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Poledniczek M, Neumayer C, Kopp CW, Schlager O, Gremmel T, Jozkowicz A, Gschwandtner ME, Koppensteiner R, Wadowski PP. Micro- and Macrovascular Effects of Inflammation in Peripheral Artery Disease-Pathophysiology and Translational Therapeutic Approaches. Biomedicines 2023; 11:2284. [PMID: 37626780 PMCID: PMC10452462 DOI: 10.3390/biomedicines11082284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 08/10/2023] [Accepted: 08/15/2023] [Indexed: 08/27/2023] Open
Abstract
Inflammation has a critical role in the development and progression of atherosclerosis. On the molecular level, inflammatory pathways negatively impact endothelial barrier properties and thus, tissue homeostasis. Conformational changes and destruction of the glycocalyx further promote pro-inflammatory pathways also contributing to pro-coagulability and a prothrombotic state. In addition, changes in the extracellular matrix composition lead to (peri-)vascular remodelling and alterations of the vessel wall, e.g., aneurysm formation. Moreover, progressive fibrosis leads to reduced tissue perfusion due to loss of functional capillaries. The present review aims at discussing the molecular and clinical effects of inflammatory processes on the micro- and macrovasculature with a focus on peripheral artery disease.
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Affiliation(s)
- Michael Poledniczek
- Division of Angiology, Department of Internal Medicine II, Medical University of Vienna, 1090 Vienna, Austria; (M.P.); (C.W.K.); (O.S.); (M.E.G.); (R.K.)
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, 1090 Vienna, Austria
| | - Christoph Neumayer
- Division of Vascular Surgery, Department of General Surgery, Medical University of Vienna, 1090 Vienna, Austria;
| | - Christoph W. Kopp
- Division of Angiology, Department of Internal Medicine II, Medical University of Vienna, 1090 Vienna, Austria; (M.P.); (C.W.K.); (O.S.); (M.E.G.); (R.K.)
| | - Oliver Schlager
- Division of Angiology, Department of Internal Medicine II, Medical University of Vienna, 1090 Vienna, Austria; (M.P.); (C.W.K.); (O.S.); (M.E.G.); (R.K.)
| | - Thomas Gremmel
- Department of Internal Medicine I, Cardiology and Intensive Care Medicine, Landesklinikum Mistelbach-Gänserndorf, 2130 Mistelbach, Austria;
- Institute of Cardiovascular Pharmacotherapy and Interventional Cardiology, Karl Landsteiner Society, 3100 St. Pölten, Austria
| | - Alicja Jozkowicz
- Department of Medical Biotechnology, Faculty of Biophysics, Biochemistry and Biotechnology, Jagiellonian University, 31-007 Krakow, Poland;
| | - Michael E. Gschwandtner
- Division of Angiology, Department of Internal Medicine II, Medical University of Vienna, 1090 Vienna, Austria; (M.P.); (C.W.K.); (O.S.); (M.E.G.); (R.K.)
| | - Renate Koppensteiner
- Division of Angiology, Department of Internal Medicine II, Medical University of Vienna, 1090 Vienna, Austria; (M.P.); (C.W.K.); (O.S.); (M.E.G.); (R.K.)
| | - Patricia P. Wadowski
- Division of Angiology, Department of Internal Medicine II, Medical University of Vienna, 1090 Vienna, Austria; (M.P.); (C.W.K.); (O.S.); (M.E.G.); (R.K.)
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Tsomidis I, Notas G, Xidakis C, Voumvouraki A, Samonakis DN, Koulentaki M, Kouroumalis E. Enzymes of Fibrosis in Chronic Liver Disease. Biomedicines 2022; 10:biomedicines10123179. [PMID: 36551935 PMCID: PMC9776355 DOI: 10.3390/biomedicines10123179] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 12/01/2022] [Accepted: 12/05/2022] [Indexed: 12/13/2022] Open
Abstract
Introduction: Liver fibrosis has been extensively studied at the cellular and molecular level, but very few data exist on the final enzymatic stages of collagen synthesis (prolyl hydroxylase, PH) and degradation (matrix metalloproteinases, MMPs), particularly in primary biliary cholangitis (PBC). Aim: We studied enzyme activities in liver tissue from patients with chronic liver diseases and compared them to normal livers. Patients: Eighteen patients with PBC of early and late stages (Ludwig’s classification) and seven on treatment with ursodeoxycholate (UDCA) were studied and compared to 34 patients with alcoholic liver disease (ALD), 25 patients with chronic viral liver disease and five normal biopsies. Sera were available from a total of 140 patients. Methods: The tritiated water released from the tritiated proline was measured in PH assessment. 14C intact and heat-denatured collagen substrates were used to measure collagenase and gelatinases, respectively. 3H Elastin was the substrate for elastase. In serum, ELISAs were used for MMP-1, TIMP-1, and TIMP-2 measurements while MMP-2 and MMP-9 were estimated by zymography. Results: PH was significantly increased in early and late PBC. Collagenase was reduced only in the late stages (p < 0.01), where the ratio PH/collagenase was increased. UDCA treatment restored values to almost normal. Gelatinases were reduced in late stages (p < 0.05). In contrast to PBC and ALD fibrosis, collagen synthesis is not increased in viral fibrosis. The balance shifted towards collagen deposition due to reduced degradation. Interestingly, gelatinolytic activity is not impaired in ALD. Elastase was similar to controls in all diseases studied. TIMP-1 was reduced in early PBC and viral and alcoholic hepatitis and cirrhosis (p < 0.001). Conclusions: (1) There is evidence that collagen synthesis increases in the early stages of PBC, but the collagenolytic mechanism may compensate for the increased synthesis. (2) In viral disease, fibrosis may be due to decreased degradation rather than increased synthesis. (3) The final biochemical stages of liver fibrosis may be quantitatively different according to underlying etiology.
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Affiliation(s)
- Ioannis Tsomidis
- First Department of Internal Medicine, AHEPA University Hospital, 54621 Thessaloniki, Chalkidiki, Greece
- Laboratory of Gastroenterology and Hepatology, School of Medicine, University of Crete, 71500 Heraklion, Crete, Greece
| | - George Notas
- Laboratory of Experimental Endocrinology, School of Medicine, University of Crete, 71500 Heraklion, Crete, Greece
| | - Costas Xidakis
- Laboratory of Gastroenterology and Hepatology, School of Medicine, University of Crete, 71500 Heraklion, Crete, Greece
| | - Argyro Voumvouraki
- First Department of Internal Medicine, AHEPA University Hospital, 54621 Thessaloniki, Chalkidiki, Greece
| | - Dimitrios N Samonakis
- Department of Gastroenterology, PAGNI University Hospital, School of Medicine, University of Crete, 71500 Heraklion, Crete, Greece
| | - Mairi Koulentaki
- Department of Gastroenterology, PAGNI University Hospital, School of Medicine, University of Crete, 71500 Heraklion, Crete, Greece
| | - Elias Kouroumalis
- Laboratory of Gastroenterology and Hepatology, School of Medicine, University of Crete, 71500 Heraklion, Crete, Greece
- Department of Gastroenterology, PAGNI University Hospital, School of Medicine, University of Crete, 71500 Heraklion, Crete, Greece
- Correspondence:
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Li T, Li X, Liu X, Yang J, Ma C. The elevated expression of TLR4 and MMP9 in human abdominal aortic aneurysm tissues and its implication. BMC Cardiovasc Disord 2021; 21:378. [PMID: 34348653 PMCID: PMC8336015 DOI: 10.1186/s12872-021-02193-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 07/30/2021] [Indexed: 01/16/2023] Open
Abstract
Background Toll-like receptor 4 (TLR4) and matrix metalloproteinase 9 (MMP9) have been investigated to play significant roles in the formation of abdominal aortic aneurysm (AAA). But the reports on the expression pattern of TLR4 and MMP9 in human AAA specimens were relatively scant. The aim of this study was to make a detailed analysis of TLR4 and MMP9 expression in situ and their association with clinical parameters involved in human AAA. Methods 40 AAA specimens were obtained from full-thickness aneurysmal tissues at the maximal dilation area during the open surgical repair, and 8 non-aneurysmal abdominal aortas from transplant donors served as controls. Expression of TLR4 and MMP9 protein was determined by immunohistochemistry. Results There were increased levels of TLR4 and MMP9 expression in human AAA tissues. Compared with macrophages or SMCs, lymphocytes showed a higher positive rate of TLR4 and MMP9 staining, and an elevated ratio of high MMP9 expression (all P < 0.05). There existed a significant association between TLR4 and MMP9 expression (r = 0.767, P < 0.001), and both TLR4 and MMP9 levels were statistically related to circulating CRP. Moreover, TLR4 expression in situ indicated a positive correlation with its serum level (r = 0.654, P = 0.006). Multiple analysis revealed that high TLR4 expression in situ was associated with the risk of large AAA (OR = 6.211, 95%CI = 1.226–31.480, P = 0.027), while high MMP9 expression was correlated to the presence of thrombus within AAA (OR = 5.494, 95%CI = 1.181–25.562, P = 0.030), separately compared with their low expression. Conclusions This study confirmed the overexpression of TLR4 and MMP9 in human AAA tissues, and their close relationship implying in the pathogenesis of AAA. We further provided evidence that TLR4 had a potential effect on AAA size and MMP9 could influence the occurrence of thrombus within AAA.
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Affiliation(s)
- Tan Li
- Department of Cardiovascular Ultrasound, the First Hospital of China Medical University, No. 155 Nanjing Bei Street, Heping District, Shenyang, 110001, Liaoning Province, People's Republic of China
| | - Xintong Li
- Department of Vascular and Thyroid Surgery, the First Hospital of China Medical University, Shenyang, 110001, People's Republic of China
| | - Xiaozheng Liu
- Department of Cardiovascular Ultrasound, the First Hospital of China Medical University, No. 155 Nanjing Bei Street, Heping District, Shenyang, 110001, Liaoning Province, People's Republic of China
| | - Jun Yang
- Department of Cardiovascular Ultrasound, the First Hospital of China Medical University, No. 155 Nanjing Bei Street, Heping District, Shenyang, 110001, Liaoning Province, People's Republic of China.
| | - Chunyan Ma
- Department of Cardiovascular Ultrasound, the First Hospital of China Medical University, No. 155 Nanjing Bei Street, Heping District, Shenyang, 110001, Liaoning Province, People's Republic of China.
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Medeiros T, Saraiva GN, Moraes LA, Gomes AC, Lacerda GS, Leite PE, Esberard EB, Andrade TG, Xavier AR, Quírico-Santos T, Rosário NF, Silva AA. Liver fibrosis improvement in chronic hepatitis C after direct acting-antivirals is accompanied by reduced profibrogenic biomarkers-a role for MMP-9/TIMP-1. Dig Liver Dis 2020; 52:1170-1177. [PMID: 32522433 DOI: 10.1016/j.dld.2020.05.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 04/20/2020] [Accepted: 05/04/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS Disturbances in matrix metalloproteinases (MMPs) and corresponding tissue inhibitors (TIMPs) contribute to hepatitis C virus (HCV)-induced fibrosis. This study aimed to determine MMP-9/TIMP-1 levels in addition to MMP-2 and -9 activities; correlating with the improvement of liver fibrosis in patients under direct-acting antiviral (DAA) therapy. METHODS Clinical and laboratory follow-up were performed before treatment and after 12 weeks post-treatment, referred as sustained viral response (SVR). We evaluated liver function including non-invasive fibrosis measurements; MMP activity by zymography; and MMP-9/TIMP-1 complex, inflammatory and pro-fibrogenic mediators by immunoenzymatic assays. RESULTS Cohort included 33 patients (59.5 ± 9.3 years, 60.6% females) whose reached SVR and 11 control-paired subjects (42.5 ± 15 years, 54.5% females). Before treatment, HCV patients presented higher MMP-9/TIMP-1 levels (P < 0.05) when compared to controls, and the highest values were observed in patients with fibrosis (P < 0.05). In addition, MMP-9/TIMP-1 levels were significantly reduced after DAA therapy (P < 0.0001) and were associated with profibrogenic biomarkers. No differences were observed for MMP-2 and -9 activities; however, these biomarkers were significantly associated with inflammatory mediators. CONCLUSION Our data suggest that MMP-9/TIMP-1 complex can be a promising biomarker of active fibrogenesis, being able to identify the interruption of fibrosis progression after HCV eradication.
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Affiliation(s)
- Thalia Medeiros
- Laboratório Multiusuário de Apoio à Pesquisa em Nefrologia e Ciências Médicas Departamento de Medicina Clínica Faculdade de Medicina, Universidade Federal Fluminense, Niterói, Brazil.
| | - Geórgia N Saraiva
- Laboratório Multiusuário de Apoio à Pesquisa em Nefrologia e Ciências Médicas Departamento de Medicina Clínica Faculdade de Medicina, Universidade Federal Fluminense, Niterói, Brazil.
| | - Laiz A Moraes
- Laboratório Multiusuário de Apoio à Pesquisa em Nefrologia e Ciências Médicas Departamento de Medicina Clínica Faculdade de Medicina, Universidade Federal Fluminense, Niterói, Brazil
| | - Aline C Gomes
- Instituto de Biologia, Universidade Federal Fluminense, Niterói, Brazil
| | - Gilmar S Lacerda
- Laboratório Multiusuário de Apoio à Pesquisa em Nefrologia e Ciências Médicas Departamento de Medicina Clínica Faculdade de Medicina, Universidade Federal Fluminense, Niterói, Brazil.
| | - Paulo Ec Leite
- Laboratório de Bioengenharia e Toxicologia in Vitro Diretoria de Metrologia Aplicada às Ciências da Vida - Dimav Instituto Nacional de Metrologia Qualidade e Tecnologia - INMETRO, Duque de Caxias, Rio de Janeiro, Brazil.
| | - Eliane Bc Esberard
- Centro de Referência de Tratamento em Hepatites/HUAP Serviço de Gastroenterologia Departamento de Medicina Clínica Faculdade de Medicina, Universidade Federal Fluminense, Niterói, Brazil
| | - Thaís G Andrade
- Centro de Referência de Tratamento em Hepatites/HUAP Serviço de Gastroenterologia Departamento de Medicina Clínica Faculdade de Medicina, Universidade Federal Fluminense, Niterói, Brazil.
| | - Analúcia R Xavier
- Laboratório Multiusuário de Apoio à Pesquisa em Nefrologia e Ciências Médicas Departamento de Medicina Clínica Faculdade de Medicina, Universidade Federal Fluminense, Niterói, Brazil; Departamento de Patologia Faculdade de Medicina, Universidade Federal Fluminense, Niterói, Brazil.
| | | | - Natalia F Rosário
- Laboratório Multiusuário de Apoio à Pesquisa em Nefrologia e Ciências Médicas Departamento de Medicina Clínica Faculdade de Medicina, Universidade Federal Fluminense, Niterói, Brazil.
| | - Andrea A Silva
- Laboratório Multiusuário de Apoio à Pesquisa em Nefrologia e Ciências Médicas Departamento de Medicina Clínica Faculdade de Medicina, Universidade Federal Fluminense, Niterói, Brazil; Departamento de Patologia Faculdade de Medicina, Universidade Federal Fluminense, Niterói, Brazil.
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Schreinlechner M, Noflatscher M, Lener D, Bauer A, Kirchmair R, Marschang P, Theurl M. NGAL Correlates with Femoral and Carotid Plaque Volume Assessed by Sonographic 3D Plaque Volumetry. J Clin Med 2020; 9:jcm9092811. [PMID: 32878068 PMCID: PMC7565934 DOI: 10.3390/jcm9092811] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 08/27/2020] [Indexed: 12/20/2022] Open
Abstract
Background/Objectives: Inflammation represents a cornerstone in the development of atherosclerosis and early detection is essential to avoid cardiovascular events. Biomarkers like interleukin-1 beta, interleukin-6, or high sensitivity CRP (hs-CRP) have been investigated intensively in this field. Since they have several limitations, additional biomarkers are needed for cardiovascular risk stratification. The acute phase protein, neutrophil gelatinase-associated lipocalin (NGAL), modulates inflammation and is elevated in cardiovascular disease (CVD). Moreover, it contributes to plaque destabilization. Methods: In this prospective, single-center study, we included 323 asymptomatic patients with at least one cardiovascular risk factor or established CVD. NGAL levels were measured in plasma samples using a commercially available ELISA. Carotid, femoral, and total atherosclerotic plaque volumes (PV) were measured using a 3D ultrasound system (Philips iU22). Patients were separated into a low (n = 243) and high (n = 80) total PV group. Results: NGAL was significantly higher in patients with high total PV versus patients with low total PV. The NGAL amplitude for the prediction of high total PV was significantly higher when compared with hs-CRP. A high predictive value could also be observed for patients without established CVD. Conclusion: NGAL seems to be a promising biomarker for the identification of asymptomatic patients with atherosclerotic disease.
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Affiliation(s)
- Michael Schreinlechner
- Medical University of Innsbruck, University Hospital of Internal Medicine, Cardiology and Angiology, Anichstrasse 35, A-6020 Innsbruck, Austria; (M.S.); (M.N.); (D.L.); (A.B.); (R.K.); (P.M.)
| | - Maria Noflatscher
- Medical University of Innsbruck, University Hospital of Internal Medicine, Cardiology and Angiology, Anichstrasse 35, A-6020 Innsbruck, Austria; (M.S.); (M.N.); (D.L.); (A.B.); (R.K.); (P.M.)
| | - Daniela Lener
- Medical University of Innsbruck, University Hospital of Internal Medicine, Cardiology and Angiology, Anichstrasse 35, A-6020 Innsbruck, Austria; (M.S.); (M.N.); (D.L.); (A.B.); (R.K.); (P.M.)
| | - Axel Bauer
- Medical University of Innsbruck, University Hospital of Internal Medicine, Cardiology and Angiology, Anichstrasse 35, A-6020 Innsbruck, Austria; (M.S.); (M.N.); (D.L.); (A.B.); (R.K.); (P.M.)
| | - Rudolf Kirchmair
- Medical University of Innsbruck, University Hospital of Internal Medicine, Cardiology and Angiology, Anichstrasse 35, A-6020 Innsbruck, Austria; (M.S.); (M.N.); (D.L.); (A.B.); (R.K.); (P.M.)
| | - Peter Marschang
- Medical University of Innsbruck, University Hospital of Internal Medicine, Cardiology and Angiology, Anichstrasse 35, A-6020 Innsbruck, Austria; (M.S.); (M.N.); (D.L.); (A.B.); (R.K.); (P.M.)
- Central Hospital of Bolzano, Department of Internal Medicine, Via Lorenz Boehler 5, I-39100 Bolzano, Italy
| | - Markus Theurl
- Medical University of Innsbruck, University Hospital of Internal Medicine, Cardiology and Angiology, Anichstrasse 35, A-6020 Innsbruck, Austria; (M.S.); (M.N.); (D.L.); (A.B.); (R.K.); (P.M.)
- Correspondence:
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Gombert A, Kotelis D, Rückbeil MV, Barbati M, Martin L, Marx G, Grommes J, Jacobs MJ, Schälte G. Increase of urinary TIMP-2 and IGFBP7 as potential predictor of acute kidney injury requiring renal replacement therapy and patients' outcome following complex endovascular and open thoracic abdominal aortic aneurysm surgery - a prospective observational study. VASA 2020; 50:101-109. [PMID: 32815460 DOI: 10.1024/0301-1526/a000902] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background: Acute kidney injury (AKI) as complication after open and endovascular repair of thoracoabdominal aortic aneurysm (TAAA) is one major predictor of mortality and postoperative complications. We evaluated tissue inhibitor of metalloproteinase 2 (TIMP-2) and insulin-like growth factor-binding protein 7 (IGFBP7) as combined early biomarker for AKI detection and predictor of patients' outcome. Patients and methods: Between 2014 and 2015, 52 patients have been enrolled in this observational study, of whom 29 (55.8%) underwent elective open repair and 23 (44.2%) endovascular repair. TIMP2 × IGFBP7 were measured until 48 hours after admission on intensive-care unit (ICU) and were analyzed regarding their predictive ability for AKI (defined according to the KDIGO criteria) requiring temporary renal replacement therapy (RRT) and 90-day mortality using ROC curves. Results: Mean patient age was 64.5 years (Min: 43, Max: 85), endovascular treated patients were older (p <0.0001). 40.4% (n = 21) developed AKI, and 21.2% (n = 11) required renal replacement therapy. In-hospital and total mortality rates were 7.7% (n = 4) and 9.6% (n = 5), respectively. At no time a significant difference in TIMP2 × IGFB7 levels between patients undergoing open or endovascular surgery was observed. The predictive quality of the TIMP2 × IGFBP7 value on ICU admission was sound regarding AKI requiring temporary renal replacement therapy (sensitivity: 55.56% [38.1-72.1%], specificity: 90.91% [58.7-99.8%] with an area under the curve [AUC]: 0.694 [0.543-0.820]). Mean follow-up was 13.2 months (Min: 2, Max: 20), regarding the 90-day mortality, the predictive property of the TIMP2 × IGFBP7 value was not sufficient (sensitivity: 80% [28.4-99.5%], specificity: 52.38% [36.4-68%], and AUC: 0.607 [0.454-0.746]). Conclusions: TIMP2 × IGFBP7 level measured 6-12 hrs postoperatively may be useful as an early detectable biomarker for AKI requiring temporary renal replacement therapy. It seems not suited to predict patients' outcome following complex thoracoabdominal aortic surgery, regardless if performed by open or endovascular repair.
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Affiliation(s)
- Alexander Gombert
- European Vascular Center Aachen-Maastricht, University Hospital Aachen, RWTH Aachen University, Germany
| | - Drosos Kotelis
- European Vascular Center Aachen-Maastricht, University Hospital Aachen, RWTH Aachen University, Germany
| | - Marcia V Rückbeil
- Department of Medical Statistics, University Hospital Aachen, RWTH Aachen University, Germany
| | - Mohammad Barbati
- European Vascular Center Aachen-Maastricht, University Hospital Aachen, RWTH Aachen University, Germany
| | - Lukas Martin
- Department of Intensive Care and Intermediate Care, University Hospital Aachen, RWTH Aachen University, Germany
| | - Gernot Marx
- Department of Intensive Care and Intermediate Care, University Hospital Aachen, RWTH Aachen University, Germany
| | - Jochen Grommes
- European Vascular Center Aachen-Maastricht, University Hospital Aachen, RWTH Aachen University, Germany
| | - Michael J Jacobs
- European Vascular Center Aachen-Maastricht, University Hospital Aachen, RWTH Aachen University, Germany
| | - Gereon Schälte
- Department of Anesthesiology, University Hospital Aachen, RWTH Aachen University, Germany
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Sladojevic M, Zlatanovic P, Stanojevic Z, Koncar I, Vidicevic S, Tasic J, Isakovic A, Tomic I, Mutavdzic P, Stevanovic K, Trailovic R, Davidovic L. Influence of preoperative statins and aspirin administration on biological and magnetic resonance imaging properties in patients with abdominal aortic aneurysm. VASA 2020; 50:116-124. [PMID: 32669062 DOI: 10.1024/0301-1526/a000895] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Background: Main objective of this study was to evaluate the influence of statins and/or acetylsalicylic acid on biochemical characteristics of abdominal aortic aneurysm (AAA) wall and intraluminal thrombus (ILT). Patients and methods: Fifty patients with asymptomatic infrarenal AAA were analyzed using magnetic resonance imaging on T1w sequence. Relative ILT signal intensity (SI) was determined as a ratio between ILT and psoas muscle SI. Samples containing the full ILT thickness and aneurysm wall were harvested from the anterior surface at the level of the maximal diameter. The concentration of enzymes such as matrix metalloproteinase (MMP) 9, MMP2 and neutrophil elastase (NE/ELA) were analyzed in ILT and AAA wall; while collagen type III, elastin and proteoglycan 4 were analyzed in harvested AAA wall. Oxidative stress in the AAA wall was assessed by catalase and malondialdehyde activity in tissue samples. Results: Relative ILT signal intensity (1.09 ± 0.41 vs 0.89 ± 0.21, p = 0.013) were higher in non-statin than in statin group. Patients who were taking aspirin had lower relative ILT area (0.89 ± 0.19 vs 1.13. ± 0.44, p = 0.016), and lower relative ILT signal intensity (0.85 [0.73-1.07] vs 1.01 [0.84-1.19], p = 0.021) compared to non-aspirin group. There were higher concentrations of elastin in AAA wall among patients taking both of aspirin and statins (1.21 [0.77-3.02] vs 0.78 (0.49-1.05) ng/ml, p = 0.044) than in patients who did not take both of these drugs. Conclusions: Relative ILT SI was lower in patients taking statin and aspirin. Combination of antiplatelet therapy and statins was associated with higher elastin concentrations in AAA wall.
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Affiliation(s)
- Milos Sladojevic
- School of Medicine, University of Belgrade, Serbia.,Clinic for Vascular and Endovascular Surgery, Clinical Center of Serbia, Belgrade, Serbia
| | - Petar Zlatanovic
- Clinic for Vascular and Endovascular Surgery, Clinical Center of Serbia, Belgrade, Serbia
| | - Zeljka Stanojevic
- Institute of Medical and Clinical Biochemistry, School of Medicine, University of Belgrade, Serbia
| | - Igor Koncar
- School of Medicine, University of Belgrade, Serbia.,Clinic for Vascular and Endovascular Surgery, Clinical Center of Serbia, Belgrade, Serbia
| | - Sasenka Vidicevic
- Institute of Medical and Clinical Biochemistry, School of Medicine, University of Belgrade, Serbia
| | - Jelena Tasic
- Institute of Medical and Clinical Biochemistry, School of Medicine, University of Belgrade, Serbia
| | - Aleksandra Isakovic
- Clinic for Vascular and Endovascular Surgery, Clinical Center of Serbia, Belgrade, Serbia.,Institute of Medical and Clinical Biochemistry, School of Medicine, University of Belgrade, Serbia
| | - Ivan Tomic
- School of Medicine, University of Belgrade, Serbia.,Clinic for Vascular and Endovascular Surgery, Clinical Center of Serbia, Belgrade, Serbia
| | - Perica Mutavdzic
- Clinic for Vascular and Endovascular Surgery, Clinical Center of Serbia, Belgrade, Serbia
| | - Ksenija Stevanovic
- School of Medicine, University of Belgrade, Serbia.,Clinic for Vascular and Endovascular Surgery, Clinical Center of Serbia, Belgrade, Serbia
| | - Ranko Trailovic
- Clinic for Vascular and Endovascular Surgery, Clinical Center of Serbia, Belgrade, Serbia
| | - Lazar Davidovic
- School of Medicine, University of Belgrade, Serbia.,Clinic for Vascular and Endovascular Surgery, Clinical Center of Serbia, Belgrade, Serbia
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8
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Simvastatin Attenuates Abdominal Aortic Aneurysm Formation Favoured by Lack of Nrf2 Transcriptional Activity. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2020; 2020:6340190. [PMID: 32617140 PMCID: PMC7315306 DOI: 10.1155/2020/6340190] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 05/19/2020] [Accepted: 05/29/2020] [Indexed: 12/21/2022]
Abstract
Surgical intervention is currently the only option for an abdominal aortic aneurysm (AAA), preventing its rupture and sudden death of a patient. Therefore, it is crucial to determine the pathogenic mechanisms of this disease for the development of effective pharmacological therapies. Oxidative stress is said to be one of the pivotal factors in the pathogenesis of AAAs. Thus, we aimed to evaluate the significance of nuclear factor erythroid 2-related factor 2 (Nrf2) transcriptional activity in the development of AAA and to verify if simvastatin, administered as pre- and cotreatment, may counteract this structural malformation. Experiments were performed on mice with inhibited transcriptional activity of Nrf2 (tKO) and wild-type (WT) counterparts. We used a model of angiotensin II- (AngII-) induced AAA, combined with a fat-enriched diet. Mice were administered with AngII or saline for up to 28 days via osmotic minipumps. Simvastatin administration was started 7 days before the osmotic pump placement and then continued until the end of the experiment. We found that Nrf2 inactivation increased the risk of development and rupture of AAA. Importantly, these effects were reversed by simvastatin in tKO mice, but not in WT. The abrupt blood pressure rise induced by AngII was mitigated in simvastatin-treated animals regardless of the genotype. Simvastatin-affected parameters that differed between the healthy structure of the aorta and aneurysmal tissue included immune cell infiltration of the aortic wall, VCAM1 mRNA and protein level, extracellular matrix degradation, TGF-β1 mRNA level, and ERK phosphorylation, but neither oxidative stress nor the level of Angiotensin II Type 1 Receptor (AT1R). Taken together, the inhibition of Nrf2 transcriptional activity facilitates AAA formation in mice, which can be prevented by simvastatin. It suggests that statin treatment of patients with hypercholesterolemia might have not only a beneficial effect in terms of controlling atherosclerosis but also potential AAA prevention.
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Jabłońska A, Zagrapan B, Neumayer C, Klinger M, Eilenberg W, Nanobachvili J, Paradowska E, Brostjan C, Huk I. TLR2 2029C/T and TLR3 1377C/T and −7C/A Polymorphisms Are Associated with the Occurrence of Abdominal Aortic Aneurysm. THE JOURNAL OF IMMUNOLOGY 2020; 204:2900-2909. [DOI: 10.4049/jimmunol.1901014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 03/23/2020] [Indexed: 01/08/2023]
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Magnetic resonance imaging assessment of proteolytic enzyme concentrations and biologic properties of intraluminal thrombus in abdominal aortic aneurysms. J Vasc Surg 2020; 72:1025-1034. [PMID: 32067878 DOI: 10.1016/j.jvs.2019.11.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 11/04/2019] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The aim of the study was to determine whether magnetic resonance imaging (MRI) can be used in assessment of biologic activity of intraluminal thrombus (ILT) and proteolytic processes of the abdominal aortic aneurysm wall. METHODS Using MRI, 50 patients with asymptomatic infrarenal abdominal aortic aneurysm were analyzed at the maximum aneurysm diameter on T1-weighted images in the arterial phase after administration of contrast material. Relative ILT signal intensity (SI) was determined as the ratio between ILT SI and psoas muscle SI. During surgery, the full thickness of the ILT and the adjacent part of the aneurysm wall were harvested at the maximal diameter for biochemical analysis. The concentrations of matrix metalloproteinase 9 and neutrophil elastase (NE/ELA) were analyzed in harvested thrombi, and the concentrations of collagen type III, elastin, and proteoglycans were analyzed in harvested aneurysm walls. RESULTS A significant positive correlation was found between the NE/ELA concentration of the ILT and the relative SI (ρ = 0.309; P = .029). Furthermore, a negative correlation was observed between the elastin content of the aneurysm wall and the relative SI (ρ = -0.300; P = .034). No correlations were found between relative SI and concentration of matrix metalloproteinase 9, NE/ELA, collagen type III, or proteoglycan 4 in the aneurysm wall. CONCLUSIONS These findings indicate a potential novel use of MRI in prediction of thrombus proteolytic enzyme concentrations and the extracellular matrix content of the aneurysm wall, thus providing additional information for the risk of potential aneurysm rupture.
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Liu YJ, Wang XZ, Wang Y, He RX, Yang L, Jing QM, Liu HW. Correlation between Sex and Prognosis of Acute Aortic Dissection in the Chinese Population. Chin Med J (Engl) 2018; 131:1430-1435. [PMID: 29893359 PMCID: PMC6006807 DOI: 10.4103/0366-6999.233943] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The prevalence, presentation, management, and prognosis of coronary heart disease differ according to sex. Greater understanding on the differences between men and women with acute aortic dissection (AAD) is needed. We aimed to investigate whether sex disparities are found in patients with AAD, and to study sex differences in complications, mortality in-hospital, and long-term. METHODS We included 884 patients enrolled in our institute between June 2002 and May 2016. Considering psychosocial factors, treatments, and the outcomes in men versus those in women with AAD, we explored the association of sex with psychosocial characteristics and mortality risk. For categorical variables, significant differences between groups were assessed with the Chi-square test or Fisher's exact test, and continuous parameters were assessed with Student's t-test. Univariate and stratified survival statistics were computed using Kaplan-Meier analysis. RESULTS A total of 884 patients (76.1% male, mean age 51.4 ± 11.8 years) were included in this study. There were fewer current smokers in female compared with male (17.5% vs. 67.2%, χ2 = 160.06, P < 0.05). The percentage of men who reported regular alcohol consumption was significantly higher than that in women (40.6% vs. 3.8%, χ2 = 100.18, P < 0.05). About 6.2% (55 of 884) of patients with AAD died before vascular or endovascular surgery was performed, 34.4% (304 of 884) of patients underwent surgical procedures, and 52.7% (466 of 884) and 12.8% (113 of 884) of patients received endovascular treatment and medication. Postoperative mortality similar (6.0% vs. 5.6%, respectively, χ2 = 0.03, P = 0.91) between men and women. Follow-up was completed in 653 of 829 patients (78.8%). Adjustment for age, history of coronary disease, hypertension, smoking and drinking, Type A and use of beta-blocker, angiotensin II receptor blockers, angiotensin converting enzyme (ACE) inhibitor, calcium-channel blockers and statins by multivariate logistic regression analysis suggested that age (odds ratios [OR s], 1.04; 95% confidence interval [CI], 1.01-1.07; P < 0.05), using of calcium-channel blockers (OR, 0.37; 95% CI, 0.18-0.74; P < 0.05), at discharge were independent predictors of late mortality, ACE inhibitors (OR, 1.91; 95% CI, 1.03-3.54; P = 0.04) was independent risk factor of late mortality. CONCLUSIONS In Chinese with AAD, sex is not independently associated with long-term clinical outcomes. Age, the intake of calcium-channel blockers at discharge might help to improve long-term outcomes.
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Affiliation(s)
- Yan-Jie Liu
- Department of Cardiology, Institute of Cardiovascular Research, General Hospital of Shenyang Military Region, Shenyang, Liaoning 110016, China
| | - Xiao-Zeng Wang
- Department of Cardiology, Institute of Cardiovascular Research, General Hospital of Shenyang Military Region, Shenyang, Liaoning 110016, China
| | - Ya Wang
- Department of Cardiology, Institute of Cardiovascular Research, General Hospital of Shenyang Military Region, Shenyang, Liaoning 110016, China
| | - Rui-Xia He
- Department of Cardiology, Institute of Cardiovascular Research, General Hospital of Shenyang Military Region, Shenyang, Liaoning 110016, China
| | - Lin Yang
- Department of Cardiology, Institute of Cardiovascular Research, General Hospital of Shenyang Military Region, Shenyang, Liaoning 110016, China
| | - Quan-Min Jing
- Department of Cardiology, Institute of Cardiovascular Research, General Hospital of Shenyang Military Region, Shenyang, Liaoning 110016, China
| | - Hai-Wei Liu
- Department of Cardiology, Institute of Cardiovascular Research, General Hospital of Shenyang Military Region, Shenyang, Liaoning 110016, China
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Siennicka A, Zuchowski M, Kaczmarczyk M, Cnotliwy M, Clark JS, Jastrzębska M. Tissue factor levels and the fibrinolytic system in thin and thick intraluminal thrombus and underlying walls of abdominal aortic aneurysms. J Vasc Surg 2018; 68:30S-37S. [PMID: 29571624 DOI: 10.1016/j.jvs.2017.12.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 12/08/2017] [Indexed: 10/17/2022]
Abstract
BACKGROUND The hemostatic system cooperates with proteolytic degradation in processes allowing abdominal aortic aneurysm (AAA) formation. In previous studies, it has been suggested that aneurysm rupture depends on intraluminal thrombus (ILT) thickness, which varies across each individual aneurysm. We hypothesized that hemostatic components differentially accumulate in AAA tissue in relation to ILT thickness. Thick (A1) and thin (B1) segments of ILTs and aneurysm wall sections A (adjacent to A1) and B (adjacent to B1) from one aneurysm sac were taken from 35 patients undergoing elective repair. METHODS Factor levels were measured using enzyme-linked immunosorbent assay of protein extract. RESULTS Tissue factor (TF) activities were significantly higher in thinner segments of AAA (B1 vs A1, P = .003; B vs A, P < .001; B vs A1, P < .001; B vs B1, P = .001). Significantly higher tissue plasminogen activator was found in thick thrombus-covered wall segments (A) than in B, A1, and B1 (P = .015, P < .001, and P < .001, respectively). Plasminogen concentrations were highest in ILT. Concentrations of α2-antiplasmin in thin ILT adjacent walls (B) were higher compared with wall (A) adjacent to thick ILT (P = .021) and thick ILT (A1; P < .001). Significant correlations between levels of different factors were mostly found in thick ILT (A1). However, no correlations were found at B sites, except for a correlation between plasmin and TF activities (r = 0.55; P = .004). CONCLUSIONS These results suggest that higher TF activities are present in thinner AAA regions. These parameters and local fibrinolysis may be part of the processes leading to destruction of the aneurysm wall.
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Affiliation(s)
- Aldona Siennicka
- Department of Laboratory Diagnostics, Pomeranian Medical University, Szczecin, Poland.
| | - Marta Zuchowski
- Department of Laboratory Diagnostics, Pomeranian Medical University, Szczecin, Poland
| | - Mariusz Kaczmarczyk
- Department of Clinical and Molecular Biochemistry, Pomeranian Medical University, Szczecin, Poland
| | - Miłosław Cnotliwy
- Department of Vascular Surgery and Angiology, Pomeranian Medical University, Szczecin, Poland
| | - Jeremy Simon Clark
- Department of Clinical and Molecular Biochemistry, Pomeranian Medical University, Szczecin, Poland
| | - Maria Jastrzębska
- Department of Laboratory Diagnostics, Pomeranian Medical University, Szczecin, Poland
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Simvastatin Treatment Upregulates HO-1 in Patients with Abdominal Aortic Aneurysm but Independently of Nrf2. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2018; 2018:2028936. [PMID: 29743974 PMCID: PMC5883937 DOI: 10.1155/2018/2028936] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 01/08/2018] [Accepted: 01/16/2018] [Indexed: 12/24/2022]
Abstract
Heme oxygenase-1 (HO-1), encoded by HMOX1 gene and regulated by Nrf2 transcription factor, is a cytoprotective enzyme. Its deficiency may exacerbate abdominal aortic aneurysm (AAA) development, which is also often associated with hyperlipidemia. Beneficial effects of statins, the broadly used antilipidemic drugs, were attributed to modulation of Nrf2/HO-1 axis. However, the effect of statins on Nrf2/HO-1 pathway in patients with AAA has not been studied yet. We analyzed AAA tissue from patients treated with simvastatin (N = 28) or without statins (N = 14). Simvastatin treatment increased HO-1 protein level in AAA, both in endothelial cells (ECs) and in smooth muscle cells (SMCs), but increased Nrf2 localization was restricted only to vasa vasorum. Nrf2 target genes HMOX1, NQO1, and GCLM expression remained unchanged in AAA. In vitro studies showed that simvastatin raises HO-1 protein level slightly in ECs and to much higher extent in SMCs, which is not related to Nrf2/ARE activation, although HMOX1 expression is upregulated by simvastatin in both cell types. In conclusion, simvastatin-induced modulation of HO-1 level in ECs and SMCs in vitro is not related to Nrf2/ARE activity. Likewise, divergent HO-1 and Nrf2 localization together with stable expression of Nrf2 target genes, including HMOX1, in AAA tissue denotes Nrf2 independency.
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Li Y, Yang N. Microarray expression profile analysis of long non-coding RNAs in thoracic aortic aneurysm. Kaohsiung J Med Sci 2017; 34:34-42. [PMID: 29310814 DOI: 10.1016/j.kjms.2017.09.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 08/22/2017] [Accepted: 09/01/2017] [Indexed: 01/16/2023] Open
Abstract
Thoracic aortic aneurysm (TAA) is a highly lethal vascular disease. Long non-coding RNAs (lncRNAs) are newly discovered as a regulator of protein genes and play critical roles in cardiovascular physio-pathological processes. However, there were a few studies looking at lncRNAs in TAA. In this study, we profiled differential expression of lncRNAs between TAA (TAA group, N = 6) and normal thoracic aorta (control group, n = 6) by third-generation lncRNA microarray. We identified 1352 up-regulated and 1624 down-regulated lncRNAs with differential expression (log fold-change > 2.0, p < 0.01). Through nearby protein-coding gene associated with extracellular matrix (ECM) metabolism and vascular smooth muscle cell (VSMC) apoptosis, 12 up-regulated and 9 down-regulated lncRNAs were selected for further analysis. By calculating phastCons score of base, we identified 8 candidate lncRNAs (4 up-regulated and 4 down-regulated) with high conservation across species. By tissue specificity analysis, we found that 5 lncRNAs (HIF1A-AS1, RP11-465L10.10, LOC100506472, CTD-2184D3.5 and RP-399O19.5) were highly expressed in aortic tissues, suggested that they may be closely associated with TAA. Among them, 2 lncRNAs (RP11-465L10.10 and CTD-2184D3.5) with higher specificity in aorta (p < 0.01) were analyzed by bioinformatics. Further catRAPID analysis revealed a strong RNA-protein interaction between RP11-465L10.10 and myeloid zinc finger gene 1 (MZF1), a transcription factor of MMP9. However, no intense RNA-protein interactions were observed between CTD-2184D3.5 and transcript factors of MAPK6. In conclusions, our study showed differential expression profiles of lncRNAs in TAA and revealed the interaction between certain lncRNAs and coding genes. These data provides insights into new biomarker and therapeutic targets for TAA.
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Affiliation(s)
- Yang Li
- Department of General Surgery, Beijing Yuho Rehabilitation Hospital of Integrated Chinese and Western Medicine, Beijing, China.
| | - Nan Yang
- Department of Stomatology, PLA 309th Hospital, Beijing, China
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Pantoja Peralta C, Hernández Aguilera A, Gómez Moya B. Quistes renales y aneurismas de aorta de gran tamaño. ANGIOLOGIA 2017. [DOI: 10.1016/j.angio.2016.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Neutrophil gelatinase-associated lipocalin levels are U-shaped in the Ludwigshafen Risk and Cardiovascular Health (LURIC) study-Impact for mortality. PLoS One 2017; 12:e0171574. [PMID: 28207778 PMCID: PMC5312954 DOI: 10.1371/journal.pone.0171574] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Accepted: 01/22/2017] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION Neutrophil gelatinase-associated lipocalin (NGAL) is a glycoprotein released by damaged renal tubular cells and mature neutrophils. It is elevated in kidney injury, but also in patients with coronary artery disease (CAD) and myocardial infarction. We investigated the prognostic value of NGAL for total and cardiovascular mortality in patients undergoing coronary angiography without history of renal insufficiency at inclusion into the study. PARTICIPANTS The LURIC study is an ongoing prospective cohort study of patients referred for coronary angiography and is designed to evaluate determinants of cardiovascular health. RESULTS NGAL was determined in plasma of 2997 persons (mean age: 62.7 years; 69.7% men) with a follow up for 10 years. 2358 patients suffered from CAD and 638 did not-these patients served as controls. Stable CAD was found in 1408 and unstable CAD in 950 patients. Death rate from cardiovascular events and all causes was highest in patients within the 4th quartile of NGAL (≥56 ng/ml, p<0.001 vs third quartile), even after adjustment for age and gender. According to multivariable-adjusted Cox analysis adjusting for well-known cardiovascular risk factors, as well as lipid lowering therapy, angiographic CAD, and C-reactive protein we found patients in the highest NGAL quartile being at increased risk for cardiovascular (hazard ratio (HR) 1.33, 95%CI 1.05-1.67, p = 0.016) and all cause mortality (HR 1.29 95%CI 1.07-1.55, p = 0.007) compared to those in the third quartile. The lowest risk was seen in the third quartile of NGAL (41-56 ng/ml) suggesting a U-shaped relationship between NGAL and mortality. Further adjustment for creatinine abrogated the predictive effect of NGAL. However, the 3rd and 4th quartiles of NGAL were significantly associated with higher neutrophil counts, which were associated with CAD, non-ST elevation and ST-elevation myocardial infarction (p<0.05). CONCLUSIONS Plasma NGAL concentrations are mainly derived from neutrophils and do not predict mortality independent of renal function.
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Mansi IA, Frei CR, Halm EA, Mortensen EM. Association of statins with aortic, peripheral, and visceral artery aneurysm development. Vascular 2016; 25:372-381. [DOI: 10.1177/1708538116684942] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Objectives Prior studies examining the effects of statins on arterial aneurysm development and progression yielded conflicting results due to their smaller size and presence of residual confounders. The objective of this study is to examine the association of statins with risk of being diagnosed with aortic, peripheral, and visceral artery aneurysm. Methods This was a retrospective cohort study of Tricare enrollees (from 1 October 2003 to 31 March 2012). Main outcomes were diagnosis of aortic, peripheral, or visceral artery aneurysm and undergoing aortic aneurysm repair procedure during follow-up period. Using 115 baseline characteristics, we generated a propensity score to match statin users and nonusers and examine the odds of outcomes (primary analysis). Secondary analysis examined outcomes at various subcohorts. Results Out of 10,910 statin users and 49,545 nonusers, we propensity score-matched 6728 pairs of statin users and nonusers. Statin users and nonusers had similar odds of being diagnosed with aortic, peripheral, and visceral artery aneurysms (odds ratio [OR]: 1.06, 95% confidence interval [95% CI]: 0.85–1.33) and of undergoing aortic aneurysm repair procedures (OR: 0.54, 95% CI: 0.22–1.35). Secondary analysis showed a tendency toward fewer aortic aneurysm procedures among statin users that did not reach statistical significance. However, high-intensity statin users in comparison to non-intensive statin users had higher adjusted odds of aortic, peripheral, and visceral artery aneurysms (OR: 1.76, 95% CI: 1.37–2.25, p < .0001). Conclusions This study does not support a clinically significant benefit or harm from statins regarding development of arterial aneurysm. However, secondary analyses may support the hypothesis proposed by previous research proposing a bidirectional role for statins.
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Affiliation(s)
- Ishak A Mansi
- Department of Medicine, VA North Texas Health Care System, Dallas, TX, USA
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Christopher R Frei
- College of Pharmacy, The University of Texas at Austin, San Antonio, TX, USA
- Department of Medicine, School of Medicine, University of Texas Health Science Center, San Antonio, TX, USA
| | - Ethan A Halm
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Eric M Mortensen
- Department of Medicine, VA North Texas Health Care System, Dallas, TX, USA
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA
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Eilenberg W, Stojkovic S, Piechota-Polanczyk A, Kaun C, Rauscher S, Gröger M, Klinger M, Wojta J, Neumayer C, Huk I, Demyanets S. Neutrophil Gelatinase-Associated Lipocalin (NGAL) is Associated with Symptomatic Carotid Atherosclerosis and Drives Pro-inflammatory State In Vitro. Eur J Vasc Endovasc Surg 2016; 51:623-31. [PMID: 26947538 DOI: 10.1016/j.ejvs.2016.01.009] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Accepted: 01/16/2016] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Neutrophil gelatinase-associated lipocalin (NGAL), a protein found in activated neutrophils, is expressed in kidney tubule cells in response to noxious stimuli, and is thus recognized as a marker of acute kidney injury. Recent studies have suggested that NGAL could also have pathophysiological importance in cardiovascular diseases. The aim of the present study was to examine NGAL expression in human carotid endarterectomy tissues ex vivo as well as the effects of NGAL in the main cell types involved in atherogenesis, namely in human macrophages, endothelial cells, and smooth muscle cells in vitro. METHODS NGAL protein was analyzed in human endarterectomy samples from patients with asymptomatic and symptomatic carotid stenosis by immunofluorescence, and NGAL mRNA expression was detected using RealTime-PCR. Human monocyte derived macrophages (MDM), human coronary artery smooth muscle cells (HCASMC), and human umbilical vein endothelial cells (HUVEC) were treated with recombinant human (rh) NGAL at different concentrations. Interleukin (IL)-6, IL-8, and monocyte chemo-attractant protein-1 (MCP-1) were determined by specific enzyme linked immunosorbent assays (ELISAs) in culture supernatants of such treated cells. RESULTS Expression of NGAL protein was demonstrated by macrophages, smooth muscle cells, and endothelial cells in human carotid atherosclerotic tissue. NGAL mRNA expression was detected at a higher rate in atherosclerotic tissue of patients with symptomatic carotid stenosis (in 70%; n = 19) compared with asymptomatic patients (in 37%; n = 20, p < .001). Treatment of MDM, HCASMC, and HUVEC with rhNGAL led to a significant (p < 0.05) and concentration dependent increase of pro-inflammatory cytokines IL-6, IL-8, and MCP-1 in all cell types analyzed. CONCLUSION By induction of pro-inflammatory mediators in human macrophages, smooth muscle cells and endothelial cells, NGAL, which is predominantly expressed in atherosclerotic plaques of symptomatic patients, could be involved in creating the local and systemic pro-inflammatory environment characteristic for atherosclerosis.
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Affiliation(s)
- W Eilenberg
- Department of Surgery, Division of Vascular Surgery, Medical University of Vienna, Austria
| | - S Stojkovic
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Austria
| | - A Piechota-Polanczyk
- Department of Surgery, Division of Vascular Surgery, Medical University of Vienna, Austria
| | - C Kaun
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Austria
| | - S Rauscher
- Core Facilities, Medical University of Vienna, Austria
| | - M Gröger
- Core Facilities, Medical University of Vienna, Austria
| | - M Klinger
- Department of Surgery, Division of Vascular Surgery, Medical University of Vienna, Austria
| | - J Wojta
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Austria; Core Facilities, Medical University of Vienna, Austria
| | - C Neumayer
- Department of Surgery, Division of Vascular Surgery, Medical University of Vienna, Austria
| | - I Huk
- Department of Surgery, Division of Vascular Surgery, Medical University of Vienna, Austria
| | - S Demyanets
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria.
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Ayça B, Rakıcı T, Atıcı Y, Avsar M, Yuksel Y, Akın F, Okuyan E, Hakan Dinckal M. Adult degenerative scoliosis associated with increased aortic diameter and plaque burden and composition. Vascular 2015. [PMID: 26223527 DOI: 10.1177/1708538115597371] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE In this study, we aimed to investigate the relationship between adult degenerative scoliosis (ADS) and the aortic plaques and diameters. METHOD We included 219 patients with ADS and 100 control patients without ADS. Diameters of ascending, arch, descending and abdominal aorta and number, localization and types of the aortic plaques, and the Cobb angles of all patients were measured from computed tomography (CT) images. We divided the patients with ADS into three groups according to the Cobb angle, and divided them into four groups according to level of spine deformity. RESULTS The patients with ADS had a larger aorta and more aortic plaques (both, p < 0.001). The patients with ADS had more fibro-fatty and mix plaques (both, p < 0.001). The patients with severe ADS had larger diameters of the ascending and arch of the aorta (p = 0.026 and p = 0.027, respectively). The patients with the main thoracic curve had a larger ascending aorta and the patients with a thoracolumbar curve had more aortic plaques (p = 0.035 and p = 0.029, respectively). In multivariate regression analysis, the ADS was an independent risk factor for both aortic dilatation (>3.6 cm) and aortic plaque build-up (both, p < 0.001). CONCLUSION The ADS may be a risk factor for aortic dilatation and aortic atherosclerosis.
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Affiliation(s)
- Burak Ayça
- Department of Cardiology, Bağcılar Education and Research Hospital, Istanbul, Turkey
| | - Taşkın Rakıcı
- Department of Radiology, Samatya Education and Research Hospital, Istanbul, Turkey
| | - Yunus Atıcı
- Department of Orthopaedics and Traumatology, Metin Sabancı Baltalimanı Bone Disease Education and Research Hospital, Istanbul, Turkey
| | - Murat Avsar
- Department of Cardiology, Bağcılar Education and Research Hospital, Istanbul, Turkey
| | - Yasin Yuksel
- Department of Cardiology, Samatya Education and Research Hospital, Istanbul, Turkey
| | - Fatih Akın
- School of Medicine, Department of Cardiology, Muğla Sıtkı Kocman University, Muğla, Turkey
| | - Ertugrul Okuyan
- Department of Cardiology, Bağcılar Education and Research Hospital, Istanbul, Turkey
| | - M Hakan Dinckal
- Department of Cardiology, Bağcılar Education and Research Hospital, Istanbul, Turkey
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