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Zhang Q, Shi LF, Chen RD, Zhao HH, Yu C, Wang YR, Lu P. Geniposide modulates GSK3β to inhibit Th17 differentiation and mitigate endothelial damage in intracranial aneurysm. Phytother Res 2024; 38:5184-5202. [PMID: 39180344 DOI: 10.1002/ptr.8320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 07/31/2024] [Accepted: 07/31/2024] [Indexed: 08/26/2024]
Abstract
Intracranial aneurysm (IA) is a common cerebrovascular disease. Immune system disorders and endothelial dysfunction are essential mechanisms of its pathogenesis. This study aims to explore the therapeutic effect and mechanism of Geniposide (Gen) on IA, which has a protective impact on endothelial cells and cardiovascular and cerebrovascular diseases. IA mouse models were administered intraperitoneal injections of geniposide for 2 weeks following elastase injection into the right basal ganglia of the brain for intervention. The efficacy of Gen in treating IA was evaluated through pathological testing and transcriptome sequencing analysis of Willis ring vascular tissue. The primary mechanism of action was linked to the expression of GSK3β in Th17 cells. The percentage of splenic Th17 cell differentiation in IA mice was significantly inhibited by Gen. GSK3β/STAT3, and other pathway protein expression levels were also significantly inhibited by Gen. Additionally, TNF-α and IL-23 cytokine contents were significantly downregulated after Gen treatment. These results indicated that Gen significantly inhibited the percentage of Th17 cell differentiation, an effect that was reversed upon overexpression of the GSK3B gene. Furthermore, Gen-treated, Th17 differentiation-inducing cell-conditioned medium significantly up-regulated the expression of tight junction proteins ZO-1, Occludin, and Claudin-5 in murine aortic endothelial cells. Administering the GSK3β inhibitor Tideglusib to IA mice alleviated the severity of IA disease pathology and up-regulated aortic tight junction protein expression. In conclusion, Gen inhibits Th17 cell differentiation through GSK3β, which reduces endothelial cell injury and up-regulates tight junction protein expression.
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Affiliation(s)
- Qian Zhang
- Department of Neurosurgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Lu-Feng Shi
- Department of Neurosurgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Run-Dong Chen
- School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, China
| | - He-He Zhao
- Department of Neurosurgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Cong Yu
- Department of Neurosurgery, Sir Run Run Shaw Hospital (Shaoxing), Shaoxing, China
| | - Yi-Rong Wang
- Department of Neurosurgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Peng Lu
- Department of Neurosurgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Amirsardari Z, Khalili A, Behnoush AH, Agahi S, Amirsardari F, Kohansal E, Sadeghipour P. Bridging the gap: Navigating the impact of dietary supplements on abdominal aortic aneurysm progression- A systematic review. PLoS One 2024; 19:e0305265. [PMID: 38923975 PMCID: PMC11207180 DOI: 10.1371/journal.pone.0305265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 05/28/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND Vitamins D, E, A, B, C, and Omega-3 play crucial roles in modulating inflammatory and oxidative stress pathways, both implicated in abdominal aortic aneurysm (AAA) development. Recent research has explored the potential impact of dietary supplements on AAA progression. The systematic review aims to assess interventional studies investigating the effects of various dietary supplements on the development and severity of abdominal aortic aneurysms. METHOD A systematic search using relevant keywords related to abdominal aortic aneurysm and dietary supplements was conducted across four databases (PubMed, Embase, Scopus, and Web of Science). Quality assessment for animal studies employed SYRCLE and the Cochrane Collaboration Risk of Bias Tool for randomized control trials. The study protocol is registered in PROSPERO under the registry code CRD42023455958. RESULTS Supplementation with Omega-3, Vitamins A, C, D, E, and the Vitamin B family exhibited positive effects in AAA progression. These supplements contributed to a reduction in AAA diameter, elastin degradation, inflammatory responses, and reactive oxygen species. Additional supplements such as Zinc, methionine, and phytoestrogen also played roles in mitigating AAA progression. CONCLUSION The findings of this study underscore the potential role of dietary supplements in the progression of AAA. Predominantly based on animal studies, the results indicate that these supplements can limit AAA progression, primarily evidenced by their ability to mitigate inflammatory processes and oxidative stress pathways.
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Affiliation(s)
- Zahra Amirsardari
- Cardiogenetic Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Asal Khalili
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Sadaf Agahi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Amirsardari
- School of Nursing and Midwifery, Lorestan University of Medical Sciences, Lorestan, Iran
| | - Erfan Kohansal
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Parham Sadeghipour
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
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Özdemir-van Brunschot DMD, Holzhey D, Botsios S. Sex-Related Differences in Proximal Neck Anatomy and Their Consequences in Patients after EVAR: A Matched Cohort Analysis. J Clin Med 2023; 12:4929. [PMID: 37568333 PMCID: PMC10419678 DOI: 10.3390/jcm12154929] [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: 06/18/2023] [Revised: 07/10/2023] [Accepted: 07/24/2023] [Indexed: 08/13/2023] Open
Abstract
INTRODUCTION Studies comparing male and female patients with abdominal aortic aneurysms have shown that female patients are generally older and more often experience postoperative complications after endovascular and open repair. There are also indications that female patients have more extensive neck pathologies and that they more often have postoperative complications related to proximal neck pathology. MATERIAL AND METHODS This retrospective study describes all consecutive female patients who underwent EVAR between 1 January 2012 and 31 December 2021. Propensity-score matching was used to obtain a matched control male cohort. Propensity scores were generated with the following anatomic parameters: infrarenal and suprarenal angulation, proximal and distal neck diameter and neck length. 1 Female patient was matched with 3 male patients. RESULTS A total of 160 patients were included, namely 120 male patients and 40 female patients. Due to matching, there were no significant differences regarding infrarenal and suprarenal angulation and proximal and distal neck diameter and length. All-cause and aneurysm-related mortality were comparable (p = 0.19 and p = 0.98). The necessity of neck-related secondary procedures was significantly higher in female patients (p = 0.02). In the multivariate analysis, the female sex was a significant predictor of endoleak type IA within 30 days. However, there was no significant association between intraoperative endoleak type IA and endoleak type IA at the end of follow-up. CONCLUSIONS This study suggests that there was a higher initial incidence of endoleak type IA in female patients, despite thematched preoperative anatomic parameter. Due to the relatively low number of included female patients, conclusions should be drawn carefully.
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Affiliation(s)
- Denise Michelle Danielle Özdemir-van Brunschot
- German Faculty of Health, Witten/Herdecke University, 58455 Witten, Germany
- Department of Vascular Surgery and Endovascular Therapy, Augusta Hospital and Catholic Hospital Group, 40472 Düsseldorf, Germany
| | - David Holzhey
- German Faculty of Health, Witten/Herdecke University, 58455 Witten, Germany
| | - Spiridon Botsios
- German Faculty of Health, Witten/Herdecke University, 58455 Witten, Germany
- Department of Vascular Surgery and Endovascular Therapy, Augusta Hospital and Catholic Hospital Group, 40472 Düsseldorf, Germany
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Novalia Rahmawati Sianipar R, Suryanegara L, Fatriasari W, Tangke Arung E, Wijaya Kusuma I, Setiati Achmadi S, Izyan Wan Azelee N, Ain Abdul Hamid Z. The Role of Selected Flavonoids from Bajakah Tampala (Spatholobus littoralis Hassk.) Stem on Cosmetic Properties: A Review. Saudi Pharm J 2023; 31:382-400. [PMID: 37026052 PMCID: PMC10071331 DOI: 10.1016/j.jsps.2023.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 01/22/2023] [Indexed: 01/27/2023] Open
Abstract
Cosmetics made from natural ingredients are increasingly popular because they contain bioactive compounds which can provide many health benefits, more environmentally friendly and sustainable. The health benefits obtained from natural-based ingredients include anti-aging, photoprotective, antioxidant, and anti-inflammatory. This article reviewed the potential of selected flavonoids from bajakah tampala (Spatholobus littoralis Hassk.) as the native plant in Indonesia. We present in silico, in vitro, in vivo, and clinical research data on the use of selected flavonoids that have been reported in other extracts.
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Yin L, Gregg AC, Riccio AM, Hoyt N, Islam ZH, Ahn J, Le Q, Patel P, Zhang M, He X, McKinney M, Kent E, Wang B. Dietary therapy in abdominal aortic aneurysm - Insights from clinical and experimental studies. Front Cardiovasc Med 2022; 9:949262. [PMID: 36211542 PMCID: PMC9532600 DOI: 10.3389/fcvm.2022.949262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 08/29/2022] [Indexed: 02/03/2023] Open
Abstract
Abdominal aortic aneurysm (AAA) is a prevalent vascular disease with high mortality rates upon rupture. Despite its prevalence in elderly populations, there remain limited treatment options; invasive surgical repair, while risky, is the only therapeutic intervention with proven clinical benefits. Dietary factors have long been suggested to be closely associated with AAA risks, and dietary therapies recently emerged as promising avenues to achieve non-invasive management of a wide spectrum of diseases. However, the role of dietary therapies in AAA remains elusive. In this article, we will summarize the recent clinical and pre-clinical efforts in understanding the therapeutic and mechanistic implications of various dietary patterns and therapeutic approaches in AAA.
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Affiliation(s)
- Li Yin
- Department of Surgery, School of Medicine, University of Virginia, Charlottesville, VA, United States
| | | | - Alessandra Marie Riccio
- Department of Surgery, School of Medicine, University of Virginia, Charlottesville, VA, United States
| | - Nicholas Hoyt
- Department of Surgery, School of Medicine, University of Virginia, Charlottesville, VA, United States,School of Medicine and Health Sciences, George Washington University, Washington, DC, United States
| | - Zain Hussain Islam
- Department of Surgery, School of Medicine, University of Virginia, Charlottesville, VA, United States
| | - Jungeun Ahn
- Department of Surgery, School of Medicine, University of Virginia, Charlottesville, VA, United States
| | - Quang Le
- Department of Surgery, School of Medicine, University of Virginia, Charlottesville, VA, United States
| | - Paranjay Patel
- Department of Surgery, School of Medicine, University of Virginia, Charlottesville, VA, United States
| | - Mengxue Zhang
- Department of Surgery, School of Medicine, University of Virginia, Charlottesville, VA, United States
| | - Xinran He
- Department of Surgery, School of Medicine, University of Virginia, Charlottesville, VA, United States
| | - Matthew McKinney
- Department of Surgery, School of Medicine, University of Virginia, Charlottesville, VA, United States
| | - Eric Kent
- Department of Surgery, School of Medicine, University of Virginia, Charlottesville, VA, United States
| | - Bowen Wang
- Department of Surgery, School of Medicine, University of Virginia, Charlottesville, VA, United States,*Correspondence: Bowen Wang
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Wu TC, Chang WH, Lu HY, Shih CC. Tolvaptan reduces angiotensin II-induced experimental abdominal aortic aneurysm and dissection. Vascul Pharmacol 2022; 144:106973. [DOI: 10.1016/j.vph.2022.106973] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 01/13/2022] [Accepted: 02/23/2022] [Indexed: 11/25/2022]
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Fashandi AZ, Spinosa M, Salmon M, Su G, Montgomery W, Mast A, Lu G, Hawkins RB, Cullen JM, Sharma AK, Ailawadi G, Upchurch GR. Female Mice Exhibit Abdominal Aortic Aneurysm Protection in an Established Rupture Model. J Surg Res 2020; 247:387-396. [PMID: 31699539 PMCID: PMC7111562 DOI: 10.1016/j.jss.2019.10.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 08/18/2019] [Accepted: 10/01/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Male gender is a well-established risk factor for abdominal aortic aneurysm (AAA), whereas estrogen is hypothesized to play a protective role. Although rupture rates are higher in women, these reasons remain unknown. In the present study, we sought to determine if female mice are protected from AAA rupture. MATERIALS AND METHODS Apolipoprotein E-deficient male and female mice (aged 7 wk; n = 25 per group) were infused with angiotensin II (AngII; 2000 ng/kg/min) plus β-aminopropionitrile (BAPN) in the drinking water for 28 d to test the effects of gender on AAA rupture. Separately, a second group of male apolipoprotein E-deficient mice underwent AngII infusion + BAPN while being fed high-fat phytoestrogen free or a high-fat phytoestrogen diet to assess effects of phytoestrogens on rupture. In a third group, female mice either underwent oophorectomy or sham operation 4 wk before infusion of AngII and BAPN to further test the effects of female hormones on AA rupture. Surviving mice abdominal aorta were collected for histology, cytokine array, and gelatin zymography on postoperative day 28. RESULTS Female mice had decreased AAA rupture rates (16% versus 46%; P = 0.029). Female mice expressed fewer elastin breaks (P = 0.0079) and decreased smooth muscle cell degradation (P = 0.0057). Multiple cytokines were also decreased in the female group. Gelatin zymography demonstrated significantly decreased pro-matrix metalloproteinase 2 in female mice (P = 0.001). Male mice fed a high dose phytoestrogen diet failed to decrease AAA rupture. Female mice undergoing oophorectomy did not have accelerated aortic rupture. CONCLUSIONS These data are the first to attempt to tease out hormonal effects on AAA rupture and the possible role of gender in rupture.
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Affiliation(s)
- Anna Z Fashandi
- Department of Surgery, School of Medicine, University of Virginia, Charlottesville, Virginia
| | - Michael Spinosa
- Department of Surgery, School of Medicine, University of Virginia, Charlottesville, Virginia
| | - Morgan Salmon
- Department of Surgery, School of Medicine, University of Virginia, Charlottesville, Virginia
| | - Gang Su
- Department of Surgery, College of Medicine, University of Florida, Gainesville, Florida
| | - William Montgomery
- Department of Surgery, School of Medicine, University of Virginia, Charlottesville, Virginia
| | - Alexis Mast
- Department of Surgery, College of Medicine, University of Florida, Gainesville, Florida
| | - Guanyi Lu
- Department of Surgery, College of Medicine, University of Florida, Gainesville, Florida
| | - Robert B Hawkins
- Department of Surgery, School of Medicine, University of Virginia, Charlottesville, Virginia
| | - J Michael Cullen
- Department of Surgery, School of Medicine, University of Virginia, Charlottesville, Virginia
| | - Ashish K Sharma
- Department of Surgery, College of Medicine, University of Florida, Gainesville, Florida
| | - Gorav Ailawadi
- Department of Surgery, School of Medicine, University of Virginia, Charlottesville, Virginia; The Robert M. Berne Cardiovascular Research Center, School of Medicine, University of Virginia, Charlottesville, Virginia
| | - Gilbert R Upchurch
- Department of Surgery, College of Medicine, University of Florida, Gainesville, Florida.
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Abstract
Current management of aortic aneurysms relies exclusively on prophylactic operative repair of larger aneurysms. Great potential exists for successful medical therapy that halts or reduces aneurysm progression and hence alleviates or postpones the need for surgical repair. Preclinical studies in the context of abdominal aortic aneurysm identified hundreds of candidate strategies for stabilization, and data from preoperative clinical intervention studies show that interventions in the pathways of the activated inflammatory and proteolytic cascades in enlarging abdominal aortic aneurysm are feasible. Similarly, the concept of pharmaceutical aorta stabilization in Marfan syndrome is supported by a wealth of promising studies in the murine models of Marfan syndrome-related aortapathy. Although some clinical studies report successful medical stabilization of growing aortic aneurysms and aortic root stabilization in Marfan syndrome, these claims are not consistently confirmed in larger and controlled studies. Consequently, no medical therapy can be recommended for the stabilization of aortic aneurysms. The discrepancy between preclinical successes and clinical trial failures implies shortcomings in the available models of aneurysm disease and perhaps incomplete understanding of the pathological processes involved in later stages of aortic aneurysm progression. Preclinical models more reflective of human pathophysiology, identification of biomarkers to predict severity of disease progression, and improved design of clinical trials may more rapidly advance the opportunities in this important field.
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Affiliation(s)
- Jan H. Lindeman
- Dept. Vascular Surgery, Leiden University Medical Center, The Netherlands
| | - Jon S. Matsumura
- Division of Vascular Surgery, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin
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Seto SW, Chang D, Kiat H, Wang N, Bensoussan A. Chinese Herbal Medicine as a Potential Treatment of Abdominal Aortic Aneurysm. Front Cardiovasc Med 2018; 5:33. [PMID: 29732374 PMCID: PMC5919947 DOI: 10.3389/fcvm.2018.00033] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 03/20/2018] [Indexed: 12/19/2022] Open
Abstract
Abdominal aortic aneurysm (AAA) is an irreversible condition where the abdominal aorta is dilated leading to potentially fatal consequence of aortic rupture. Multiple mechanisms are involved in the development and progression of AAA, including chronic inflammation, oxidative stress, vascular smooth muscle (VSMC) apoptosis, immune cell infiltration and extracellular matrix (ECM) degradation. Currently surgical therapies, including minimally invasive endovascular aneurysm repair (EVAR), are the only viable interventions for AAAs. However, these treatments are not appropriate for the majority of AAAs, which measure <50 mm. Substantial effort has been invested to identify and develop pharmaceutical treatments such as statins and doxycycline for this potentially lethal condition but these interventions failed to offer a cure or to retard the progression of AAA. Chinese herbal medicine (CHM) has been used for the management of cardiovascular diseases for thousands of years in China and other Asian countries. The unique multi-component and multi-target property of CHMs makes it a potentially ideal therapy for multifactorial diseases such as AAA. In this review, we review the current scientific evidence to support the use of CHMs for the treatment of AAA. Mechanisms of action underlying the effects of CHMs on AAA are also discussed.
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Affiliation(s)
- Sai Wang Seto
- NICM Health Research Institute, Western Sydney University, Penrith, Australia
| | - Dennis Chang
- NICM Health Research Institute, Western Sydney University, Penrith, Australia
| | - Hosen Kiat
- Faculty of Medicine, University of New South Wales, Sydney, Australia.,School of Medicine, Western Sydney University, Penrith, Australia.,Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| | - Ning Wang
- NICM Health Research Institute, Western Sydney University, Penrith, Australia.,Key Laboratory of Xin'an Medicine, Ministry of Education, Hefei, China.,College of Pharmacy, Anhui University of Chinese Medicine, Hefei, China.,Institute for Pharmacodynamics and Safety Evaluation of Chinese Medicine, Anhui University of Chinese Medicine, Hefei, China
| | - Alan Bensoussan
- NICM Health Research Institute, Western Sydney University, Penrith, Australia
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Tanaka T, Moriyama T, Kawamura Y, Yamanouchi D. Puerarin Suppresses Macrophage Activation via Antioxidant Mechanisms in a CaPO 4-Induced Mouse Model of Aneurysm. J Nutr Sci Vitaminol (Tokyo) 2017; 62:425-431. [PMID: 28202848 DOI: 10.3177/jnsv.62.425] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Aneurysm is characterized by balloon-like expansion of the arterial wall and eventual rupture of the aorta. The pathogenesis of aneurysm is associated with the degradation of matrix proteins by matrix metalloproteinases (MMPs) produced by activated macrophages. Although aneurysm is associated with significant mortality and morbidity, surgical intervention is the only proven treatment strategy. Therefore, development of therapeutic agents for aneurysm is greatly anticipated. Here, we demonstrated the protective effects of the major isoflavone puerarin, which is found in kudzu roots and vines. Aneurysms were surgically induced in ten-wk-old male mice using CaPO4. Subsequently, animals were intraperitoneally injected daily with puerarin at 2.5 mg/kg body weight or with vehicle alone for 2 wk. CaPO4-induced aneurysm was significantly suppressed by puerarin administration. In subsequent macrophage activation assays using Tumor necrosis factor (TNFα) and CaPO4 crystals in vitro, puerarin decreased Mmp9 mRNA expression and secreted protein levels. Moreover, induction of IκB, ERK, and p38 phosphorylation by TNFα and CaPO4 in macrophages was suppressed by puerarin treatments. Finally, puerarin attenuated reactive oxygen species production, following induction by TNFα and CaPO4. Taken together, the present data demonstrate that puerarin suppresses macrophage activation by inhibiting IκB, ERK, and p38 activity and reactive oxygen species production in a CaPO4-induced mouse model of aneurysm.
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Affiliation(s)
- Teruyoshi Tanaka
- Division of Vascular Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health
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Ye Z, Austin E, Schaid DJ, Bailey KR, Pellikka PA, Kullo IJ. ADAB2IPgenotype: sex interaction is associated with abdominal aortic aneurysm expansion. J Investig Med 2017; 65:1077-1082. [DOI: 10.1136/jim-2016-000404] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2017] [Indexed: 02/06/2023]
Abstract
A faster expansion rate of abdominal aortic aneurysm (AAA) increases the risk of rupture. Women are at higher risk of rupture than men, but the mechanisms underlying this increased risk are unknown. We investigated whether genetic variants that influence susceptibility for AAA (CDKN2A-2B,SORT1,DAB2IP,LRP1andLDLR) are associated with AAA expansion and whether these associations differ by sex in 650 patients with AAA (mean age 70±8 years, 17% women) enrolled in the Mayo Clinic Vascular Disease Biorepository. Women had a mean aneurysm expansion 0.41 mm/year greater than men after adjustment for baseline AAA size. In addition to baseline size, mean arterial pressure (MAP), non-diabetic status,SORT1-rs599839[G] andDAB2IP-rs7025486[A] were associated with greater aneurysm expansion (all p<0.05). The associations of MAP and rs599839[G] were similar in both sexes, while the associations of baseline size, pulse pressure (PP) and rs7025486[A] were stronger in women than men (all p-sexinteraction≤0.02). A three-way interaction of PP*sex* rs7025486[A] was noted in a full-factorial analysis (p=0.007) independent of baseline size and MAP. In the high PP group (≥median), women had a mean growth rate 0.68 mm/year greater per [A] of rs7025486 than men (p-sexinteraction=0.003), whereas there was no difference in the low PP group (p-sexinteraction=0.8). We demonstrate that variantsDAB2IP-rs7025486[A] andSORT1-rs599839[G] are associated with AAA expansion. The association of rs7025486[A] is stronger in women than men and amplified by high PP, contributing to sex differences in aneurysm expansion.
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A novel chronic advanced stage abdominal aortic aneurysm murine model. J Vasc Surg 2017; 66:232-242.e4. [PMID: 28274752 DOI: 10.1016/j.jvs.2016.07.105] [Citation(s) in RCA: 98] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Accepted: 07/03/2016] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The purpose of this study was to establish a reliable, chronic model of abdominal aortic aneurysm (AAA). METHODS Wild-type 8-week-old C56BL/6 male mice (n = 120) were equally divided into three groups: (1) BAPN group: 0.2% 3-aminopropionitrile fumarate salt (BAPN) drinking water was provided to mice 2 days before surgery until the end of study. Sham aneurysm induction surgery was performed using 5 μL of heat deactivated elastase. (2) Elastase group: mice were given regular drinking water without BAPN. During aneurysm induction surgery, 5 μL of the active form of elastase (10.3 mg protein/mL, 5.9 U/mg protein) was applied on top of the infrarenal abdominal aorta adventitia for 5 minutes. (3) BAPN+elastase group: mice were given BAPN drinking water and the active form of elastase application, as above. On postoperative days 7, 14, 21, 28, and 100, aortic samples were collected for histology, cytokine array, and gelatin zymography after aortic diameter measurement. RESULTS Compared with the elastase group, the BAPN+elastase group had a higher AAA formation rate (93% vs 65%; P < .01) with more advanced AAAs (25 of 42 vs 1 of 40 for stage II and III; P < .001). Aneurysms from the BAPN+elastase group demonstrated persistent long-term growth (221.5% ± 36.6%, 285.8% ± 78.6%, and 801% ± 160% on days 21, 28, and 100, respectively; P < .001), with considerable thrombus formation (54%) and rupture (31%) at the advanced stages of AAA development. Cytokine levels (pro-matrix metalloproteinase 9, interleukin-1β, interleukin-6, chemokine [C-C motif] ligand 5, triggering receptor expressed on myeloid cells 1, monocyte chemotactic protein 1, and tissue inhibitor of metalloproteinase 1) in the BAPN+elastase group were higher than in the elastase group on day 7. After day 7, cytokine levels returned to baseline, with the exception of elevated matrix metalloproteinase 2 activity. By histology, CD3-positive T cells in the BAPN+elastase group were elevated on days 28 and 100. CONCLUSIONS A combination of oral BAPN administration and periaortic elastase application induced a chronic, advanced-stage AAA with characteristics of persistent aneurysm growth, thrombus formation, and spontaneous rupture. Future studies should use this model, especially for examining tissue remodeling during the late stages of aneurysm development.
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Tripathi R, Sainathan S, Ziganshin BA, Elefteriades JA. Thoracic Aortic Aneurysm from Chronic Antiestrogen Therapy. Int J Angiol 2017; 26:60-63. [PMID: 28255218 DOI: 10.1055/s-0036-1583522] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 03/24/2016] [Indexed: 01/03/2023] Open
Abstract
Aortic aneurysms are a common but often undetected pathology prevalent in the population. They are often detected as incidental findings on imaging studies performed for unrelated pathologies. Estrogens have been shown to exert a protective influence on aortic tissue. Pharmacological agents blocking the actions of estrogens may thus be implicated in causing aortic pathologies. We present the case of an elderly woman with breast carcinoma treated for 18 years with antiestrogen therapy who subsequently developed acute thoracic aortic deterioration (enlargement and wall disruption).
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Affiliation(s)
- Rishi Tripathi
- Aortic Institute at Yale-New Haven, Yale University School of Medicine, New Haven, Connecticut
| | - Sandeep Sainathan
- Aortic Institute at Yale-New Haven, Yale University School of Medicine, New Haven, Connecticut
| | - Bulat A Ziganshin
- Aortic Institute at Yale-New Haven, Yale University School of Medicine, New Haven, Connecticut; Department of Surgical Diseases, Kazan State Medical University, Kazan, Russia
| | - John A Elefteriades
- Aortic Institute at Yale-New Haven, Yale University School of Medicine, New Haven, Connecticut
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Busch A, Holm A, Wagner N, Ergün S, Rosenfeld M, Otto C, Baur J, Kellersmann R, Lorenz U. Extra- and Intraluminal Elastase Induce Morphologically Distinct Abdominal Aortic Aneurysms in Mice and Thus Represent Specific Subtypes of Human Disease. J Vasc Res 2016; 53:49-57. [DOI: 10.1159/000447263] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 05/28/2016] [Indexed: 11/19/2022] Open
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梁 仔, 菅 洪, 林 谦, 罗 赛, 张 小. [Postoperative changes of Th17/Treg balance in patients with intracranial aneurysm rupture]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2016; 37:546-550. [PMID: 28446412 PMCID: PMC6744094 DOI: 10.3969/j.issn.1673-4254.2017.04.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/05/2016] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To observe the dynamic changes of Th17/Treg balance in patients following surgical intervention for intracranial aneurysm rupture. METHODS The percentage of Th cells and the intracellular IL-17 level, Treg cell percentage and transforming growth factor -β1 (TGF-β1) levels were examined in 73 patients with rupture of aneurysms before and at 24 h, 72 h and 1 week after operation, with 62 patients with unruptured aneurysms and 65 healthy volunteers as the control. The correlations among the immune cells, cytokines and clinical characteristics of the patients (NIHSS, ADL and hospitalization stay) were analyzed. RESULTS Th17 percentage and intracellular IL-17 levels were significantly higher in the patients with ruptured and unruptured aneurysms than in the healthy volunteers, and were significantly higher in patients with ruptured aneurysms than in those with unruptured aneurysms. Treg cell percentage and TGF-β1 level were significantly lower in patients with aneurysms than in the healthy volunteers, and were lower in patients with ruptured aneurysms than in those with uruptured aneurysms (P<0.05). Patients with intracranial aneurysm rupture showed significantly increased Th17 cell percentage and IL-17 level but significantly lowered Treg cell percentage and TGF-β1 at 24 h following the surgery (P<0.05); these changes were reversed significantly at 72 h and 1 week after the surgery. Th17 cell percentage and IL-17 level were positively correlated with NIHSS and the length of postoperative hospital stay but inversely correlated with ADL; Treg cell percentage and TGF-β1 were inversely correlated with NIHSS and hospital stay but positively with ADL (P<0.05). CONCLUSION In patients with intracranial aneurysms, the systemic immune inflammatory response is highlighted by excessive Th17 cells and insufficient Treg cells, which are closely related with the outcomes of the patients following surgical intervention. Evaluation of Th17/Treg balance and the cytokine levels can help to assess the prognosis of patients with aneurysm rupture.
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Affiliation(s)
- 仔 梁
- 广东医科大学附属廉江医院廉江市人民医院神经外科,广东 廉江 524400Department of Neurosurgery, Lianjiang Hospital Affiliated to Guangdong Medical University/Lianjiang People's Hospital, Lianjiang 524400, China
| | - 洪健 菅
- 南方医科大学南方医院急诊科,广东 广州 5105153Department of Emergency Medicine, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - 谦益 林
- 南方医科大学第一临床医学院,广东 广州 510515First Clinical College, Southern Medical University, Guangzhou 510515, China
| | - 赛华 罗
- 广东医科大学附属廉江医院廉江市人民医院神经外科,广东 廉江 524400Department of Neurosurgery, Lianjiang Hospital Affiliated to Guangdong Medical University/Lianjiang People's Hospital, Lianjiang 524400, China
| | - 小鹏 张
- 广州军区广州总医院神经外科,广东 广州 510010Department of Neurosurgery, General Hospital of Guangzhou Military Command, Guangzhou 510010, China
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Pharmacologic blockade and genetic deletion of androgen receptor attenuates aortic aneurysm formation. J Vasc Surg 2016; 63:1602-1612.e2. [PMID: 26817611 DOI: 10.1016/j.jvs.2015.11.038] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Accepted: 11/05/2015] [Indexed: 11/22/2022]
Abstract
BACKGROUND Testosterone is theorized to play a major role in the pathophysiology of abdominal aortic aneurysms (AAAs) because this disease occurs primarily in men. The role of the androgen receptor (AR) in the formation of AAAs has not been well elucidated, and therefore, it is hypothesized that androgen blockade will attenuate experimental aortic aneurysm formation. METHODS Aortas of 8- to 12-week-old male C57Bl/6 wild-type (WT) mice or male AR knockout (AR(-/-)) mice were perfused with purified porcine pancreatic elastase (0.35 U/mL) to induce AAA formation. Two groups of WT male mice were treated with the AR blockers flutamide (50 mg/kg) or ketoconazole (150 mg/kg) twice daily by intraperitoneal injection. Aortas were harvested on day 14 after video micrometry was used to measure AAA diameter. Cytokine arrays and histologic analysis were performed on aortic tissue. Groups were compared using an analysis of variance and a Tukey post hoc test. RESULTS Flutamide and ketoconazole treatment (mean ± standard error of the mean) attenuated AAA formation in WT mice (84.2% ± 22.8% [P = .009] and 91.5% ± 18.2% [P = .037]) compared with WT elastase (121% ± 5.23%). In addition, AR(-/-) mice showed attenuation of AAA growth (64.4% ± 22.7%; P < .0001) compared with WT elastase. Cytokine arrays of aortic tissue revealed decreased levels of proinflammatory cytokines interleukin (IL)-α, IL-6, and IL-17 in flutamide-treated and AR(-/-) groups compared with controls. CONCLUSIONS Pharmacologic and genetic AR blockade cause attenuation of AAA formation. Therapies for AR blockade used in prostate cancer may provide medical treatment to halt progression of AAAs in humans.
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Relationship between Postmenopausal Estrogen Deficiency and Aneurysmal Subarachnoid Hemorrhage. Behav Neurol 2015; 2015:720141. [PMID: 26538819 PMCID: PMC4619901 DOI: 10.1155/2015/720141] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Revised: 07/09/2015] [Accepted: 08/02/2015] [Indexed: 11/18/2022] Open
Abstract
Aneurysmal subarachnoid hemorrhage (SAH) is one of the most severe forms of stroke, which results from the rupture of a cerebral aneurysm. SAH is the only type of stroke with a female predominance, suggesting that reproductive factors may play a significant role in the etiology. Estrogen has important effects on vascular physiology and pathophysiology of cerebral aneurysm and SAH and, thus, potential therapeutic implications. There have been growing bodies of epidemiological and experimental studies which support the hypothesis of a significant relationship between estrogen deficiency and cerebral aneurysm formation with subsequent SAH. This hypothesis is the focus of this review as well as possible pathology-based therapeutics with regard to aspects of molecular pathophysiology, especially related to women's health.
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Makrygiannis G, Courtois A, Drion P, Defraigne JO, Kuivaniemi H, Sakalihasan N. Sex Differences in Abdominal Aortic Aneurysm: The Role of Sex Hormones. Ann Vasc Surg 2014; 28:1946-58. [DOI: 10.1016/j.avsg.2014.07.008] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Revised: 06/21/2014] [Accepted: 07/27/2014] [Indexed: 01/16/2023]
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