and 31% of patients fulfill indications for coronary revascularization.
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Affiliation(s)
- Fabio Marsico
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Giuseppe Giugliano
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Donatella Ruggiero
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Antonio Parente
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Stefania Paolillo
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Luca Del Guercio
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Giovanni Esposito
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Bruno Trimarco
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
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Liu R, Leslie KL, Martin KA. Epigenetic regulation of smooth muscle cell plasticity. BIOCHIMICA ET BIOPHYSICA ACTA-GENE REGULATORY MECHANISMS 2014; 1849:448-53. [PMID: 24937434 DOI: 10.1016/j.bbagrm.2014.06.004] [Citation(s) in RCA: 96] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Accepted: 06/08/2014] [Indexed: 01/03/2023]
Abstract
Smooth muscle cells (SMC) are the major cell type in blood vessels. Their principal function in the body is to regulate blood flow and pressure through vessel wall contraction and relaxation. Unlike many other mature cell types in the adult body, SMC do not terminally differentiate but retain a remarkable plasticity. They have the unique ability to toggle between a differentiated and quiescent "contractile" state and a highly proliferative and migratory "synthetic" phenotype in response to environmental stresses. While there have been major advances in our understanding of SMC plasticity through the identification of growth factors and signals that can influence the SMC phenotype, how these regulate SMC plasticity remains unknown. To date, several key transcription factors and regulatory cis elements have been identified that play a role in modulating SMC state. The frontier in understanding the molecular mechanisms underlying SMC plasticity has now advanced to the level of epigenetics. This review will summarize the epigenetic regulation of SMC, highlighting the role of histone modification, DNA methylation, and our most recent identification of a DNA demethylation pathway in SMC that is pivotal in the regulation of the SMC phenotypic state. Many disorders are associated with smooth muscle dysfunction, including atherosclerosis, the major underlying cause of stroke and coronary heart disease, as well as transplant vasculopathy, aneurysm, asthma, hypertension, and cancer. An increased understanding of the major regulators of SMC plasticity will lead to the identification of novel target molecules that may, in turn, lead to novel drug discoveries for the treatment of these diseases. This article is part of a Special Issue entitled: Stress as a fundamental theme in cell plasticity.
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Affiliation(s)
- Renjing Liu
- Agnes Ginges Laboratory for Diseases of the Aorta, Centre for the Endothelium, Vascular Biology Program, Centenary Institute, Sydney, Australia; Sydney Medical School, University of Sydney, Australia
| | - Kristen L Leslie
- Departments of Internal Medicine and Pharmacology, Yale Cardiovascular Research Center, Section of Cardiovascular Medicine, Yale University, New Haven, CT 06511, USA
| | - Kathleen A Martin
- Departments of Internal Medicine and Pharmacology, Yale Cardiovascular Research Center, Section of Cardiovascular Medicine, Yale University, New Haven, CT 06511, USA.
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Affiliation(s)
- Alan Daugherty
- From the Saha Cardiovascular Research Center, University of Kentucky, Lexington (A.D.); and Department of Surgery and Cancer, Imperial College, London, United Kingdom (J.T.P.)
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Active smoking increases microsomal PGE2-synthase-1/PGE-receptor-4 axis in human abdominal aortic aneurysms. Mediators Inflamm 2014; 2014:316150. [PMID: 24876670 PMCID: PMC4021751 DOI: 10.1155/2014/316150] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2014] [Accepted: 04/10/2014] [Indexed: 01/19/2023] Open
Abstract
Background. The cyclooxygenase- (COX-) 2/microsomal PGE-synthase- (mPGES-) 1/PGE-receptor- (EP-) 4 axis could play a key role in the physiopathology of abdominal aortic aneurysm (AAA) in humans. In this study, we investigated the influence of cardiovascular risk factors on the expression of the PGE2 pathway in human AAA. Methods. Aortic (n = 89) and plasma (n = 79) samples from patients who underwent AAA repair were collected. Patients were grouped according to risk factors. COX-isoenzymes, mPGES-1, EPs, α-actin, and CD45 and CD68 transcripts levels were quantified by QRT-PCR and plasma PGE2 metabolites by EIA. Results. Current smoking (CS) patients compared to no-CS had significantly higher local levels of mPGES-1 (P = 0.009), EP-4 (P = 0.007), and PGE2 metabolites plasma levels (P = 0.008). In the multiple linear regression analysis, these parameters remained significantly enhanced in CS after adding confounding factors. Results from association studies with cell type markers suggested that the increased mPGES-1/EP-4 levels were mainly associated with microvascular endothelial cells. Conclusions. This study shows that elements of the PGE2 pathway, which play an important role in AAA development, are increased in CS. These results provide insight into the relevance of tobacco smoking in AAA development and reinforce the potential of mPGES-1 and EP-4 as targets for therapy in AAA patients.
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Aneurisma aórtico. CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS 2013; 25:224-30. [DOI: 10.1016/j.arteri.2013.10.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Accepted: 10/17/2013] [Indexed: 11/21/2022]
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