51
|
Gomez D, Kessler K, Borges LF, Richard B, Touat Z, Ollivier V, Mansilla S, Bouton MC, Alkoder S, Nataf P, Jandrot-Perrus M, Jondeau G, Vranckx R, Michel JB. Smad2-dependent protease nexin-1 overexpression differentiates chronic aneurysms from acute dissections of human ascending aorta. Arterioscler Thromb Vasc Biol 2013; 33:2222-32. [PMID: 23814118 DOI: 10.1161/atvbaha.113.301327] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Tissue activation of proteolysis is involved in acute intramural rupture (dissections, acute ascending aortic dissection) and in progressive dilation (aneurysms, thoracic aneurysm of the ascending aorta) of human ascending aorta. The translational aim of this study was to characterize the regulation of antiproteolytic serpin expression in normal, aneurysmal, and dissecting aorta. APPROACH AND RESULTS We explored expression of protease nexin-1 (PN-1) and plasminogen activator inhibitor-1 and their regulation by the Smad2 signaling pathway in human tissue and cultured vascular smooth muscle cells (VSMCs) of aneurysms (thoracic aneurysm of the ascending aorta; n=46) and acute dissections (acute ascending aortic dissection; n=10) of the ascending aorta compared with healthy aortas (n=10). Both PN-1 and plasminogen activator inhibitor-1 mRNA and proteins were overexpressed in medial tissue extracts and primary VSMC cultures from thoracic aneurysm of the ascending aorta compared with acute ascending aortic dissection and controls. Transforming growth factor-β induced increased PN-1 expression in control but not in aneurysmal VSMCs. PN-1 and plasminogen activator inhibitor-1 overexpression by aneurysmal VSMCs was associated with increased Smad2 binding on their promoters and, functionally, resulted in VSMC self-protection from plasmin-induced detachment and death. This phenomenon was restricted to aneurysms and not observed in acute dissections. CONCLUSIONS These results demonstrate that epigenetically regulated PN-1 overexpression promotes development of an antiproteolytic VSMC phenotype and might favor progressive aneurysmal dilation, whereas absence of this counter-regulation in dissections would lead to acute wall rupture.
Collapse
Affiliation(s)
- Delphine Gomez
- Inserm, UMR 698, Paris 7-Denis Diderot University, CHU X. Bichat, Paris, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
52
|
Bashur CA, Rao RR, Ramamurthi A. Perspectives on stem cell-based elastic matrix regenerative therapies for abdominal aortic aneurysms. Stem Cells Transl Med 2013; 2:401-8. [PMID: 23677642 DOI: 10.5966/sctm.2012-0185] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Abdominal aortic aneurysms (AAAs) are potentially fatal conditions that are characterized by decreased flexibility of the aortic wall due to proteolytic loss of the structural matrix. This leads to their gradual weakening and ultimate rupture. Drug-based inhibition of proteolytic enzymes may provide a nonsurgical treatment alternative for growing AAAs, although it might at best be sufficient to slow their growth. Regenerative repair of disrupted elastic matrix is required if regression of AAAs to a healthy state is to be achieved. Terminally differentiated adult and diseased vascular cells are poorly capable of affecting such regenerative repair. In this context, stem cells and their smooth muscle cell-like derivatives may represent alternate cell sources for regenerative AAA cell therapies. This article examines the pros and cons of using different autologous stem cell sources for AAA therapy, the requirements they must fulfill to provide therapeutic benefit, and the current progress toward characterizing the cells' ability to synthesize elastin, assemble elastic matrix structures, and influence the regenerative potential of diseased vascular cell types. The article also provides a detailed perspective on the limitations, uncertainties, and challenges that will need to be overcome or circumvented to translate current strategies for stem cell use into clinically viable AAA therapies. These therapies will provide a much needed nonsurgical treatment option for the rapidly growing, high-risk, and vulnerable elderly demographic.
Collapse
MESH Headings
- Aged
- Animals
- Aorta, Abdominal/drug effects
- Aorta, Abdominal/metabolism
- Aorta, Abdominal/pathology
- Aortic Aneurysm, Abdominal/metabolism
- Aortic Aneurysm, Abdominal/pathology
- Aortic Aneurysm, Abdominal/rehabilitation
- Aortic Aneurysm, Abdominal/therapy
- Becaplermin
- Elasticity/drug effects
- Elasticity/physiology
- Elastin/biosynthesis
- Extracellular Matrix/drug effects
- Extracellular Matrix/metabolism
- Humans
- Myocytes, Smooth Muscle/cytology
- Myocytes, Smooth Muscle/metabolism
- Proto-Oncogene Proteins c-sis/pharmacology
- Regeneration/drug effects
- Regeneration/physiology
- Stem Cell Transplantation/methods
- Stem Cell Transplantation/trends
- Stem Cells/cytology
- Stem Cells/metabolism
- Transforming Growth Factor beta/pharmacology
- Transplantation, Autologous
Collapse
Affiliation(s)
- Chris A Bashur
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH, USA
| | | | | |
Collapse
|
53
|
Franck G, Dai J, Fifre A, Ngo S, Justine C, Michineau S, Allaire E, Gervais M. Reestablishment of the Endothelial Lining by Endothelial Cell Therapy Stabilizes Experimental Abdominal Aortic Aneurysms. Circulation 2013; 127:1877-87. [DOI: 10.1161/circulationaha.113.001677] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background—
Loss of the endothelium and its replacement by a thick thrombus are structural features of human abdominal aortic aneurysms (AAAs). In AAAs, the relationship between aortic diameter expansion, the presence of thrombus, and the lack of endothelial cells (ECs) remains unexplored. We hypothesized that reendothelialization by cell therapy would modulate aortic wall destruction and ultimately stabilize AAAs. We evaluated the impact of local seeding of rat aortic ECs or peripheral blood–derived outgrowth ECs on AAA evolution.
Methods and Results—
Rat aortic ECs (n=30) or serum-free medium (controls; n=29) were seeded endovascularly immediately (day 0) or 14 days after surgery in the rat xenograft model. Rat aortic EC seeding prevented AAA formation and stabilized formed AAAs at 28 days (diameter increase at day 0+28, 51±6% versus 83±6%; day 14+28, −1±4% versus 22±6% in rat aortic ECs and controls, respectively;
P
<0.01). This stabilizing effect was associated with the reestablishment of the endothelial lining, the suspension of proteolysis, and the reconstitution of new aortic wall rich in smooth muscle cells and extracellular matrix. Transplanted rat aortic ECs did not participate directly in aortic wall repair but exerted their healing properties through paracrine mechanisms involving the upregulation of endothelium-derived stabilizing factors and the recruitment of resident vascular cells. In rats, the transplantation of outgrowth ECs (n=7) significantly reduced by 30% the progression of AAAs and restored the abluminal endothelium at 28 days compared with controls (n=9).
Conclusion—
Our study demonstrates the potential of restoring the endothelial lining to control AAA dynamics and designates ECs as an efficient therapy to stop AAA expansion.
Collapse
Affiliation(s)
- Grégory Franck
- From CNRS EAC 7054, Centre de Recherches Chirurgicales Dominique Chopin, Faculty of Medicine, Paris-Est Créteil University, Créteil, France
| | - Jianping Dai
- From CNRS EAC 7054, Centre de Recherches Chirurgicales Dominique Chopin, Faculty of Medicine, Paris-Est Créteil University, Créteil, France
| | - Alexandre Fifre
- From CNRS EAC 7054, Centre de Recherches Chirurgicales Dominique Chopin, Faculty of Medicine, Paris-Est Créteil University, Créteil, France
| | - Saravuth Ngo
- From CNRS EAC 7054, Centre de Recherches Chirurgicales Dominique Chopin, Faculty of Medicine, Paris-Est Créteil University, Créteil, France
| | - Claire Justine
- From CNRS EAC 7054, Centre de Recherches Chirurgicales Dominique Chopin, Faculty of Medicine, Paris-Est Créteil University, Créteil, France
| | - Stéphanie Michineau
- From CNRS EAC 7054, Centre de Recherches Chirurgicales Dominique Chopin, Faculty of Medicine, Paris-Est Créteil University, Créteil, France
| | - Eric Allaire
- From CNRS EAC 7054, Centre de Recherches Chirurgicales Dominique Chopin, Faculty of Medicine, Paris-Est Créteil University, Créteil, France
| | - Marianne Gervais
- From CNRS EAC 7054, Centre de Recherches Chirurgicales Dominique Chopin, Faculty of Medicine, Paris-Est Créteil University, Créteil, France
| |
Collapse
|
54
|
Bone marrow mesenchymal stem cells stabilize already-formed aortic aneurysms more efficiently than vascular smooth muscle cells in a rat model. Eur J Vasc Endovasc Surg 2013; 45:666-72. [PMID: 23598054 DOI: 10.1016/j.ejvs.2013.03.007] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2012] [Accepted: 03/11/2013] [Indexed: 11/21/2022]
Abstract
PURPOSE Abdominal aortic aneurysms (AAAs) expand because of aortic wall destruction. Enrichment in Vascular Smooth Muscle Cells (VSMCs) stabilizes expanding AAAs in rats. Mesenchymal Stem Cells (MSCs) can differentiate into VSMCs. We have tested the hypothesis that bone marrow-derived MSCs (BM-MSCs) stabilizes AAAs in a rat model. MATERIAL AND METHODS Rat Fischer 344 BM-MSCs were isolated by plastic adhesion and seeded endovascularly in experimental AAAs using xenograft obtained from guinea pig. Culture medium without cells was used as control group. The main criteria was the variation of the aortic diameter at one week and four weeks. We evaluated the impact of cells seeding on inflammatory response by immunohistochemistry combined with RT-PCR on MMP9 and TIMP1 at one week. We evaluated the healing process by immunohistochemistry at 4 weeks. RESULTS The endovascular seeding of BM-MSCs decreased AAA diameter expansion more powerfully than VSMCs or culture medium infusion (6.5% ± 9.7, 25.5% ± 17.2 and 53.4% ± 14.4; p = .007, respectively). This result was sustained at 4 weeks. BM-MSCs decreased expression of MMP-9 and infiltration by macrophages (4.7 ± 2.3 vs. 14.6 ± 6.4 mm(2) respectively; p = .015), increased Tissue Inhibitor Metallo Proteinase-1 (TIMP-1), compared to culture medium infusion. BM-MSCs induced formation of a neo-aortic tissue rich in SM-alpha active positive cells (22.2 ± 2.7 vs. 115.6 ± 30.4 cells/surface units, p = .007) surrounded by a dense collagen and elastin network covered by luminal endothelial cells. CONCLUSIONS We have shown in this rat model of AAA that BM-MSCs exert a specialized function in arterial regeneration that transcends that of mature mesenchymal cells. Our observation identifies a population of cells easy to isolate and to expand for therapeutic interventions based on catheter-driven cell therapy.
Collapse
|
55
|
Lu H, Rateri DL, Bruemmer D, Cassis LA, Daugherty A. Novel mechanisms of abdominal aortic aneurysms. Curr Atheroscler Rep 2013; 14:402-12. [PMID: 22833280 DOI: 10.1007/s11883-012-0271-y] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Abdominal aortic aneurysms (AAAs) are a common but asymptomatic disease that has high susceptibility to rupture. Current therapeutic options are limited to surgical procedures because no pharmacological approaches have been proven to decrease either expansion or rupture of human AAAs. The current dearth of effective medical treatment is attributed to insufficient understanding of the mechanisms underlying the initiation, propagation and rupture of AAAs. This review will emphasize recent advances in mechanistic studies that may provide insights into potential pharmacological treatments for this disease. While we primarily focus on recent salient findings, we also discuss mechanisms that continue to be controversial depending on models under study. Despite the progress on exploring mechanisms of experimental AAAs, ultimate validation of mechanisms will require completion of prospective double-blinded clinical trials. In addition, we advocate increased emphasis of collaborative studies using animal models and human tissues for determination of mechanisms that explore expansion and rupture of existing AAAs.
Collapse
Affiliation(s)
- Hong Lu
- Saha Cardiovascular Research Center, Biomedical Biological Sciences Research Building, B243, University of Kentucky, Lexington, KY 40536-0509, USA.
| | | | | | | | | |
Collapse
|
56
|
Abstract
Underlying the dynamic regulation of tropoelastin expression and elastin formation in development and disease are transcriptional and post-transcriptional mechanisms that have been the focus of much research. Of particular importance is the cytokine-governed elastin regulatory axis in which the pro-elastogenic activities of transforming growth factor β-1 (TGFβ1) and insulin-like growth factor-I (IGF-I) are opposed by anti-elastogenic activities of basic fibroblast growth factor (bFGF/FGF-2), heparin-binding epidermal growth factor-like growth factor (HB-EGF), EGF, PDGF-BB, TGFα, tumor necrosis factor-alpha (TNF-α), interleukin (IL)-1β and noncanonical TGFβ1 signaling. A key mechanistic feature of the regulatory axis is that cytokines influence elastin formation through effects on the cell cycle involving control of cyclin-cyclin dependent kinase complexes and activation of the Ras/MEK/ERK signaling pathway. In this article we provide an overview of the major cytokines/growth factors that modulate elastogenesis and describe the underlying molecular mechanisms for their action on elastin production.
Collapse
Affiliation(s)
- Erin P Sproul
- Department of Regenerative Medicine and Cell Biology, Medical University of South Carolina, Charleston, SC 29425, USA.
| | | |
Collapse
|
57
|
Transforming growth factor-β and abdominal aortic aneurysms. Cardiovasc Pathol 2013; 22:126-32. [DOI: 10.1016/j.carpath.2012.07.005] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2012] [Revised: 07/22/2012] [Accepted: 07/30/2012] [Indexed: 12/22/2022] Open
|
58
|
Wilson JS, Baek S, Humphrey JD. Parametric study of effects of collagen turnover on the natural history of abdominal aortic aneurysms. Proc Math Phys Eng Sci 2013; 469:20120556. [PMID: 23633905 DOI: 10.1098/rspa.2012.0556] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Accepted: 10/23/2012] [Indexed: 12/16/2022] Open
Abstract
Abdominal aortic aneurysms (AAAs) are characterized by significant changes in the architecture of the aortic wall, notably, loss of functional elastin and smooth muscle. Because collagen is the principal remaining load-bearing constituent of the aneurysmal wall, its turnover must play a fundamental role in the natural history of the lesion. Nevertheless, detailed investigations of the effects of different aspects of collagen turnover on AAA development are lacking. A finite-element membrane model of the growth and remodelling of idealized AAAs was thus used to investigate parametrically four of the primary aspects of collagen turnover: rates of production, half-life, deposition stretch (prestretch) and material stiffness. The predicted rates of aneurysmal expansion and spatio-temporal changes in wall thickness, biaxial stresses and maximum collagen fibre stretch at the apex of the lesion depended strongly on all four factors, as did the predicted clinical endpoints (i.e. arrest, progressive expansion or rupture). Collagen turnover also affected the axial expansion, largely due to mechanical changes within the shoulder region of the lesion. We submit, therefore, that assessment of rupture risk could be improved by future experiments that delineate and quantify different aspects of patient-specific collagen turnover and that such understanding could lead to new targeted therapeutics.
Collapse
Affiliation(s)
- J S Wilson
- Department of Biomedical Engineering , Yale University , New Haven, CT 06520, USA
| | | | | |
Collapse
|
59
|
Sivaraman B, Bashur CA, Ramamurthi A. Advances in biomimetic regeneration of elastic matrix structures. Drug Deliv Transl Res 2012; 2:323-50. [PMID: 23355960 PMCID: PMC3551595 DOI: 10.1007/s13346-012-0070-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Elastin is a vital component of the extracellular matrix, providing soft connective tissues with the property of elastic recoil following deformation and regulating the cellular response via biomechanical transduction to maintain tissue homeostasis. The limited ability of most adult cells to synthesize elastin precursors and assemble them into mature crosslinked structures has hindered the development of functional tissue-engineered constructs that exhibit the structure and biomechanics of normal native elastic tissues in the body. In diseased tissues, the chronic overexpression of proteolytic enzymes can cause significant matrix degradation, to further limit the accumulation and quality (e.g., fiber formation) of newly deposited elastic matrix. This review provides an overview of the role and importance of elastin and elastic matrix in soft tissues, the challenges to elastic matrix generation in vitro and to regenerative elastic matrix repair in vivo, current biomolecular strategies to enhance elastin deposition and matrix assembly, and the need to concurrently inhibit proteolytic matrix disruption for improving the quantity and quality of elastogenesis. The review further presents biomaterial-based options using scaffolds and nanocarriers for spatio-temporal control over the presentation and release of these biomolecules, to enable biomimetic assembly of clinically relevant native elastic matrix-like superstructures. Finally, this review provides an overview of recent advances and prospects for the application of these strategies to regenerating tissue-type specific elastic matrix structures and superstructures.
Collapse
Affiliation(s)
- Balakrishnan Sivaraman
- Department of Biomedical Engineering, The Cleveland Clinic, 9500 Euclid Avenue, ND 20, Cleveland, OH 44195, USA
| | - Chris A. Bashur
- Department of Biomedical Engineering, The Cleveland Clinic, 9500 Euclid Avenue, ND 20, Cleveland, OH 44195, USA
| | - Anand Ramamurthi
- Department of Biomedical Engineering, The Cleveland Clinic, 9500 Euclid Avenue, ND 20, Cleveland, OH 44195, USA
| |
Collapse
|
60
|
Venkataraman L, Lenis AT, Couri BM, Damaser MS, Ramamurthi A. Induced Regenerative Elastic Matrix Repair in LOXL1 Knockout Mouse Cell Cultures: Towards Potential therapy for Pelvic Organ Prolapse. ACTA ACUST UNITED AC 2012; 3. [PMID: 30854248 DOI: 10.4172/2157-7552.1000120] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Impaired elastic matrix remodeling occurs in reproductive tissues after vaginal delivery. This has been linked to development of pelvic organ prolapse (POP) for which there currently is no pharmacologic therapy. Hyaluronan oligomers and transforming growth factor beta 1 (termed elastogenic factors, EFs) have been shown to significantly enhance tropoelastin synthesis, elastic fiber assembly, and crosslinking by adult vascular smooth muscle cells (SMCs). The goal of this study was to ascertain if these factors similarly improve the quantity and quality of elastic matrix deposition by vaginal SMCs (VSMCs) isolated from lysyl oxidase like-1 knock out (LOXL1 KO) mouse model of POP. Cells isolated from whole vagina of a LOXL1 KO mouse (multiparous, stage 3 prolapse) were cultured and identified as SMCs by their expression of various SMC markers. Passage 2 vaginal SMCs (VSMCs; 3×104/10 cm2) were cultured for 21 days with EFs. Cell layers and spent medium aliquots were assessed for elastin content and quality. EF-treated VSMCs proliferated at a similar rate to untreated controls but synthesized more total elastin primarily in the form of soluble matrix elastin. Elastin mRNA was also increased compared to controls. The elastic matrix was significantly denser in EF-treated cultures, which was composed of more mature, non-interrupted elastic fibers that were absent in controls. The results are promising towards development of a therapy to enhance regenerative elastic matrix repair in post-partum female pelvic floor tissues.
Collapse
Affiliation(s)
- L Venkataraman
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH.,Department of Bioengineering, Clemson University
| | - A T Lenis
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH
| | - B M Couri
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH
| | - M S Damaser
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH.,Advanced Platform Technology Center, Louis Stokes Cleveland VA Medical Center, Cleveland, OH
| | - A Ramamurthi
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH
| |
Collapse
|
61
|
Humphrey JD. Possible mechanical roles of glycosaminoglycans in thoracic aortic dissection and associations with dysregulated transforming growth factor-β. J Vasc Res 2012; 50:1-10. [PMID: 23018968 DOI: 10.1159/000342436] [Citation(s) in RCA: 92] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2012] [Accepted: 07/25/2012] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Four distinguishing histopathological characteristics of thoracic aortic aneurysms and dissections (TAADs) are the fragmentation or degradation of elastic fibers, loss of smooth muscle, pooling of glycosaminoglycans, and remodeling of fibrillar collagens. Of these, pooling of glycosaminoglycans appears to be unique to these lesions. METHODS This review acknowledges the importance of dysregulated transforming growth factor-β (TGF-β) in TAADs and offers a complementary hypothesis that increased TGF-β could contribute to the accumulation of glycosaminoglycans in the media of the proximal thoracic aorta. Regardless, observed pools of glycosaminoglycans could decrease tensile strength, cause stress concentrations, and increase intralamellar swelling pressure, all of which could initiate local delaminations that could subsequently propagate as dissections and result in a false lumen or rupture. CONCLUSIONS There is a pressing need to investigate potential mechanical as well as biological consequences of accumulated glycosaminoglycans in TAADs and to elucidate responsible signaling pathways, with particular attention to synthetic cells of nonmesodermal lineage. Such research could provide insight into the mechanisms of dissection and the seemingly paradoxical role of the over-expression of a cytokine that is typically associated with fibrosis but is implicated in a degenerative disease of the aorta that can result in a catastrophic mechanical failure.
Collapse
Affiliation(s)
- J D Humphrey
- Department of Biomedical Engineering, Yale University, and Vascular Biology and Therapeutics Program, Yale School of Medicine, New Haven, CT 06520, USA.
| |
Collapse
|
62
|
Radu NC, Gervais M, Michineau S, Blanc R, Fifre A, Kirsch EWM, Allaire E. New ascending aortic aneurysm model in rats reproduces main structural features of degenerative ascending thoracic aortic aneurysms in human beings. J Thorac Cardiovasc Surg 2012; 145:1627-34. [PMID: 22935446 DOI: 10.1016/j.jtcvs.2012.07.050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2012] [Revised: 07/03/2012] [Accepted: 07/26/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVES The singularity of the ascending aorta regarding mechanisms driving aneurysm formation requires the development of specific animal models. We investigated if adventitial elastase application results in ascending aorta aneurysms in rats. METHODS Adult Lewis rats (n = 26) were anesthetized, their ascending aortas measured by transthoracic ultrasound, and exposed via median sternotomy. Elastase or saline was applied on the ascending aortic adventitia. Ascending aorta diameters were monitored by ultrasound at 10 and 30 days, when the animals were killed. Wall area was measured on orcein stained sections. Matrix metalloproteinase-2 and matrix metalloproteinase-9 levels were quantified on gelatin zymography. RESULTS Following elastase application, ascending aortic diameter increased at 10 and 30 days follow-up by 38% and 44%, respectively (P = .004). Despite thinning of the media secondary to vascular dilation, standardized medial area was not different between elastase-treated aortas and controls. Standardized total wall area had a significant increase in treated aortas compared with controls. Active matrix metalloproteinase-2 was significantly increased at 30 days in treated aortas, whereas active matrix metalloproteinase-9 was no different from controls. CONCLUSIONS Elastase application on rat ascending aortic adventitia produced aneurysms, creating a reproducible model. Aortic wall remodeling evolved toward an increase in total wall area, reproducing the main structural features of this disease in human beings.
Collapse
Affiliation(s)
- Narcis Costin Radu
- Surgical Research Center, Université Paris Est-Créteil, Créteil, France.
| | | | | | | | | | | | | |
Collapse
|
63
|
Durand E, Fournier B, Couty L, Lemitre M, Achouh P, Julia P, Trinquart L, Fabiani JN, Seguier S, Gogly B, Coulomb B, Lafont A. Endoluminal Gingival Fibroblast Transfer Reduces the Size of Rabbit Carotid Aneurisms via Elastin Repair. Arterioscler Thromb Vasc Biol 2012; 32:1892-901. [DOI: 10.1161/atvbaha.112.251439] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Eric Durand
- From the Université Paris Descartes, INSERM, Assistance Publique-Hôpitaux de Paris, Laboratoire de Recherche Bio-Chirurgicale Fondation Alain Carpentier (E.D., B.F., L.C., M.L., P.A., P.J., L.T., J.N.F., S.S., B.G., B.C., A.L.); INSERM UMR 970, PARCC, European Georges Pompidou Hospital (E.D., B.F., L.C., M.L., P.A., P.J., J.N.F., S.S., B.G., B.C., A.L.); and Unité de Recherche Clinique (L.T.), Paris, France
| | - Benjamin Fournier
- From the Université Paris Descartes, INSERM, Assistance Publique-Hôpitaux de Paris, Laboratoire de Recherche Bio-Chirurgicale Fondation Alain Carpentier (E.D., B.F., L.C., M.L., P.A., P.J., L.T., J.N.F., S.S., B.G., B.C., A.L.); INSERM UMR 970, PARCC, European Georges Pompidou Hospital (E.D., B.F., L.C., M.L., P.A., P.J., J.N.F., S.S., B.G., B.C., A.L.); and Unité de Recherche Clinique (L.T.), Paris, France
| | - Ludovic Couty
- From the Université Paris Descartes, INSERM, Assistance Publique-Hôpitaux de Paris, Laboratoire de Recherche Bio-Chirurgicale Fondation Alain Carpentier (E.D., B.F., L.C., M.L., P.A., P.J., L.T., J.N.F., S.S., B.G., B.C., A.L.); INSERM UMR 970, PARCC, European Georges Pompidou Hospital (E.D., B.F., L.C., M.L., P.A., P.J., J.N.F., S.S., B.G., B.C., A.L.); and Unité de Recherche Clinique (L.T.), Paris, France
| | - Mathilde Lemitre
- From the Université Paris Descartes, INSERM, Assistance Publique-Hôpitaux de Paris, Laboratoire de Recherche Bio-Chirurgicale Fondation Alain Carpentier (E.D., B.F., L.C., M.L., P.A., P.J., L.T., J.N.F., S.S., B.G., B.C., A.L.); INSERM UMR 970, PARCC, European Georges Pompidou Hospital (E.D., B.F., L.C., M.L., P.A., P.J., J.N.F., S.S., B.G., B.C., A.L.); and Unité de Recherche Clinique (L.T.), Paris, France
| | - Paul Achouh
- From the Université Paris Descartes, INSERM, Assistance Publique-Hôpitaux de Paris, Laboratoire de Recherche Bio-Chirurgicale Fondation Alain Carpentier (E.D., B.F., L.C., M.L., P.A., P.J., L.T., J.N.F., S.S., B.G., B.C., A.L.); INSERM UMR 970, PARCC, European Georges Pompidou Hospital (E.D., B.F., L.C., M.L., P.A., P.J., J.N.F., S.S., B.G., B.C., A.L.); and Unité de Recherche Clinique (L.T.), Paris, France
| | - Pierre Julia
- From the Université Paris Descartes, INSERM, Assistance Publique-Hôpitaux de Paris, Laboratoire de Recherche Bio-Chirurgicale Fondation Alain Carpentier (E.D., B.F., L.C., M.L., P.A., P.J., L.T., J.N.F., S.S., B.G., B.C., A.L.); INSERM UMR 970, PARCC, European Georges Pompidou Hospital (E.D., B.F., L.C., M.L., P.A., P.J., J.N.F., S.S., B.G., B.C., A.L.); and Unité de Recherche Clinique (L.T.), Paris, France
| | - Ludovic Trinquart
- From the Université Paris Descartes, INSERM, Assistance Publique-Hôpitaux de Paris, Laboratoire de Recherche Bio-Chirurgicale Fondation Alain Carpentier (E.D., B.F., L.C., M.L., P.A., P.J., L.T., J.N.F., S.S., B.G., B.C., A.L.); INSERM UMR 970, PARCC, European Georges Pompidou Hospital (E.D., B.F., L.C., M.L., P.A., P.J., J.N.F., S.S., B.G., B.C., A.L.); and Unité de Recherche Clinique (L.T.), Paris, France
| | - Jean Noel Fabiani
- From the Université Paris Descartes, INSERM, Assistance Publique-Hôpitaux de Paris, Laboratoire de Recherche Bio-Chirurgicale Fondation Alain Carpentier (E.D., B.F., L.C., M.L., P.A., P.J., L.T., J.N.F., S.S., B.G., B.C., A.L.); INSERM UMR 970, PARCC, European Georges Pompidou Hospital (E.D., B.F., L.C., M.L., P.A., P.J., J.N.F., S.S., B.G., B.C., A.L.); and Unité de Recherche Clinique (L.T.), Paris, France
| | - Sylvie Seguier
- From the Université Paris Descartes, INSERM, Assistance Publique-Hôpitaux de Paris, Laboratoire de Recherche Bio-Chirurgicale Fondation Alain Carpentier (E.D., B.F., L.C., M.L., P.A., P.J., L.T., J.N.F., S.S., B.G., B.C., A.L.); INSERM UMR 970, PARCC, European Georges Pompidou Hospital (E.D., B.F., L.C., M.L., P.A., P.J., J.N.F., S.S., B.G., B.C., A.L.); and Unité de Recherche Clinique (L.T.), Paris, France
| | - Bruno Gogly
- From the Université Paris Descartes, INSERM, Assistance Publique-Hôpitaux de Paris, Laboratoire de Recherche Bio-Chirurgicale Fondation Alain Carpentier (E.D., B.F., L.C., M.L., P.A., P.J., L.T., J.N.F., S.S., B.G., B.C., A.L.); INSERM UMR 970, PARCC, European Georges Pompidou Hospital (E.D., B.F., L.C., M.L., P.A., P.J., J.N.F., S.S., B.G., B.C., A.L.); and Unité de Recherche Clinique (L.T.), Paris, France
| | - Bernard Coulomb
- From the Université Paris Descartes, INSERM, Assistance Publique-Hôpitaux de Paris, Laboratoire de Recherche Bio-Chirurgicale Fondation Alain Carpentier (E.D., B.F., L.C., M.L., P.A., P.J., L.T., J.N.F., S.S., B.G., B.C., A.L.); INSERM UMR 970, PARCC, European Georges Pompidou Hospital (E.D., B.F., L.C., M.L., P.A., P.J., J.N.F., S.S., B.G., B.C., A.L.); and Unité de Recherche Clinique (L.T.), Paris, France
| | - Antoine Lafont
- From the Université Paris Descartes, INSERM, Assistance Publique-Hôpitaux de Paris, Laboratoire de Recherche Bio-Chirurgicale Fondation Alain Carpentier (E.D., B.F., L.C., M.L., P.A., P.J., L.T., J.N.F., S.S., B.G., B.C., A.L.); INSERM UMR 970, PARCC, European Georges Pompidou Hospital (E.D., B.F., L.C., M.L., P.A., P.J., J.N.F., S.S., B.G., B.C., A.L.); and Unité de Recherche Clinique (L.T.), Paris, France
| |
Collapse
|
64
|
Cardoso S, Robertson SP, Daniel PB. TGFBR1 mutations associated with Loeys-Dietz syndrome are inactivating. J Recept Signal Transduct Res 2012; 32:150-5. [PMID: 22414221 DOI: 10.3109/10799893.2012.664553] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
To assess the effect of Loeys-Dietz syndrome (LDS) mutations affecting TGFΒR1 a selection of seven disease-associated amino acid substitutions were introduced into wild type TGFβR1 and constitutively active TGFβR1(T204D). Receptor function was tested by co-transfection with a luciferase reporter or EGFP-tagged SMAD2 in HEK293 cells. All of the mutations were found to be inactivating for canonical TGF-β signaling. Differences in residual activity were not found to correlate with disease subtype. In co-transfection experiments with equal amounts wild-type receptor, the LDS mutations were found to confer a modest dominant negative effect. These results are discussed in relation to LDS and the related Marfan syndrome.
Collapse
Affiliation(s)
- Sarah Cardoso
- Department of Women's and Children's Health, Dunedin School of Medicine, Otago University, Dunedin, New Zealand
| | | | | |
Collapse
|
65
|
Bashur CA, Venkataraman L, Ramamurthi A. Tissue engineering and regenerative strategies to replicate biocomplexity of vascular elastic matrix assembly. TISSUE ENGINEERING PART B-REVIEWS 2012; 18:203-17. [PMID: 22224468 DOI: 10.1089/ten.teb.2011.0521] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Cardiovascular tissues exhibit architecturally complex extracellular matrices, of which the elastic matrix forms a major component. The elastic matrix critically maintains native structural configurations of vascular tissues, determines their ability to recoil after stretch, and regulates cell signaling pathways involved in morphogenesis, injury response, and inflammation via biomechanical transduction. The ability to tissue engineer vascular replacements that incorporate elastic matrix superstructures unique to cardiac and vascular tissues is thus important to maintaining vascular homeostasis. However, the vascular elastic matrix is particularly difficult to tissue engineer due to the inherently poor ability of adult vascular cells to synthesize elastin precursors and organize them into mature structures in a manner that replicates the biocomplexity of elastic matrix assembly during development. This review discusses current tissue engineering materials (e.g., growth factors and scaffolds) and methods (e.g., dynamic stretch and contact guidance) used to promote cellular synthesis and assembly of elastic matrix superstructures, and the limitations of these approaches when applied to smooth muscle cells, the primary elastin-generating cell type in vascular tissues. The potential application of these methods for in situ regeneration of disrupted elastic matrix at sites of proteolytic vascular disease (e.g., abdominal aortic aneurysms) is also discussed. Finally, the review describes the potential utility of alternative cell types to elastic tissue engineering and regenerative matrix repair. Future progress in the field is contingent on developing a thorough understanding of developmental elastogenesis and then mimicking the spatiotemporal changes in the cellular microenvironment that occur during that phase. This will enable us to tissue engineer clinically applicable elastic vascular tissue replacements and to develop elastogenic therapies to restore homeostasis in de-elasticized vessels.
Collapse
Affiliation(s)
- Chris A Bashur
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, Ohio, USA
| | | | | |
Collapse
|
66
|
Maegdefessel L, Azuma J, Toh R, Merk DR, Deng A, Chin JT, Raaz U, Schoelmerich AM, Raiesdana A, Leeper NJ, McConnell MV, Dalman RL, Spin JM, Tsao PS. Inhibition of microRNA-29b reduces murine abdominal aortic aneurysm development. J Clin Invest 2012; 122:497-506. [PMID: 22269326 DOI: 10.1172/jci61598] [Citation(s) in RCA: 227] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2011] [Accepted: 12/14/2011] [Indexed: 12/19/2022] Open
Abstract
MicroRNAs (miRs) regulate gene expression at the posttranscriptional level and play crucial roles in vascular integrity. As such, they may have a role in modifying abdominal aortic aneurysm (AAA) expansion, the pathophysiological mechanisms of which remain incompletely explored. Here, we investigate the role of miRs in 2 murine models of experimental AAA: the porcine pancreatic elastase (PPE) infusion model in C57BL/6 mice and the AngII infusion model in Apoe-/- mice. AAA development was accompanied by decreased aortic expression of miR-29b, along with increased expression of known miR-29b targets, Col1a1, Col3a1, Col5a1, and Eln, in both models. In vivo administration of locked nucleic acid anti-miR-29b greatly increased collagen expression, leading to an early fibrotic response in the abdominal aortic wall and resulting in a significant reduction in AAA progression over time in both models. In contrast, overexpression of miR-29b using a lentiviral vector led to augmented AAA expansion and significant increase of aortic rupture rate. Cell culture studies identified aortic fibroblasts as the likely vascular cell type mediating the profibrotic effects of miR-29b modulation. A similar pattern of reduced miR-29b expression and increased target gene expression was observed in human AAA tissue samples compared with that in organ donor controls. These data suggest that therapeutic manipulation of miR-29b and its target genes holds promise for limiting AAA disease progression and protecting from rupture.
Collapse
Affiliation(s)
- Lars Maegdefessel
- Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
67
|
Long term stabilization of expanding aortic aneurysms by a short course of cyclosporine A through transforming growth factor-beta induction. PLoS One 2011; 6:e28903. [PMID: 22194945 PMCID: PMC3237613 DOI: 10.1371/journal.pone.0028903] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2011] [Accepted: 11/16/2011] [Indexed: 01/14/2023] Open
Abstract
Abdominal aortic aneurysms (AAAs) expand as a consequence of extracellular matrix destruction, and vascular smooth muscle cell (VSMC) depletion. Transforming growth factor (TGF)-beta 1 overexpression stabilizes expanding AAAs in rat. Cyclosporine A (CsA) promotes tissue accumulation and induces TGF -beta1 and, could thereby exert beneficial effects on AAA remodelling and expansion. In this study, we assessed whether a short administration of CsA could durably stabilize AAAs through TGF-beta induction. We showed that CsA induced TGF-beta1 and decreased MMP-9 expression dose-dependently in fragments of human AAAs in vitro, and in animal models of AAA in vivo. CsA prevented AAA formation at 14 days in the rat elastase (diameter increase: CsA: 131.9±44.2%; vehicle: 225.9±57.0%, P = 0.003) and calcium chloride mouse models (diameters: CsA: 0.72±0.14 mm; vehicle: 1.10±0.11 mm, P = .008), preserved elastic fiber network and VSMC content, and decreased inflammation. A seven day administration of CsA stabilized formed AAAs in rats seven weeks after drug withdrawal (diameter increase: CsA: 14.2±15.1%; vehicle: 45.2±13.7%, P = .017), down-regulated wall inflammation, and increased αSMA-positive cell content. Co-administration of a blocking anti-TGF-beta antibody abrogated CsA impact on inflammation, αSMA-positive cell accumulation and diameter control in expanding AAAs. Our study demonstrates that pharmacological induction of TGF-beta1 by a short course of CsA administration represents a new approach to induce aneurysm stabilization by shifting the degradation/repair balance towards healing.
Collapse
|
68
|
Zhang F, Banker G, Liu X, Suwanabol PA, Lengfeld J, Yamanouchi D, Kent KC, Liu B. The novel function of advanced glycation end products in regulation of MMP-9 production. J Surg Res 2011; 171:871-6. [PMID: 20638679 PMCID: PMC3623272 DOI: 10.1016/j.jss.2010.04.027] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2010] [Revised: 03/26/2010] [Accepted: 04/15/2010] [Indexed: 10/19/2022]
Abstract
BACKGROUND Advanced glycation end products (AGEs), formed from proteins and peptides by nonenzymatic glycoxidation after contact with aldose sugars, have been implicated in the pathogenesis of age-related cardiac and vascular dysfunction. Our previous study demonstrated significantly elevated levels of AGE and the receptor for AGE (RAGE) in human abdominal aortic aneurysm (AAA) tissues. Inhibition of AGE signaling by targeted gene deletion of RAGE markedly reduced the development of aneurysm in a mouse model of AAA. We also showed that AGE may stimulate aneurysm formation by promoting metalloproteinase (MMP)-9 expression. In this study, we investigated the molecular mechanism underlying this novel function of AGE. METHODS The murine macrophage cell line RAW 264.7 was pretreated with AGE, TGF-β, and MAPK inhibitors. The protein was collected for Western blot analysis. Culture supernatants were collected to determine MMP-9 activity by gelatin zymography. RESULTS We found that AGE induced the production of MMP-9 in macrophages in a dose-dependent manner. This induction of MMP-9 was markedly diminished by pretreatment with TGF-β. To delineate the underlying molecular mechanism, we showed that AGE increased phosphorylation of p44/42 ERK, p38, JNK, and PI3K in macrophages. Moreover, AGE induced active p65 subunit of NF- κB. Inhibition of ERK (UO126) or p38 (SB203580), but not PI3K (LY294002 or wortmannin), blocked AGE-induced MMP-9 expression. In contrast, inhibition of JNK (SP-600125) significantly enhanced the stimulatory effect of AGE on MMP-9. Furthermore, TGF-β suppressed AGE-induced expression of the active p65 subunit of NF-κB. CONCLUSIONS Our data indicate that AGE induces MMP-9 through activation of ERK, p38 mitogen-activated protein and NF-κB, a pathway that is antagonized by TGF-β. This finding in conjunction with previously reported AGE functions in inflammation suggests that anti-AGE therapies could be effective in the prevention of human AAA development and progression.
Collapse
Affiliation(s)
- Fan Zhang
- Department of Surgery, Division of Vascular Surgery, University of Wisconsin School of Medicine, Madison, Wisconsin
| | - Greg Banker
- Department of Surgery, Division of Vascular Surgery, University of Wisconsin School of Medicine, Madison, Wisconsin
| | - Xiaodong Liu
- Department of Surgery, Division of Vascular Surgery, University of Wisconsin School of Medicine, Madison, Wisconsin
| | - Pasithorn A. Suwanabol
- Department of Surgery, Division of Vascular Surgery, University of Wisconsin School of Medicine, Madison, Wisconsin
| | - Justin Lengfeld
- Department of Surgery, Division of Vascular Surgery, University of Wisconsin School of Medicine, Madison, Wisconsin
| | - Dai Yamanouchi
- Department of Surgery, Division of Vascular Surgery, University of Wisconsin School of Medicine, Madison, Wisconsin
| | - K. Craig Kent
- Department of Surgery, Division of Vascular Surgery, University of Wisconsin School of Medicine, Madison, Wisconsin
| | - Bo Liu
- Department of Surgery, Division of Vascular Surgery, University of Wisconsin School of Medicine, Madison, Wisconsin
| |
Collapse
|
69
|
Bashur CA, Ramamurthi A. Aligned electrospun scaffolds and elastogenic factors for vascular cell-mediated elastic matrix assembly. J Tissue Eng Regen Med 2011; 6:673-86. [PMID: 21953981 DOI: 10.1002/term.470] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2011] [Revised: 04/16/2011] [Accepted: 07/05/2011] [Indexed: 12/24/2022]
Abstract
Strategies to enhance the production of organized elastic matrix by smooth muscle cells (SMCs) are critical in engineering functional vascular conduits. Therefore, the goal of this study was to determine the effect of different surfaces, i.e. random and aligned electrospun poly(ε-caprolactone) meshes and two-dimensional (2D) controls, and exogenous elastogenic factors on the cultured rat aortic SMC phenotype and production of extracellular matrix. This study demonstrated that aligned electrospun fibres guide cell alignment, induce a more elongated cell morphology and promote a more synthetic phenotype. Importantly, these cells produced greater amounts of elastin-rich matrix per cell on the electrospun scaffolds. In addition, exogenous elastogenic factors severely limited rat aortic smooth muscle cells (RASMCs) proliferation and promoted a more synthetic SMC phenotype on electrospun meshes, but they had less effect on 2D controls. Finally, the elastogenic factors induced the SMCs to generate more matrix collagen and elastin on a per cell basis. Together, these results demonstrate the elastogenic benefits of electrospun meshes.
Collapse
Affiliation(s)
- Chris A Bashur
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH, USA
| | - Anand Ramamurthi
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH, USA.,Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA.,Department of Bioengineering, Clemson University, Clemson, SC, USA
| |
Collapse
|
70
|
Alvira CM, Guignabert C, Kim YM, Chen C, Wang L, Duong TT, Yeung RSM, Li DY, Rabinovitch M. Inhibition of transforming growth factor β worsens elastin degradation in a murine model of Kawasaki disease. THE AMERICAN JOURNAL OF PATHOLOGY 2011; 178:1210-20. [PMID: 21356372 DOI: 10.1016/j.ajpath.2010.11.054] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2010] [Revised: 11/03/2010] [Accepted: 11/09/2010] [Indexed: 12/13/2022]
Abstract
Kawasaki disease (KD) is an acute inflammatory illness marked by coronary arteritis. However, the factors increasing susceptibility to coronary artery lesions are unknown. Because transforming growth factor (TGF) β increases elastin synthesis and suppresses proteolysis, we hypothesized that, in contrast to the benefit observed in aneurysms forming in those with Marfan syndrome, inhibition of TGF-β would worsen inflammatory-induced coronary artery lesions. By using a murine model of KD in which injection of Lactobacillus casei wall extract (LCWE) induces coronary arteritis, we show that LCWE increased TGF-β signaling in the coronary smooth muscle cells beginning at 2 days and continuing through 14 days, the point of peak coronary inflammation. By 42 days, LCWE caused fragmentation of the internal and external elastic lamina. Blocking TGF-β by administration of a neutralizing antibody accentuated the LCWE-mediated fragmentation of elastin and induced an overall loss of medial elastin without increasing the inflammatory response. We attributed these increased pathological characteristics to a reduction in the proteolytic inhibitor, plasminogen activator inhibitor-1, and an associated threefold increase in matrix metalloproteinase 9 activity compared with LCWE alone. Therefore, our data demonstrate that in the coronary arteritis associated with KD, TGF-β suppresses elastin degradation by inhibiting plasmin-mediated matrix metalloproteinase 9 activation. Thus, strategies to block TGF-β, used in those with Marfan syndrome, are unlikely to be beneficial and could be detrimental.
Collapse
Affiliation(s)
- Cristina M Alvira
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California 94305-5162, USA
| | | | | | | | | | | | | | | | | |
Collapse
|
71
|
Ong KT, Perdu J, De Backer J, Bozec E, Collignon P, Emmerich J, Fauret AL, Fiessinger JN, Germain DP, Georgesco G, Hulot JS, De Paepe A, Plauchu H, Jeunemaitre X, Laurent S, Boutouyrie P. Effect of celiprolol on prevention of cardiovascular events in vascular Ehlers-Danlos syndrome: a prospective randomised, open, blinded-endpoints trial. Lancet 2010; 376:1476-84. [PMID: 20825986 DOI: 10.1016/s0140-6736(10)60960-9] [Citation(s) in RCA: 231] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Vascular Ehlers-Danlos syndrome is a rare severe disease that causes arterial dissections and ruptures that can lead to early death. No preventive treatment has yet been validated. Our aim was to assess the ability of celiprolol, a β(1)-adrenoceptor antagonist with a β(2)-adrenoceptor agonist action, to prevent arterial dissections and ruptures in vascular Ehlers-Danlos syndrome. METHODS Our study was a multicentre, randomised, open trial with blinded assessment of clinical events in eight centres in France and one in Belgium. Patients with clinical vascular Ehlers-Danlos syndrome were randomly assigned to 5 years of treatment with celiprolol or to no treatment. Randomisation was done from a centralised, previously established list of sealed envelopes with stratification by patients' age (≤32 years or >32 years). 33 patients were positive for mutation of collagen 3A1 (COL3A1). Celiprolol was administered twice daily and uptritrated by 100 mg steps every 6 months to a maximum of 400 mg per day. [DOSAGE ERROR CORRECTED]. The primary endpoints were arterial events (rupture or dissection, fatal or not). This study is registered with ClinicalTrials.gov, number NCT00190411. FINDINGS 53 patients were randomly assigned to celiprolol (25 patients) or control groups (28). Mean duration of follow-up was 47 (SD 5) months, with the trial stopped early for treatment benefit. The primary endpoints were reached by five (20%) in the celiprolol group and by 14 (50%) controls (hazard ratio [HR] 0·36; 95% CI 0·15-0·88; p=0·040). Adverse events were severe fatigue in one patient after starting 100 mg celiprolol and mild fatigue in two patients related to dose uptitration. INTERPRETATION We suggest that celiprolol might be the treatment of choice for physicians aiming to prevent major complications in patients with vascular Ehlers-Danlos syndrome. Whether patients with similar clinical presentations and no mutation are also protected remains to be established. FUNDING French Ministry of Health, Programme Hospitalier de Recherche Clinique 2001.
Collapse
Affiliation(s)
- Kim-Thanh Ong
- Assistance Publique, Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
72
|
Forte A, Della Corte A, De Feo M, Cerasuolo F, Cipollaro M. Role of myofibroblasts in vascular remodelling: focus on restenosis and aneurysm. Cardiovasc Res 2010; 88:395-405. [PMID: 20621923 DOI: 10.1093/cvr/cvq224] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Myofibroblasts (MFs) are contractile cells deriving from a multiplicity of resident cells and/or circulating progenitors that are known to play a key role in wound healing. They were first discovered and analysed in the early 1970s in granulation tissue. Since their first identification, the role of MF and their mechanisms of differentiation have been highlighted in a number of diseases, including organ fibrosis and tumours, with particular attention devoted to the liver, kidney, and pulmonary fibrosis. The aim of this review is to summarize the current evidence for the role played by MFs in two frequent vascular diseases related to the remodelling of the vascular wall: the different forms of arterial restenosis and the most common forms of thoracic aortic aneurysm. The in-depth knowledge of the molecular pathways involved in MF differentiation, contraction, and survival/apoptosis could contribute to the identification of novel therapeutic strategies for anti-fibrotic and anti-remodelling therapy of vascular diseases in which these cells are involved.
Collapse
Affiliation(s)
- Amalia Forte
- Department of Experimental Medicine, Excellence Research Centre for Cardiovascular Diseases, Second University of Naples, Via L. De Crecchio, 7, 80138 Naples, Italy.
| | | | | | | | | |
Collapse
|
73
|
Michineau S, Dai J, Gervais M, Zidi M, Clowes AW, Becquemin JP, Michel JB, Allaire E. Aortic length changes during abdominal aortic aneurysm formation, expansion and stabilisation in a rat model. Eur J Vasc Endovasc Surg 2010; 40:468-74. [PMID: 20554458 DOI: 10.1016/j.ejvs.2010.05.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2010] [Accepted: 05/05/2010] [Indexed: 11/17/2022]
Abstract
BACKGROUND Determinants of extracellular matrix (ECM) destruction/reconstruction balance influencing abdominal aortic aneurysm (AAA) diameter may impact length. OBJECTIVE Document aortic lengthening, its correlation to diameter, and determine how treatments that impact diameter also affect length. METHODS Three hundred and fifty-five diameter and length measurements were performed in 308 rats during AAA formation, expansion and stabilisation in guinea pig aortas xenografted in rats. Impact of modulation of ECM destructive/reconstructive balance by endovascular Vascular Smooth Muscle Cell (VSMCs) seeding, TIMP-1, PAI-1 and TGF-beta1 overexpression on length has been assessed. RESULTS Length increased in correlation with diameter during formation (correlation coefficient (cc): 0.584, P<0.0001) and expansion (cc: 0.352, P=0.0055) of AAAs. Overexpression of TIMP-1 and PAI-1 decreased lengthening (P=0.02 and 0.014, respectively) demonstrating that elongation is driven by matrix metalloproteinases and their activation by the plasmin pathway. Overexpression of TGF-beta1 controlled length in formed AAAs (17.3 ± 9.6 vs. 5.9 ± 7.4mm, P=0.022), but not VSMC seeding, although both therapies efficiently prevented further diameter increase. Length and diameter correlation was lost after biotherapies. CONCLUSION Length increases in correlation with diameter during AAA formation and expansion, as a consequence of ECM injury driven by MMPs activated by the plasmin pathway. Correlation between length and diameter increases is not universally preserved.
Collapse
MESH Headings
- Analysis of Variance
- Animals
- Aorta, Abdominal/metabolism
- Aorta, Abdominal/pathology
- Aorta, Abdominal/surgery
- Aortic Aneurysm, Abdominal/metabolism
- Aortic Aneurysm, Abdominal/pathology
- Aortic Aneurysm, Abdominal/surgery
- Disease Models, Animal
- Extracellular Matrix/pathology
- Guinea Pigs
- Muscle, Smooth, Vascular/cytology
- Plasminogen Activator Inhibitor 1/metabolism
- Rats
- Statistics, Nonparametric
- Tissue Inhibitor of Metalloproteinase-1/metabolism
- Transforming Growth Factor beta1/metabolism
Collapse
Affiliation(s)
- S Michineau
- CNRS EAC 7054, Centre de Recherches Chirurgicales Dominique Chopin, University Paris, 12 Val de Marne, 8 Rue du Général Sarrail, 94010 Créteil Cedex, France
| | | | | | | | | | | | | | | |
Collapse
|
74
|
Cho BS, Roelofs KJ, Ford JW, Henke PK, Upchurch GR. Decreased collagen and increased matrix metalloproteinase-13 in experimental abdominal aortic aneurysms in males compared with females. Surgery 2010; 147:258-67. [PMID: 19767051 PMCID: PMC3017342 DOI: 10.1016/j.surg.2009.06.047] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2009] [Accepted: 06/29/2009] [Indexed: 12/30/2022]
Abstract
BACKGROUND This study examined differences in sex in collagen regulation during rodent experimental abdominal aortic aneurysm formation. METHODS Infrarenal aortas of male and female rats were perfused with elastase or saline (control). Aortic diameters were measured at baseline (day 0) and on postoperative days 7 and 14. Transforming growth factor-beta 1, collagen subtypes I and III, and matrix metalloproteinase-13 (MMP-13; collagenase-3) expression and/or protein levels from aortic tissue were determined by real-time reverse transcription polymerase chain reaction and Western blotting. Aortic tissue was stained for total collagen, neutrophils, and macrophages using immunohistochemistry on days 4 and 7. RESULTS At 7 and 14 days after perfusion, aortic diameter increased in elastase-perfused males compared with females (P < .001 for each). At 4 and 7 days postperfusion, significantly more neutrophils and macrophages were present in elastase-perfused males compared with females. By 7 days postperfusion, protein levels of transforming growth factor-beta 1 were less in males compared with females (P = .04). Type I collagen levels also decreased on days 7 (P < .001) and 14 (P = .002), and type III collagen levels decreased on days 7 (P < .001) and 14 (P < .001) in males compared with females. With Masson's trichrome stain, less adventitial collagen was observed in the elastase-perfused males compared with females. MMP-13 expression (P < .001) and protein levels (P = .006) in elastase-perfused males were greater than females on day 14. CONCLUSION This study documents a decrease in types I and III collagen with a concurrent increase in MMP-13 after elastase perfusion in males compared with females. These data suggest that alterations in extracellular matrix collagen turnover may be responsible for altered abdominal aortic aneurysm formation between sexes.
Collapse
Affiliation(s)
- Brenda S Cho
- Conrad Jobst Vascular Surgery Research Laboratories, Section of Vascular Surgery, Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | | | | | | | | |
Collapse
|
75
|
Wang Y, Ait-Oufella H, Herbin O, Bonnin P, Ramkhelawon B, Taleb S, Huang J, Offenstadt G, Combadière C, Rénia L, Johnson JL, Tharaux PL, Tedgui A, Mallat Z. TGF-beta activity protects against inflammatory aortic aneurysm progression and complications in angiotensin II-infused mice. J Clin Invest 2010; 120:422-32. [PMID: 20101093 DOI: 10.1172/jci38136] [Citation(s) in RCA: 320] [Impact Index Per Article: 22.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2008] [Accepted: 11/04/2009] [Indexed: 12/16/2022] Open
Abstract
Complicated abdominal aortic aneurysm (AAA) is a major cause of mortality in elderly men. Ang II-dependent TGF-beta activity promotes aortic aneurysm progression in experimental Marfan syndrome. However, the role of TGF-beta in experimental models of AAA has not been comprehensively assessed. Here, we show that systemic neutralization of TGF-beta activity breaks the resistance of normocholesterolemic C57BL/6 mice to Ang II-induced AAA formation and markedly increases their susceptibility to the disease. These aneurysms displayed a large spectrum of complications on echography, including fissuration, double channel formation, and rupture, leading to death from aneurysm complications. The disease was refractory to inhibition of IFN-gamma, IL-4, IL-6, or TNF-alpha signaling. Genetic deletion of T and B cells or inhibition of the CX3CR1 pathway resulted in partial protection. Interestingly, neutralization of TGF-beta activity enhanced monocyte invasiveness, and monocyte depletion markedly inhibited aneurysm progression and complications. Finally, TGF-beta neutralization increased MMP-12 activity, and MMP-12 deficiency prevented aneurysm rupture. These results clearly identify a critical role for TGF-beta in the taming of the innate immune response and the preservation of vessel integrity in C57BL/6 mice, which contrasts with its reported pathogenic role in Marfan syndrome.
Collapse
Affiliation(s)
- Yu Wang
- INSERM U970, Paris Cardiovascular Research Center, Université Paris-Descartes and Assistance Publique-Hôpitaux de Paris, Paris, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
76
|
Ailawadi G, Moehle CW, Pei H, Walton SP, Yang Z, Kron IL, Lau CL, Owens GK. Smooth muscle phenotypic modulation is an early event in aortic aneurysms. J Thorac Cardiovasc Surg 2009; 138:1392-9. [PMID: 19931668 DOI: 10.1016/j.jtcvs.2009.07.075] [Citation(s) in RCA: 224] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2009] [Revised: 06/30/2009] [Accepted: 07/29/2009] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Vascular smooth muscle cells can undergo profound changes in phenotype, defined by coordinated repression of smooth muscle cell marker genes and production of matrix metalloproteinases in response to injury. However, little is known of the role of smooth muscle cells in aortic aneurysms. We hypothesized that smooth muscle cells undergo phenotypic modulation early in the development of aortic aneurysms. METHODS Abdominal aortas from C57B6 mice (n = 79) were perfused with elastase or saline (control) and harvested at 1, 3, 7, or 14 days. Aortas were analyzed by means of quantitative polymerase chain reaction and immunohistochemistry for smooth muscle cell marker genes, including SM22A, smooth muscle alpha-actin, and matrix metalloproteinases 2 and 9. In complimentary experiments human aneurysms (n = 10) and control aorta (n = 10) were harvested at the time of surgical intervention and analyzed. RESULTS By 14 days, aortic diameter was larger after elastase perfusion compared with control diameter (100% +/- 9.6% vs 59.5% +/- 18.9%, P = .0002). At 7 days, elastase-perfused mice had a 78% and 85% reduction in SM22 alpha and smooth muscle alpha-actin expression, respectively, compared with that seen in control animals well before aneurysms were present, and these values remained repressed at 14 days. Immunohistochemistry confirmed less SM22 alpha and smooth muscle alpha-actin in experimental aneurysms at 14 days in concert with increased matrix metalloproteinase 2 and 9 expression at 7 and 14 days. Similarly, human aneurysms had less SM22 alpha and smooth muscle alpha-actin and increased matrix metalloproteinase 2 and 9 staining, compared with control values, as determined by means of quantitative polymerase chain reaction. CONCLUSIONS Aneurysms demonstrate smooth muscle cell phenotypic modulation characterized by downregulation of smooth muscle cell marker genes and upregulation of matrix metalloproteinases. These events in experimental models occur before aneurysm formation. Targeting smooth muscle cells to a reparative phenotype might provide a novel therapy in the treatment of aortic aneurysms.
Collapse
Affiliation(s)
- Gorav Ailawadi
- Department of Surgery, University of Virginia, Charlottesville, VA 22908, USA.
| | | | | | | | | | | | | | | |
Collapse
|
77
|
Thompson AR, Cooper JA, Jones GT, Drenos F, van Bockxmeer FM, Biros E, Walker PJ, van Rij AM, Golledge J, Norman PE, Hafez H, Humphries SE. Assessment of the association between genetic polymorphisms in transforming growth factor beta, and its binding protein (LTBP), and the presence, and expansion, of Abdominal Aortic Aneurysm. Atherosclerosis 2009; 209:367-73. [PMID: 19897194 DOI: 10.1016/j.atherosclerosis.2009.09.073] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2009] [Revised: 09/08/2009] [Accepted: 09/26/2009] [Indexed: 12/22/2022]
Abstract
OBJECTIVES Abdominal Aortic Aneurysm (AAA) has a strong genetic predisposition. Transforming growth factor beta 1 (TGF-beta1) is a causal factor in ascending aortic dilatation; however, a role in AAA pathology is unclear. The aim of the study was to determine whether genes coding TGF-beta and its binding protein are associated with the presence and expansion of AAA. METHODS Four geographically distinct case control studies, totaling 1890 AAA cases and 3785 controls, were genotyped and compared to the presence, size and growth rate of AAA. 26 single nucleotide polymorphisms (SNPs) in 5 genes were genotyped in the UK cohort and the result was replicated in 3 independent cohorts. RESULTS No associations between genotypes or haplotypes and the presence of AAA disease were confirmed. Five SNPs in Latent TGF-beta Binding Protein (LTBP4) and an allelic variant of TGFB3 were associated with a significant decrease in AAA growth (p< or =0.02), in the UK cohort. Altered growth was demonstrated in carriers of two common haplotypes of LTBP4 (+0.38 mm/year, p=0.003; -0.41 mm/year, p=0.02, per haplotype copy) and a single haplotype of TGFB3 (-0.53 mm/year, p=0.05). This association with AAA growth could not be demonstrated in two other independent cohorts. Meta-analysis of AAA size and growth rates in larger AAA (> or =45 mm), in all four cohorts, demonstrated a significant association with the LTBP4 21011A>T genotype (a 2% decrease in AAA diameter, or a 0.53 mm/year reduction in AAA growth rate, per T allele [p=0.03, p=0.01]). CONCLUSION This study suggests that the LTBP4 gene may contribute to AAA progression.
Collapse
Affiliation(s)
- Andrew R Thompson
- The Centre for Cardiovascular Genetics, British Heart Foundation Laboratories, Royal Free and University College London Medical School, UK
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
78
|
|
79
|
Baas AF, Medic J, van 't Slot R, de Kovel CG, Zhernakova A, Geelkerken RH, Kranendonk SE, van Sterkenburg SM, Grobbee DE, Boll AP, Wijmenga C, Blankensteijn JD, Ruigrok YM. Association of the TGF-beta receptor genes with abdominal aortic aneurysm. Eur J Hum Genet 2009; 18:240-4. [PMID: 19672284 DOI: 10.1038/ejhg.2009.141] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Abdominal aortic aneurysm (AAA) is a multifactorial condition. The transforming growth factor beta (TGF-beta) pathway regulates vascular remodeling and mutations in its receptor genes, TGFBR1 and TGFBR2, cause syndromes with thoracic aortic aneurysm (TAA). The TGF-beta pathway may be involved in aneurysm development in general. We performed an association study by analyzing all the common genetic variants in TGFBR1 and TGFBR2 using tag single nucleotide polymorphisms (SNPs) in a Dutch AAA case-control population in a two-stage genotyping approach. In stage 1, analyzing 376 cases and 648 controls, three of the four TGFBR1 SNPs and nine of the 28 TGFBR2 SNPs had a P<0.07. Genotyping of these SNPs in an independent cohort of 360 cases and 376 controls in stage 2 confirmed association (P<0.05) for the same allele of one SNP in TGFBR1 and two SNPs in TGFBR2. Joint analysis of the 736 cases and 1024 controls showed statistically significant associations of these SNPs, which sustained after proper correction for multiple testing (TGFBR1 rs1626340 OR 1.32 95% CI 1.11-1.56 P=0.001 and TGFBR2 rs1036095 OR 1.32 95% CI 1.12-1.54 P=0.001 and rs4522809 OR 1.28 95% CI 1.12-1.46 P=0.0004). We conclude that genetic variations in TGFBR1 and TGFBR2 associate with AAA in the Dutch population. This suggests that AAA may develop partly by similar defects as TAA, which in the future may provide novel therapeutic options.
Collapse
Affiliation(s)
- A F Baas
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
80
|
Churchman AT, Anwar AA, Li FYL, Sato H, Ishii T, Mann GE, Siow RCM. Transforming growth factor-beta1 elicits Nrf2-mediated antioxidant responses in aortic smooth muscle cells. J Cell Mol Med 2009; 13:2282-2292. [PMID: 19674192 DOI: 10.1111/j.1582-4934.2009.00874.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The anti-inflammatory properties of transforming growth factor-beta(1) (TGF-beta(1)) account for its protection against atherosclerotic plaque rupture. This study investigates whether activation of the Nrf2 (nuclear factor erythroid 2 [NF-E2]-related factor 2) transcription pathway is involved in TGF-beta(1) mediated induction of the antioxidant enzyme heme oxygenase-1 (HO-1) in smooth muscle cells (SMC). Human aortic smooth muscle cells (HAoSMC) or wild-type and Nrf2-deficient mouse (MAoSMC) aortic SMC were treated with TGF-beta(1) (2.5-10 ng/ml, 0-24 hrs). We report the first evidence that TGF-beta(1) induces Nrf2 mediated HO-1 expression and antioxidant response element activity, which was paralleled by enhanced superoxide production and expression of the NAD(P)H oxidase subunit p22(phox). TGF-beta(1) failed to induce HO-1 expression in MAoSMC derived from Nrf2-deficient mice, and HO-1 induction by TGF-beta(1) in HAoSMC was attenuated by inhibition of extracellular signal regulated kinase or c-jun-N-terminal kinase but not p38 mitogen activated protein kinase. Inhibition of NAD(P)H oxidase or scavenging of superoxide diminished HO-1 induction in response to TGF-beta(1). The oxidative stress agents glucose oxidase (GOx) and diethylmaleate enhanced TGF-beta(1) generation and HO-1 expression in HAoSMC, while antagonism of TGF-beta(1) signalling by adenoviral Smad7 overexpression attenuated their induction of HO-1. Pre-treatment of HAoSMC with TGF-beta(1) reduced nuclear translocation of the pro-apoptotic mediator p53 elicited by GOx. Our findings demonstrate that Nrf2 is a new target of TGF-beta(1) signalling in the vasculature which may contribute to the atheroprotective properties attributed to this growth factor.
Collapse
Affiliation(s)
| | - Anila A Anwar
- Cardiovascular Division, School of Medicine, King's College London, UK
| | - Francois Y L Li
- Cardiovascular Division, School of Medicine, King's College London, UK
| | - Hideyo Sato
- Department of Bioresources, Faculty of Agriculture, Yamagata University, Tsuruoka, Japan
| | - Tetsuro Ishii
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tuskuba, Japan
| | - Giovanni E Mann
- Cardiovascular Division, School of Medicine, King's College London, UK
| | - Richard C M Siow
- Cardiovascular Division, School of Medicine, King's College London, UK
| |
Collapse
|
81
|
Jean Bachet. La cirugía de la aorta está muerta. ¡Larga vida a la cirugía de la aorta! CIRUGIA CARDIOVASCULAR 2009. [DOI: 10.1016/s1134-0096(09)70140-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
|
82
|
Golledge J, Clancy P, Jones GT, Cooper M, Palmer LJ, van Rij AM, Norman PE. Possible association between genetic polymorphisms in transforming growth factor beta receptors, serum transforming growth factor beta1 concentration and abdominal aortic aneurysm. Br J Surg 2009; 96:628-32. [PMID: 19434696 DOI: 10.1002/bjs.6633] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Previous studies have suggested a role for transforming growth factor (TGF) beta and its receptor in thoracic aortic aneurysm, but their role in abdominal aortic aneurysm (AAA) is unknown. This study examined the possible association between TGF-beta receptor 1 and 2 (TGFBR-1 and -2) single nucleotide polymorphisms (SNPs) and serum TGF-beta1 with AAA. METHODS Serum concentrations of TGF-beta1 and 58 SNPs for TGFBR-1 and -2 were examined in 1003 and 1711 men respectively from the Health In Men Study. Validation of SNPs was examined in a second referral cohort of 1043 subjects from New Zealand, of whom 654 had an AAA. RESULTS Serum TGF-beta1 was not associated with AAA. Only one SNP in TGFBR-2 was weakly associated with AAA; TGFBR2 g.42917C > T, SNP ID rs1078985CC; odds ratio 0.64 (95 per cent confidence interval (c.i.) 0.45 to 0.93); P = 0.020 uncorrected; but this association did not hold after adjusting for multiple testing and was not validated in the New Zealand cohort: odds ratio 0.98 (95 per cent c.i. 0.50 to 1.94); P = 0.960. CONCLUSION These findings suggest there is no important role of genetic polymorphisms in the main receptors for TGF-beta and circulating TGF-beta1 in AAA in older individuals. (c) 2009 British Journal of Surgery Society Ltd.
Collapse
Affiliation(s)
- J Golledge
- Vascular Biology Unit, School of Medicine, James Cook University, Townsville, Queensland, Australia.
| | | | | | | | | | | | | |
Collapse
|
83
|
Gomez D, Al Haj Zen A, Borges LF, Philippe M, Gutierrez PS, Jondeau G, Michel JB, Vranckx R. Syndromic and non-syndromic aneurysms of the human ascending aorta share activation of the Smad2 pathway. J Pathol 2009; 218:131-42. [PMID: 19224541 DOI: 10.1002/path.2516] [Citation(s) in RCA: 132] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Common features such as elastic fibre destruction, mucoid accumulation, and smooth muscle cell apoptosis are co-localized in aneurysms of the ascending aorta of various aetiologies. Recent experimental studies reported an activation of TGF-beta in aneurysms related to Marfan (and Loeys-Dietz) syndrome. Here we investigate TGF-beta signalling in normal and pathological human ascending aortic wall in syndromic and non-syndromic aneurysmal disease. Aneurysmal ascending aortic specimens, classified according to aetiology: syndromic MFS (n = 15, including two mutations in TGFBR2), associated with BAV (n = 15) or degenerative forms (n = 19), were examined. We show that the amounts of TGF-beta1 protein retained within and released by aneurysmal tissue were greater than for control aortic tissue, whatever the aetiology, contrasting with an unchanged TGF-beta1 mRNA level. The increase in stored TGF-beta1 was associated with enhanced LTBP-1 protein and mRNA levels. These dysregulations of the extracellular ligand are associated with higher phosphorylated Smad2 and Smad2 mRNA levels in the ascending aortic wall from all types of aneurysm. This activation correlated with the degree of elastic fibre fragmentation. Surprisingly, there was no consistent association between the nuclear location of pSmad2 and extracellular TGF-beta1 and LTBP-1 staining and between their respective mRNA expressions. In parallel, decorin was focally increased in aneurysmal media, whereas biglycan was globally decreased in aneurysmal aortas. In conclusion, this study highlights independent dysregulations of TGF-beta retention and Smad2 signalling in syndromic and non-syndromic aneurysms of the ascending aorta.
Collapse
|
84
|
New Insight in Aetiopathogenesis of Aortic Diseases. Eur J Vasc Endovasc Surg 2009; 37:531-7. [DOI: 10.1016/j.ejvs.2009.02.002] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2009] [Accepted: 02/04/2009] [Indexed: 11/20/2022]
|
85
|
Frutkin AD, Otsuka G, Stempien-Otero A, Sesti C, Du L, Jaffe M, Dichek HL, Pennington CJ, Edwards DR, Nieves-Cintrón M, Minter D, Preusch M, Hu JH, Marie JC, Dichek DA. TGF-[beta]1 limits plaque growth, stabilizes plaque structure, and prevents aortic dilation in apolipoprotein E-null mice. Arterioscler Thromb Vasc Biol 2009; 29:1251-7. [PMID: 19325140 DOI: 10.1161/atvbaha.109.186593] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVE Impairment of transforming growth factor (TGF)-beta1 signaling accelerates atherosclerosis in experimental mice. However, it is uncertain whether increased TGF-beta1 expression would retard atherosclerosis. The role of TGF-beta1 in aneurysm formation is also controversial. We tested whether overexpression of active TGF-beta1 in hyperlipidemic mice affects atherogenesis and aortic dilation. METHODS AND RESULTS We generated apolipoprotein E-null mice with transgenes that allow regulated overexpression of active TGF-beta1 in their hearts. Compared to littermate controls, these mice had elevated cardiac and plasma TGF-beta1, less aortic root atherosclerosis (P< or =0.002), fewer lesions in the thoracic and abdominal aortae (P< or =0.01), less aortic root dilation (P<0.001), and fewer pseudoaneurysms (P=0.02). Mechanistic studies revealed no effect of TGF-beta1 overexpression on plasma lipids or cytokines, or on peripheral lymphoid organ cells. However, aortae of TGF-beta1-overexpressing mice had fewer T-lymphocytes, more collagen, less lipid, lower expression of inflammatory cytokines and matrix metalloproteinase-13, and higher expression of tissue inhibitor of metalloproteinase-2. CONCLUSIONS When overexpressed in the heart and plasma, TGF-beta1 is an antiatherogenic, vasculoprotective cytokine that limits atherosclerosis and prevents aortic dilation. These actions are associated with significant changes in cellularity, collagen and lipid accumulation, and gene expression in the artery wall.
Collapse
Affiliation(s)
- Andrew D Frutkin
- Department of Medicine, University of Washington School of Medicine, Seattle, WA 98195-7710, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
86
|
King VL, Lin AY, Kristo F, Anderson TJT, Ahluwalia N, Hardy GJ, Owens AP, Howatt DA, Shen D, Tager AM, Luster AD, Daugherty A, Gerszten RE. Interferon-gamma and the interferon-inducible chemokine CXCL10 protect against aneurysm formation and rupture. Circulation 2009; 119:426-35. [PMID: 19139386 DOI: 10.1161/circulationaha.108.785949] [Citation(s) in RCA: 94] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Vascular disease can manifest as stenotic plaques or ectatic aneurysms, although the mechanisms culminating in these divergent disease manifestations remain poorly understood. T-helper type 1 cytokines, including interferon-gamma and CXCL10, have been strongly implicated in atherosclerotic plaque development. METHODS AND RESULTS Here, we specifically examined their role in the formation of abdominal aortic aneurysms in the angiotensin II-induced murine model. Unexpectedly, we found increased suprarenal aortic diameters, abdominal aortic aneurysm incidence, and aneurysmal death in apolipoprotein E- and interferon-gamma-deficient (Apoe(-/-)/Ifng(-/-)) mice compared with Apoe(-/-) controls, although atherosclerotic luminal plaque formation was attenuated. The interferon-gamma-inducible T-cell chemoattractant CXCL10 was highly induced by angiotensin II infusion in Apoe(-/-) mice, but this induction was markedly attenuated in Apoe(-/-)/Ifng(-/-) mice. Apoe(-/-)/Cxcl10(-/-) mice had decreased luminal plaque but also increased aortic size, worse morphological grades of aneurysms, and a higher incidence of death due to aortic rupture than Apoe(-/-) controls. Furthermore, abdominal aortic aneurysms in Apoe(-/-)/Cxcl10(-/-) mice were enriched for non-T-helper type 1-related signals, including transforming growth factor-beta1. Treatment of Apoe(-/-)/Cxcl10(-/-) mice with anti-transforming growth factor-beta neutralizing antibody diminished angiotensin II-induced aortic dilation. CONCLUSIONS The present study defines a novel pathway in which interferon-gamma and its effector, CXCL10, contribute to divergent pathways in abdominal aortic aneurysm versus plaque formation, inhibiting the former pathology but promoting the latter. Thus, efforts to develop antiinflammatory strategies for atherosclerosis must carefully consider potential effects on all manifestations of vascular disease.
Collapse
Affiliation(s)
- Victoria L King
- Cardiovascular Research Center, University of Kentucky, Lexington, KY, USA
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
87
|
Dai J, Louedec L, Philippe M, Michel JB, Houard X. Effect of blocking platelet activation with AZD6140 on development of abdominal aortic aneurysm in a rat aneurysmal model. J Vasc Surg 2008; 49:719-27. [PMID: 19028049 DOI: 10.1016/j.jvs.2008.09.057] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2008] [Revised: 08/01/2008] [Accepted: 09/27/2008] [Indexed: 12/21/2022]
Abstract
BACKGROUND Platelet activation and thrombus renewal are keys to intraluminal thrombus formation and progression of abdominal aortic aneurysms (AAA). This study explored the ability of AZD6140, a P2Y(12) receptor antagonist, to inhibit platelet activation and prevent aneurysm development in a rat experimental model of AAA. METHOD Aortic aneurysms were induced by implanting a segment of sodium dodecyl sulfate-decellularized guinea pig aorta in rat aortas. One day later, rats were randomized to AZD6140 (10 mg/kg twice daily by mouth) or diluent (n = 23 per group) for either 10 (n = 18) or 42 days (n = 28). Adenosine diphosphate (ADP)-mediated platelet aggregation, aneurysm expansion, intraluminal thrombus formation, inflammatory infiltration, matrix metalloproteinase-9 (MMP-9) expression, and smooth muscle cell colonization were measured. RESULTS AZD6140 inhibited ADP-induced platelet aggregation in vivo for 12 hours, justifying twice-daily administration in rats. The spontaneous increase in aortic diameter shown in the aneurysmal model (2.22 +/- 0.56 mm at day 10 vs 5.21 +/- 1.22 mm at day 42) was reduced with AZD6140 (3.61 +/- 1.46 mm at day 42, P < .01). This beneficial effect was associated with a significant reduction of thrombus development, platelet CD41 expression (P < .05), and leukocyte infiltration of the mural thrombus at days 10 and 42 (P < .01). MMP-9 expression correlated with mural thrombus area and was significantly reduced by AZD6140 (P < .05). AZD6140 limited elastic fiber degradation (P < .05) and enhanced progressive colonization of the thrombus by smooth muscle cells at day 42 (P < .01). CONCLUSIONS These data suggest that inhibition of platelet activation limits intraluminal thrombus biologic activities, thereby impairing aneurysm development.
Collapse
Affiliation(s)
- Jianping Dai
- INSERM U698, Cardiovascular Haematology, Bio-Engineering and Remodeling, Bichat-Claude Bernard Hospital, Paris, France
| | | | | | | | | |
Collapse
|
88
|
Inhibitory effects of a biodegradable gelatin hydrogel sponge sheet on the progression of experimental abdominal aortic aneurysms. Ann Vasc Surg 2008; 23:224-30. [PMID: 18783914 DOI: 10.1016/j.avsg.2008.06.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2008] [Revised: 04/21/2008] [Accepted: 06/18/2008] [Indexed: 11/20/2022]
Abstract
We investigated the effects of a biodegradable gelatin hydrogel sponge sheet (GHSS) or GHSS incorporating basic fibroblast growth factor (GHSS + bFGF), which could prolong the effects of bFGF, on the progression of experimental abdominal aortic aneurysms (AAAs). Experimental AAAs were induced in male Sprague-Dawley rats by intra-aortic elastase infusion. The rats were divided according to the following treatments: (1) untreated, (2) GHSS alone, (3) GHSS incorporating 100 ng, 1 microg, and 10 microg of bFGF. GHSSs were placed over the elastase-infused aortas. After 14 days, the GHSS alone group and the three groups with GHSS + bFGF demonstrated significantly smaller aortic diameters than the untreated group, and these groups significantly attenuated a reduction of the elastic fibers and smooth muscle cells in the pathological findings. However, no additional therapeutic effect was noted between the GHSS alone and GHSS + bFGF groups. Immunohistochemical analysis revealed an increase of positive cells for endogenous bFGF in the media and adventitia of both the GHSS alone and GHSS + bFGF groups in comparison to the untreated group. In conclusion, GHSS itself possessed significant therapeutic effects on AAA progression by inducing the production of endogenous bFGF, leading to the preservation of elastic fibers and smooth muscle cells.
Collapse
|
89
|
Jones JA, Spinale FG, Ikonomidis JS. Transforming growth factor-beta signaling in thoracic aortic aneurysm development: a paradox in pathogenesis. J Vasc Res 2008; 46:119-37. [PMID: 18765947 DOI: 10.1159/000151766] [Citation(s) in RCA: 125] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2007] [Accepted: 03/24/2008] [Indexed: 12/16/2022] Open
Abstract
Thoracic aortic aneurysms (TAAs) are potentially devastating, and due to their asymptomatic behavior, pose a serious health risk characterized by the lack of medical treatment options and high rates of surgical morbidity and mortality. Independent of the inciting stimuli (biochemical/mechanical), TAA development proceeds by a multifactorial process influenced by both cellular and extracellular mechanisms, resulting in alterations of the structure and composition of the vascular extracellular matrix (ECM). While the role of enhanced ECM proteolysis in TAA formation remains undisputed, little attention has been focused on the upstream signaling events that drive the remodeling process. Recent evidence highlighting the dysregulation of transforming growth factor-beta (TGF-beta) signaling in ascending TAAs from Marfan syndrome patients has stimulated an interest in this intracellular signaling pathway. However, paradoxical discoveries have implicated both enhanced TGF-beta signaling and loss of function TGF-beta receptor mutations, in aneurysm formation; obfuscating a clear functional role for TGF-beta in aneurysm development. In an effort to elucidate this subject, TGF-beta signaling and its role in vascular remodeling and pathology will be reviewed, with the aim of identifying potential mechanisms of how TGF-beta signaling may contribute to the formation and progression of TAA.
Collapse
Affiliation(s)
- Jeffrey A Jones
- Department of Surgery, Division of Cardiothoracic Surgery Research, Medical University of South Carolina, Charleston, S.C. 29425, USA.
| | | | | |
Collapse
|
90
|
Ruddy JM, Jones JA, Spinale FG, Ikonomidis JS. Regional heterogeneity within the aorta: relevance to aneurysm disease. J Thorac Cardiovasc Surg 2008; 136:1123-30. [PMID: 19026791 DOI: 10.1016/j.jtcvs.2008.06.027] [Citation(s) in RCA: 85] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2008] [Accepted: 06/24/2008] [Indexed: 01/14/2023]
Abstract
Vascular remodeling within the aorta results in a loss of structural integrity with consequent aneurysm formation. This degradation is more common in the abdominal aorta but also occurs above the diaphragm in the thoracic aorta. Conventionally, the aorta has been considered a large vascular conduit with uniform cellular and extracellular structure and function. Evidence is accumulating, however, to suggest that variations exist between the thoracic and abdominal aorta, thereby demonstrating regional heterogeneity. Further pathophysiologic studies of aortic dilation in each of these regions have identified disparities in atherosclerotic plaque deposition, vessel mechanics, protease profiles, and cell-signaling pathways. Improved understanding of this spatial heterogeneity might promote evolution in the management of aneurysm disease through computational models of aortic wall stress, imaging of proteolytic activity, targeted pharmacologic treatment, and application of region-specific gene therapy.
Collapse
Affiliation(s)
- Jean Marie Ruddy
- Division of Cardiothoracic Surgery, Department of Surgery, Medical University of South Carolina, Charleston, SC 29425, USA
| | | | | | | |
Collapse
|
91
|
Elastic fibers reconstructed using adenovirus-mediated expression of tropoelastin and tested in the elastase model of abdominal aortic aneurysm in rats. J Vasc Surg 2008; 48:965-73. [PMID: 18585885 DOI: 10.1016/j.jvs.2008.04.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2008] [Revised: 04/03/2008] [Accepted: 04/06/2008] [Indexed: 11/20/2022]
Abstract
OBJECTIVE An adenoviral vector carrying a recombinant tropoelastin (TE) gene with a Green Fluorescent Protein (GFP) tag adenoviral tropoelastin green fluorescent protein (AdTE-GFP) was transferred to aortic vascular smooth muscle cells (VSMCs) for studying the expression of recombinant elastin in vitro and the reconstruction of elastic fibers in vivo in experimental abdominal aortic aneurysm (AAA). METHODS The AAAs were induced in rats by perfusing the arteries with porcine pancreatic elastase, and after AAA formation, adenoviral vectors were perfused directly into the aneurysmal lumen. VSMCs transfected with AdTE-GFP in vitro and in vivo were detected by fluorescence microscopy. The TE mRNA levels and the level of recombinant elastin expression of AdTE-GFP transfected VSMCs in vitro (at 1, 3, and 5 days) and in vivo (at 2 and 4 weeks) were compared by real-time reverse transcriptase polymerase chain reaction (RT-PCR) and Western blot analysis, respectively. The aortic diameters (AD) of the aneurysms were measured at three time points (immediately, 2 weeks, and 4 weeks post-perfusion) and comparisons were made among the AdTE-GFP transfected group, an empty adenovirus (AdNull) transfected group, and a phosphate buffered saline (PBS) perfused group. Formation of new elastic fibers in vivo was assessed by histologic analysis. RESULTS AdTE-GFP transfection reversed AAA formation (mean +/- standard error), with the controls showing increased ADs (a 48.50 +/- 16.55% increase for the PBS perfusion group and a 39.84 +/- 15.59% increase for the AdNull treated group) and the AdTE-GFP transfected group showing a decreased AD (23.04 +/- 14.49%, P < .01). Histological studies showed that the AdTE-GFP transfected group also had reconstructed elastic fibers in the aneurysmal wall. Real-time PCR for TE mRNA demonstrated a significant increase upon transfection of AdTE-GFP in vitro and in vivo. Western blot analysis for GFP demonstrated elastin-GFP expression only upon transfection of AdTE-GFP, although the amount of elastin-GFP protein tended to be lower in vivo than in vitro. Elastin von-Giesson stain combined with GFP antibody immunohistochemistry demonstrated new elastic fibers in the transfected aneurysmal VSMCs. CONCLUSION VSMCs were transfected efficiently with a special AdTE-GFP vector, enabling recombinant elastin to be produced in these VSMCs in vitro and in vivo. This expression of a recombinant elastin and the related reconstruction of elastic fibers within the aneurysmal tissue appeared to prevent or reverse the aneurysm dilatation.
Collapse
|
92
|
Lucarini L, Sticchi E, Sofi F, Pratesi G, Pratesi C, Pulli R, Gensini GF, Abbate R, Pepe G, Fatini C. ACE and TGFBR1 genes interact in influencing the susceptibility to abdominal aortic aneurysm. Atherosclerosis 2008; 202:205-10. [PMID: 18550062 DOI: 10.1016/j.atherosclerosis.2008.04.038] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2007] [Revised: 04/14/2008] [Accepted: 04/19/2008] [Indexed: 11/26/2022]
Abstract
A role of ACE I/D polymorphism in the pathogenesis of abdominal aortic aneurysm (AAA) has been demonstrated, possibly due to the effect of angiotensin II on vascular tissue remodelling. Angiotensin II exerts profibrogenic effects through the local induction of TGF-beta. Dysregulated TGF-beta signalling may result from mutations in TGFBR1 and TGFBR2 genes, thus resulting in degenerative changes in the vessel wall. We performed a case-control study in order to investigate the role of TGFBR1 9A6A polymorphism as predisposing factor to AAA per se, and in the presence of ACE DD and AT1R 1166 CC genotypes in 201 AAA patients (mean age+/-S.D., 71.5+/-6.9) referred to the Unit of Vascular Surgery of the University of Florence, compared with 252 healthy controls (mean age+/-S.D., 70.6+/-8.6). A significant difference in genotype distribution and allele frequency between patients and controls was found for ACE, but not for AT1R and TGFBR1 polymorphisms. At univariate analysis a significant association between ACE DD, but not AT1R CC and TGFBR1 6A allele, and the susceptibility to the disease was found [ACE DD OR=1.86 (95% CI 1.26-2.76), p=0.002]. After adjustment for age, gender, traditional cardiovascular risk factors, and CAD, PAD and CVD, ACE DD genotype still affected the susceptibility to AAA [OR=2.13 (95% CI 1.06-4.28), p=0.03], and the contemporary presence of ACE DD genotype and TGFBR1 6A allele, increased the predisposition to the disease [OR=5.09 (95% CI 1.44-18.02), p=0.01]. This study, which demonstrates an interaction between ACE and TGFBR1 genes in predisposing to AAA, may provide further information on the mechanisms contributing to AAA susceptibility, and offer a topic for future larger studies.
Collapse
Affiliation(s)
- Laura Lucarini
- Department of Medical and Surgical Critical Care, University of Florence, Thrombosis Centre, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | | | | | | | | | | | | | | | | | | |
Collapse
|
93
|
Deux JF, Dai J, Rivière C, Gazeau F, Méric P, Gillet B, Roger J, Pons JN, Letourneur D, Boudghène FP, Allaire E. Aortic aneurysms in a rat model: in vivo MR imaging of endovascular cell therapy. Radiology 2007; 246:185-92. [PMID: 18033758 DOI: 10.1148/radiol.2461070032] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To prospectively evaluate in rats whether magnetic cell labeling can be used to noninvasively assess the technical success of endovascular cell therapy for abdominal aortic aneurysms (AAAs). MATERIALS AND METHODS The study was approved by an institutional animal care and use committee. Vascular smooth muscle cells (VSMCs) labeled with iron oxide nanoparticles were seeded endovascularly in already formed AAAs. T2*-weighted gradient-echo and T2-weighted spin-echo magnetic resonance (MR) imaging was performed in vivo at 1.5 T before and 30 minutes after the injection of iron-loaded VSMCs (14 rats), nonlabeled VSMCs (three rats), or iron-free particles (three rats). Ten rats were euthanized shortly after the injection (day 0). Of the 10 remaining rats, which were seeded with iron-loaded cells, three were imaged on day 7 after cell delivery; three, on day 14; and four, on day 28; then they were euthanized. Ex vivo high-field-strength MR imaging of two AAAs was performed 28 days after cell delivery. Histologic examination of cross sections of all AAAs was performed. Statistical evaluations were performed with a nonparametric Wilcoxon correlation test. RESULTS Magnetic cell labeling did not alter the capability of VSMCs to stabilize the diameter of the aneurysms. T2*-weighted gradient-echo images showed areas of hypointense signal within the aortic wall immediately and up to 1 month after cell therapy. The mean signal intensity decreased significantly after cell delivery (from 2362 +/- 244 [standard deviation] before to 434 +/- 275 after delivery, P < .001). Areas of hypointense signal and iron-loaded VSMCs were colocalized in the area of aortic wall reconstruction at both high-field-strength MR imaging and histologic analysis. CONCLUSION MR imaging with magnetic cell labeling can be used to document endovascular cell delivery in already formed AAAs in rats.
Collapse
Affiliation(s)
- Jean-François Deux
- INSERM U 698, Bioengineering Department, University Paris 7-University Paris 13, X. Bichat Hospital, Paris, France.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
94
|
Abstract
Use of molecular tools to diagnose and treat aortic disease, in particular, aortic aneurysms and aortic dissections, is still in its infancy, with great advancements expected in the future. Currently under investigation are the genetic markers linked to aortic disease that may help to identify patients at risk for their development prior to clinical presentation. In addition, specific gene defects may be identified that can assist in the understanding of the basic mechanisms contributing to development of aortic disease. Biomarkers are under investigation that can be used to monitor the development, progression, and possible response to therapy for aortic aneurysms and acute aortic syndromes. Equally important, further investigations into the molecular mechanisms involved in aortic pathology will result in increased understanding of the disease etiology and will lead to development of alternate therapies for these diseases prior to their catastrophic development. With advances in molecular technology, the molecular diagnosis and treatment of aortic diseases will begin to expand at a rapid rate and provide unique, improved therapies.
Collapse
Affiliation(s)
- Matthew J Eagleton
- Department of Vascular Surgery, Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH 44195, USA.
| |
Collapse
|
95
|
Aoki H, Yoshimura K, Matsuzaki M. Turning back the clock: regression of abdominal aortic aneurysms via pharmacotherapy. J Mol Med (Berl) 2007; 85:1077-88. [PMID: 17522832 DOI: 10.1007/s00109-007-0213-2] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2006] [Revised: 04/08/2007] [Accepted: 04/25/2007] [Indexed: 10/23/2022]
Abstract
Abdominal aortic aneurysm (AAA) is a common disease that causes progressive expansion and rupture of the aorta with high mortality. There is a large and unmet need for nonsurgical treatment for AAA. Research has shown that an intricate network of inflammatory cells and interstitial cells contributes to the formation of AAA by producing pro-inflammatory mediators that activate enzymes to degrade the extracellular matrix (ECM) and impair ECM biosynthesis. Pharmacological agents such as statins and angiotensin-converting enzyme inhibitors may promote tissue stabilization in AAA by diminishing pro-inflammatory signaling and normalizing metabolism of the ECM. Our recent experiments in animal models demonstrate that inhibition of c-Jun N terminal kinase (JNK) inhibits multiple pathological processes and causes regression of established AAA. Thus, emerging evidence indicates that pharmacological intervention targeting pro-inflammatory signaling and abnormal ECM metabolism is a promising strategy for treatment of AAA.
Collapse
Affiliation(s)
- Hiroki Aoki
- Department of Molecular Cardiovascular Biology, Yamaguchi University School of Medicine, 1-1-1 Minami Kogushi, Ube, Yamaguchi, 755-8505, Japan.
| | | | | |
Collapse
|
96
|
|
97
|
Duftner C, Seiler R, Dejaco C, Fraedrich G, Schirmer M. Increasing evidence for immune-mediated processes and new therapeutic approaches in abdominal aortic aneurysms--a review. Ann N Y Acad Sci 2007; 1085:331-8. [PMID: 17182953 DOI: 10.1196/annals.1383.036] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Animal models for abdominal aortic aneurysms (AAAs), immunogenetical and pathophysiological studies support the importance of immune-mediated processes in the pathogenesis of AAA disease. Neutrophils, natural killer (NK) cells, monocytes/macrophages, and proinflammatory cytokines are involved in the complex and dynamic tissue remodeling of the AAA vessel wall. Our group showed an increased prevalence of circulating interferon-gamma (IFN-gamma) producing CD28(-) T cells especially in smaller AAAs, thus supporting the concept of a T cell-mediated pathophysiology of AAAs, especially during the early development of AAAs. Further research should now assess the possible benefit of anti-inflammatory therapeutic approaches in AAA patients, especially with small AAAs.
Collapse
Affiliation(s)
- Christina Duftner
- Department of Internal Medicine, Clinical Division of General Internal Medicine, Innsbruck Medical University, Innsbruck, Austria
| | | | | | | | | |
Collapse
|
98
|
Kirsch EWM, Radu NC, Gervais M, Allaire E, Loisance DY. Heterogeneity in the remodeling of aneurysms of the ascending aorta with tricuspid aortic valves. J Thorac Cardiovasc Surg 2006; 132:1010-6. [PMID: 17059916 DOI: 10.1016/j.jtcvs.2006.04.051] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2006] [Revised: 04/01/2006] [Accepted: 04/24/2006] [Indexed: 11/18/2022]
Abstract
OBJECTIVES The study addresses mechanisms driving the formation of ascending aortic aneurysms by comparing the maximal dilatation area with the transition area immediately adjacent to the normal aortic tissue left in place during surgical repair. METHODS Aortic wall specimens were taken from the maximal dilatation area and transition area in 10 patients undergoing surgery for ascending aortic aneurysms and fixed for histology and immunohistochemistry for vascular smooth muscle cells (alpha-actin), endothelial cells (CD31), and macrophages (CD68). Tissue concentrations of vascular endothelial growth factor, matrix metalloproteinase-2, and matrix metalloproteinase-9 were determined by enzyme-linked immunosorbent assay. The results are expressed as medians with their 25th and 75th centiles. RESULTS Vascular smooth muscle cells were significantly more abundant in the maximal dilatation area than in the transition area (20.3 [14.8-24.4]/10(-2) mm2 vs 8.0 [6.4-9.3]/10(-2) mm2, respectively, P = .002). In the maximal dilatation area, vascular smooth muscle cells had lost their typical lamellar organization, whereas it was preserved in the transition area. Microvessels were significantly more abundant in the media of transition area than in the maximal dilatation area (7.5 [2.9-10.1]/mm2 vs 1.75 [1.5-2.0]/mm2, respectively, P = .008) and were associated with an inflammatory cell infiltration that predominated in their immediate vicinity. There were no significant differences in vascular endothelial growth factor, matrix metalloproteinase-2, and matrix metalloproteinase-9 between both areas. CONCLUSIONS The transition area appears as a disease progression front characterized by microvessel formation and inflammatory cell infiltration. In contrast, increased vascular smooth muscle cell density in the maximal dilatation area suggests a healing process, although inefficient to prevent aortic dilatation.
Collapse
Affiliation(s)
- E W Matthias Kirsch
- Surgical Research Center, Paris XII University, IFR de Médecine, Hôpital Henri Mondor, Créteil, France.
| | | | | | | | | |
Collapse
|
99
|
Sinha I, Cho BS, Roelofs KJ, Stanley JC, Henke PK, Upchurch GR. Female gender attenuates cytokine and chemokine expression and leukocyte recruitment in experimental rodent abdominal aortic aneurysms. Ann N Y Acad Sci 2006; 1085:367-79. [PMID: 17182958 DOI: 10.1196/annals.1383.027] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Female gender appears to be protective in the development of abdominal aortic aneurysms (AAAs). This study sought to identify gender differences in cytokine and chemokine expression in an experimental rodent AAA model. Male and female rodent aortas were perfused with either saline (control) or elastase to induce AAA formation. Aortic diameter was determined and aortic tissue was harvested on postperfusion days 4 and 7. Cytokine and chemokine gene expression was examined using focused gene arrays. Immunohistochemistry was used to quantify aortic leukocyte infiltration. Data were analyzed by Student's t-tests and ANOVA. Elastase-perfused female rodents developed significantly smaller aneurysms compared to males by day 7 (93 +/- 10% vs. 201 +/- 25%, P = 0.003). Elastase-perfused female aortas exhibited a fivefold decrease in expression of the BMP family and ligands of the TNF superfamily compared to males. In addition, the expression of members of the TGF beta and VEGF families were three to fourfold lower in female elastase-perfused aortas compared to males. Multiple members of the interleukin, CC chemokine receptor, and CC ligand families were detectable in only the male elastase-perfused aortas. Female elastase-perfused aortas demonstrated a corollary twofold lower neutrophil count (females: 17.5 +/- 1.1 PMN/HPF; males: 41 +/- 5.2 neutrophils/HPF, P = 0.01) and a 1.5-fold lower macrophage count (females: 12 +/- 1.1 macrophages/HPF; males: 17.5 +/- 1.1 macrophages/HPF, P = 0.003) compared to male elastase-perfused aortas. This study documents decreased expression of multiple cytokines and chemokines and diminished leukocyte trafficking in female rat aortas compared to male aortas following elastase perfusion. These genes may contribute to the gender disparity seen in AAA formation.
Collapse
Affiliation(s)
- Indranil Sinha
- Department of Surgery, Jobst Vascular Research Laboratories, Section of Vascular Surgery, University of Michigan, Ann Arbor, MI 48109-0329, USA
| | | | | | | | | | | |
Collapse
|
100
|
Zhou X, Ji WJ, Tu Y, Yao M, Li YM. Abdominal aortic aneurysm and cerebral aneurysm present different pathological evolutions and responses to pharmacological therapy. Med Hypotheses 2006; 68:601-6. [PMID: 17030100 DOI: 10.1016/j.mehy.2006.06.062] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2006] [Accepted: 06/28/2006] [Indexed: 10/24/2022]
Abstract
Over-degradation of extracellular components by matrix metalloproteinases (MMPs) has been implicated as an important characteristic during the pathological evolution of the abdominal aortic aneurysm (AAA) and cerebral aneurysm (CA), which contribute to progressive dilation of vascular wall. However, mRNA and protein expression of local rennin-angiotensin system (RAS) components are found down-regulated in CA walls, which is contrary to long-holding concept that local RAS will be activated in response to increased hemodynamic stress and contributes to thickening of arterial wall. Similarly, MMPs inhibition by doxycycline effectively ameliorate AAA expansion in basic and clinical researches, but can not reduce the incidence of CA formation in rat. These evidences may suggest that suppression of RAS favors the regression of AAA, but at an increased risk of CA rupture. As the strategies of RAS blockade have became the optimal antihypertensive drugs of choice in clinical arena, the discrepant responses to pharmacologic intervention of AAA and CA should be received considerable attentions, due to their high prevalence in hypertensive population. Here we proposed that AAA and CA, outward remodeling of elastic and muscular arteries respectively, presented with different pathological evolutions and distinct responses to drug intervention, i.e., RAS and MMPs inhibition. It can not be excluded that the potentially deleterious effects of RAS inhibition on CA may be masked by the beneficial action of controlled blood pressure, and the propagation of CA will be exacerbated once suboptimal dose have been prescribed, or under the condition of stress, even drug withdrawal. If the paradoxical outcomes of these two kinds of arterial remodeling were proven true in basic research, clinical use of RAS blockade should be prudent in hypertensive patients, and routine procedures to detect the existence of CA should be considered. Therefore, in depth investigation in their responses to pharmacological approaches will provide us with more insights into the pathogenesis of arterial aneurysm.
Collapse
Affiliation(s)
- Xin Zhou
- Graduate School of Medicine, Tianjin Medical University, Qi-Xiang-Tai Street, Tianjin, China
| | | | | | | | | |
Collapse
|