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Zhou T, Yang H, Assa C, DeRoo E, Bontekoe J, Burkel B, Ponik S, Lu HS, Daugherty A, Liu B. Myeloid-Specific Thrombospondin-1 Deficiency Exacerbates Aortic Rupture via Broad Suppression of Extracellular Matrix Proteins. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.07.30.605216. [PMID: 39211130 PMCID: PMC11361016 DOI: 10.1101/2024.07.30.605216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
Rationale Rupture of abdominal aortic aneurysms (AAA) is associated with high mortality. However, the precise molecular and cellular drivers of AAA rupture remain elusive. Our prior study showed that global and myeloid-specific deletion of matricellular protein thrombospondin-1 (TSP1) protects mice from aneurysm formation primarily by inhibiting vascular inflammation. Objective To investigate the cellular and molecular mechanisms that drive AAA rupture by testing how TSP1 deficiency in different cell populations affects the rupture event. Methods and Results We deleted TSP1 in endothelial cells and macrophages --- the major TSP1-expressing cells in aneurysmal tissues ---- by crossbreeding Thbs1 flox/flox mice with VE-cadherin Cre and Lyz2-cre mice, respectively. Aortic aneurysm and rupture were induced by angiotensin II in mice with hypercholesterolemia. Myeloid-specific Thbs1 knockout, but not endothelial-specific knockout, increased the rate of lethal aortic rupture by more than 2 folds. Combined analyses of single-cell RNA sequencing and histology showed a unique cellular and molecular signature of the rupture-prone aorta that was characterized by a broad suppression in inflammation and extracellular matrix production. Visium spatial transcriptomic analysis on human AAA tissues showed a correlation between low TSP1 expression and aortic dissection. Conclusions TSP1 expression by myeloid cells negatively regulates aneurysm rupture, likely through promoting the matrix repair phenotypes of vascular smooth muscle cells thereby increasing the strength of the vascular wall.
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Lawrence KW, Yin K, Connelly HL, Datar Y, Brydges H, Balasubramaniyan R, Karlson KJ, Edwards NM, Dobrilovic N. Sex-based outcomes in surgical repair of acute type A aortic dissection: A meta-analysis and meta-regression. J Thorac Cardiovasc Surg 2024; 167:76-85.e13. [PMID: 35331557 DOI: 10.1016/j.jtcvs.2022.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 01/08/2022] [Accepted: 02/01/2022] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Epidemiologic variation with respect to sex has been established in aortic dissection. However, current literature on sex-based outcomes in patients with aortic dissection is conflicting. In this study we aimed to compare perioperative outcomes according to sex in patients treated surgically for acute type A aortic dissection. METHODS PubMed/MEDLINE, Embase, and Web of Science were searched for studies that reported sex-based differences in postoperative outcomes among patients with acute type A aortic dissection. The primary outcome was in-hospital/30-day mortality, and secondary outcomes included postoperative stroke, renal failure requiring dialysis, and reoperation for bleeding. Data were aggregated using the random effects model as pooled risk ratio (RR). Meta-regression was applied to identify sources of heterogeneity between studies. RESULTS Nine of 1022 studies were included for final analysis comprising 3338 female and 5979 male participants. Compared with male sex, female sex was associated with similar in-hospital/30-day mortality (RR, 1.04; 95% CI, 0.85-1.28; P = .67), postoperative stroke risk (RR, 1.07; 95% CI, 0.91-1.25; P = .43), and postoperative risk of acute renal failure requiring dialysis (RR, 0.84; 95% CI, 0.59-1.19; P = .32). A decreased risk of reoperation for bleeding (RR, 0.84; 95% CI, 0.75-0.94; P < .01) was observed in female participants. Meta-regression analysis indicated that differences in preoperative shock were a source of heterogeneity in the sex difference in in-hospital/30-day mortality across studies. CONCLUSIONS Among patients treated surgically for acute type A aortic dissection, female sex was not associated with increased risk of short-term mortality nor with major postoperative complications. Male sex was associated with a greater risk of postoperative bleeding.
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Affiliation(s)
- Kyle W Lawrence
- Division of Cardiothoracic Surgery, Boston Medical Center, Boston University School of Medicine, Boston, Mass
| | - Kanhua Yin
- Division of Cardiothoracic Surgery, Boston Medical Center, Boston University School of Medicine, Boston, Mass
| | - Haley L Connelly
- Division of Cardiothoracic Surgery, Boston Medical Center, Boston University School of Medicine, Boston, Mass
| | - Yesh Datar
- Division of Cardiothoracic Surgery, Boston Medical Center, Boston University School of Medicine, Boston, Mass
| | - Hilliard Brydges
- Division of Cardiothoracic Surgery, Boston Medical Center, Boston University School of Medicine, Boston, Mass
| | - Ramkumar Balasubramaniyan
- Division of Cardiothoracic Surgery, Boston Medical Center, Boston University School of Medicine, Boston, Mass
| | - Karl J Karlson
- Division of Cardiothoracic Surgery, Boston Medical Center, Boston University School of Medicine, Boston, Mass
| | - Niloo M Edwards
- Division of Cardiothoracic Surgery, Boston Medical Center, Boston University School of Medicine, Boston, Mass
| | - Nikola Dobrilovic
- Division of Cardiothoracic Surgery, Boston Medical Center, Boston University School of Medicine, Boston, Mass; Division of Cardiac Surgery, NorthShore University HealthSystem, Chicago, Ill.
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Yang L, Sui HG, Wang MM, Li JY, He XF, Li JY, Wang XZ. MiR-30c-1-3p targets matrix metalloproteinase 9 involved in the rupture of abdominal aortic aneurysms. J Mol Med (Berl) 2022; 100:1209-1221. [PMID: 35840740 PMCID: PMC9329399 DOI: 10.1007/s00109-022-02230-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 06/23/2022] [Accepted: 06/27/2022] [Indexed: 11/26/2022]
Abstract
Abstract Abdominal aortic aneurysm (AAA) can be fatal if ruptured, but there is no predictive biomarker. Our aim was to evaluate the prognostic potential of microRNAs (miRNAs/miRs) in an AAA mouse model and patients with unruptured AAA (URAAA) and ruptured AAA (RAAA). Among the 64 miRNAs differentially expressed in mice with AAA compared to control, miR-30c-1-3p, miR-432-3p, miR-3154, and miR-379-5p had high homology with human miRNAs. MiR-30c-1-3p plasma levels were significantly lower in patients with RAAA than in those with URAAA or control and tended to negatively correlate with the maximum aortic diameter (r = −0.3153, P = 0.06109). MiR-30c-1-3p targeted matrix metalloproteinase (MMP)-9 mRNA through the coding region and downregulated its expression in vitro. MMP-9 plasma concentrations were significantly higher in the RAAA group than in the URAAA group (P < 0.001) and were negatively associated with miR-30c-1-3p levels (r = −0.3671, P = 0.01981) and positively–with the maximal aortic diameter (r = 0.6251, P < 0.0001). The optimal cutoff values for MMP-9 expression and the maximal aortic diameter were 461.08 ng/ml and 55.95 mm, with areas under the curve of 0.816 and 0.844, respectively. Our results indicate that plasma levels of miR-30c-1-3p and MMP-9 may be candidate biomarkers of AAA progression. Key messages Downregulation of miR-30c-1-3p expression and upregulation of its potential target MMP-9 are predictors of the devastation of AAA. Downregulation of miR-30c-1-3p expression and its downstream impact on MMP-9 have a potential on predicting the development and rupture of AAA.
Supplementary Information The online version contains supplementary material available at 10.1007/s00109-022-02230-2.
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Affiliation(s)
- Lin Yang
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, Liaoning, 110167, China
- Department of Cardiology and Cardiovascular Research Institute, General Hospital of Northern Theater Command, 83 Wenhua Road, Shenyang, 110016, Liaoning, China
| | - Hong-Gang Sui
- Department of Cardiology and Cardiovascular Research Institute, General Hospital of Northern Theater Command, 83 Wenhua Road, Shenyang, 110016, Liaoning, China
| | - Meng-Meng Wang
- Department of Cardiology and Cardiovascular Research Institute, General Hospital of Northern Theater Command, 83 Wenhua Road, Shenyang, 110016, Liaoning, China
| | - Jia-Yin Li
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, Liaoning, 110167, China
- Department of Cardiology and Cardiovascular Research Institute, General Hospital of Northern Theater Command, 83 Wenhua Road, Shenyang, 110016, Liaoning, China
| | - Xiao-Feng He
- Department of Cardiology and Cardiovascular Research Institute, General Hospital of Northern Theater Command, 83 Wenhua Road, Shenyang, 110016, Liaoning, China
| | - Jing-Yuan Li
- Department of Cardiology and Cardiovascular Research Institute, General Hospital of Northern Theater Command, 83 Wenhua Road, Shenyang, 110016, Liaoning, China
| | - Xiao-Zeng Wang
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, Liaoning, 110167, China.
- Department of Cardiology and Cardiovascular Research Institute, General Hospital of Northern Theater Command, 83 Wenhua Road, Shenyang, 110016, Liaoning, China.
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Shan T, Li X, Yan M, Pan X. Evaluation of Prognosis and Risk of Death by Neutrophil/Lymphocyte Ratio, C-Reactive Protein/Albumin Ratio and Plasma D-Dimer in Patients with Pulmonary Thromboembolism. Int J Gen Med 2021; 14:9219-9225. [PMID: 34880661 PMCID: PMC8645943 DOI: 10.2147/ijgm.s343039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 11/16/2021] [Indexed: 11/23/2022] Open
Abstract
Objective To investigate the relationship between neutrophil/lymphocyte ratio, C-reactive protein/albumin ratio, plasma D-dimer and prognosis in patients with pulmonary thromboembolism, and to evaluate the risk of death. Methods We retrospectively analyzed peripheral hematology and coagulation-related indicators of 362 pulmonary thromboembolism patients and 32 normal people, and the differences between the patients and control group and between good and poor prognosis groups were compared. And we analyzed and compared separate detection and combined detection of neutrophil/lymphocyte ratio, C-reactive protein/albumin ratio and D-dimer on the efficiency of risk of death in patients. Results ① Neutrophil/lymphocyte ratio of pulmonary thromboembolism patients was 8.96±1.94, significantly higher than that of control group 1.76±0.53 (t=2.4281, P<0.05). C-reactive protein/albumin ratio was 2.13±2.08, significantly higher than 0.03±0.01 in control group (t=20.7736, P<0.01). D-dimer was 9.69±8.61mg/L, significantly higher than 0.20±0.11mg/L in control group (t=3.0066, P<0.01). ② Hemoglobin, lymphocyte, albumin and lymphocyte/monocyte ratio in patients with good prognosis were significantly lower than those in poor prognosis group, while white blood cell, C-creative protein, neutrophil, C-reactive protein/albumin ratio, neutrophil/lymphocyte ratio and D-dimer were significantly lower than those in poor prognosis group (P all <0.05). ③ Regression analysis showed that neutrophil/lymphocyte ratio (P=0.007), C-reactive protein/albumin ratio (P=0.010) and D-dimer (P=0.003) were independent prognostic factors for pulmonary thromboembolism. ④ In assessing the risk of death of patients, D-dimer alone had the highest sensitivity (93.1%), and C-reactive protein/albumin ratio alone had the highest specificity (68.8%). The combined detection of these three indicators had higher sensitivity (86.2%) and higher specificity (67.6%) at the same time. ⑤ The area under receiver operating characteristic curve for combined detection of neutrophil/lymphocyte ratio, C-reactive protein/albumin ratio and D-dimer was the largest (up to 0.821). Conclusion Patients with pulmonary thromboembolism highly expressed in neutrophil/lymphocyte ratio, C-reactive protein/albumin ratio and D-dimer. The combined detection of these three indicators can improve the assessment efficacy of the risk of death in patients with pulmonary thromboembolism.
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Affiliation(s)
- Tiantian Shan
- Department of Hematology, Taicang Hospital Affiliated to Soochow University, Taicang City, Jiangsu Province, People's Republic of China
| | - Xinran Li
- Department of Hematology, Taicang Hospital Affiliated to Soochow University, Taicang City, Jiangsu Province, People's Republic of China
| | - Min Yan
- Department of Hematology, Taicang Hospital Affiliated to Soochow University, Taicang City, Jiangsu Province, People's Republic of China
| | - Xiangtao Pan
- Department of Hematology, Taicang Hospital Affiliated to Soochow University, Taicang City, Jiangsu Province, People's Republic of China
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Lopez‐Sanz L, Bernal S, Jimenez‐Castilla L, Prieto I, La Manna S, Gomez‐Lopez S, Blanco‐Colio LM, Egido J, Martin‐Ventura JL, Gomez‐Guerrero C. Fcγ receptor activation mediates vascular inflammation and abdominal aortic aneurysm development. Clin Transl Med 2021; 11:e463. [PMID: 34323424 PMCID: PMC8255062 DOI: 10.1002/ctm2.463] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 05/24/2021] [Accepted: 05/30/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Abdominal aortic aneurysm (AAA), a degenerative vascular pathology characterized by permanent dilation of the aorta, is considered a chronic inflammatory disease involving innate/adaptive immunity. However, the functional role of antibody-dependent immune response against antigens present in the damaged vessel remains unresolved. We hypothesized that engagement of immunoglobulin G (IgG) Fc receptors (FcγR) by immune complexes (IC) in the aortic wall contributes to AAA development. We therefore evaluated FcγR expression in AAA lesions and analysed whether inhibition of FcγR signaling molecules (γ-chain and Syk kinase) influences AAA formation in mice. METHODS FcγR gene/protein expression was assessed in human and mouse AAA tissues. Experimental AAA was induced by aortic elastase perfusion in wild-type (WT) mice and γ-chain knockout (γKO) mice (devoid of activating FcγR) in combination with macrophage adoptive transfer or Syk inhibitor treatment. To verify the mechanisms of FcγR in vitro, vascular smooth muscle cells (VSMC) and macrophages were stimulated with IgG IC. RESULTS FcγR overexpression was detected in adventitia and media layers of human and mouse AAA. Elastase-perfused γKO mice exhibited a decrease in AAA incidence, aortic dilation, elastin degradation, and VSMC loss. This was associated with (1) reduced infiltrating leukocytes and immune deposits in AAA lesions, (2) inflammatory genes and metalloproteinases downregulation, (3) redox balance restoration, and (4) converse phenotype of anti-inflammatory macrophage M2 and contractile VSMC. Adoptive transfer of FcγR-expressing macrophages aggravated aneurysm in γKO mice. In vitro, FcγR deficiency attenuated inflammatory gene expression, oxidative stress, and phenotypic switch triggered by IC. Additionally, Syk inhibition prevented IC-mediated cell responses, reduced inflammation, and mitigated AAA formation. CONCLUSION Our findings provide insight into the role and mechanisms mediating IgG-FcγR-associated inflammation and aortic wall injury in AAA, which might represent therapeutic targets against AAA disease.
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MESH Headings
- Animals
- Antigen-Antibody Complex/adverse effects
- Aorta, Abdominal/metabolism
- Aorta, Abdominal/pathology
- Aortic Aneurysm, Abdominal/pathology
- Aortic Aneurysm, Abdominal/prevention & control
- Disease Models, Animal
- Humans
- Immunoglobulin gamma-Chains/genetics
- Immunoglobulin gamma-Chains/metabolism
- Inflammation/metabolism
- Inflammation/pathology
- Macrophages/cytology
- Macrophages/immunology
- Macrophages/metabolism
- Male
- Matrix Metalloproteinases/genetics
- Matrix Metalloproteinases/metabolism
- Mice
- Mice, Inbred C57BL
- Mice, Knockout
- Muscle, Smooth, Vascular/cytology
- Muscle, Smooth, Vascular/metabolism
- Niacinamide/analogs & derivatives
- Niacinamide/therapeutic use
- Oxidative Stress
- Pancreatic Elastase/adverse effects
- Pyrimidines/therapeutic use
- Receptors, IgG/genetics
- Receptors, IgG/metabolism
- Syk Kinase/antagonists & inhibitors
- Syk Kinase/metabolism
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Affiliation(s)
- Laura Lopez‐Sanz
- Renal, Vascular and Diabetes Research LabIIS‐Fundacion Jimenez Diaz (IIS‐FJD)MadridSpain
- Universidad Autonoma de Madrid (UAM)MadridSpain
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM)MadridSpain
| | - Susana Bernal
- Renal, Vascular and Diabetes Research LabIIS‐Fundacion Jimenez Diaz (IIS‐FJD)MadridSpain
- Universidad Autonoma de Madrid (UAM)MadridSpain
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM)MadridSpain
| | - Luna Jimenez‐Castilla
- Renal, Vascular and Diabetes Research LabIIS‐Fundacion Jimenez Diaz (IIS‐FJD)MadridSpain
- Universidad Autonoma de Madrid (UAM)MadridSpain
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM)MadridSpain
| | - Ignacio Prieto
- Renal, Vascular and Diabetes Research LabIIS‐Fundacion Jimenez Diaz (IIS‐FJD)MadridSpain
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM)MadridSpain
| | - Sara La Manna
- Renal, Vascular and Diabetes Research LabIIS‐Fundacion Jimenez Diaz (IIS‐FJD)MadridSpain
- Universidad Autonoma de Madrid (UAM)MadridSpain
| | | | - Luis Miguel Blanco‐Colio
- Renal, Vascular and Diabetes Research LabIIS‐Fundacion Jimenez Diaz (IIS‐FJD)MadridSpain
- Spanish Biomedical Research Centre in Cardiovascular Diseases (CIBERCV)MadridSpain
| | - Jesus Egido
- Renal, Vascular and Diabetes Research LabIIS‐Fundacion Jimenez Diaz (IIS‐FJD)MadridSpain
- Universidad Autonoma de Madrid (UAM)MadridSpain
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM)MadridSpain
| | - Jose Luis Martin‐Ventura
- Renal, Vascular and Diabetes Research LabIIS‐Fundacion Jimenez Diaz (IIS‐FJD)MadridSpain
- Universidad Autonoma de Madrid (UAM)MadridSpain
- Spanish Biomedical Research Centre in Cardiovascular Diseases (CIBERCV)MadridSpain
| | - Carmen Gomez‐Guerrero
- Renal, Vascular and Diabetes Research LabIIS‐Fundacion Jimenez Diaz (IIS‐FJD)MadridSpain
- Universidad Autonoma de Madrid (UAM)MadridSpain
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM)MadridSpain
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LncRNA H19 regulates smooth muscle cell functions and participates in the development of aortic dissection through sponging miR-193b-3p. Biosci Rep 2021; 41:227493. [PMID: 33403385 PMCID: PMC7823186 DOI: 10.1042/bsr20202298] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 12/03/2020] [Accepted: 12/23/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Multiple studies showed that long-chain noncoding RNA H19 (LncRNA H19) is high-expressed in human and mouse abdominal aortic aneurysms (AAAs). We speculated that it plays an important role in arterial disease, and therefore studied the role and mechanism of H19 in aortic dissection (AD). METHODS The expressions of related genes in human aortic smooth muscle cells (HASMCs) induced by platelet-derived growth factor BB (PDGF-BB) or in the aortic tissue of AD patients/mice were identified by Western blot and quantitative real-time polymerase chain reaction. The targeting relationship between H19 and miR-193b-3p was predicted and verified by bioinformatics analysis, dual luciferase assay, RNA pull-down assay, RNA immunoprecipitation (RIP), and Pearson correlation coefficient. The H19 and miR-193b-3p effects on the biological functions of tissues and cells were examined by MTT (3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide, thiazolyl blue tetrazolium bromide) assay, wound-healing assay, and Hematoxylin-Eosin (HE) staining. RESULTS LncRNA H19 was abnormally high-expressed in thoracic aorta tissues of AD patients, and it could competitively bind to and inhibit miR-193b-3p. In the PDGF-BB group, the expressions of H19, matrix metallopeptidase (MMP) 2 (MMP-2) and MMP-9 were up-regulated and the expressions of miR-193b-3p, α-SMA, and SM22α were down-regulated; moreover, the proliferation and migration rate of HASMCs were increased. However, H19 silencing reversed the regulation of PDGF-BB on HASMCs. More interestingly, miR-193b-3p inhibitor could partially reverse the effect of H19 silencing. In addition, the above results were verified by animal experiments, showing that shH19 and up-regulated miR-193b-3p could significantly reduce the thoracic aorta pathological damage in AD mice. CONCLUSION LncRNA H19 regulated smooth muscle cell function by sponging miR-193b-3p and it participated in the development of AD.
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Papoutsis K, Kapelouzou A, Georgiopoulos G, Kontogiannis C, Kourek C, Mylonas KS, Patelis N, Cokkinos DV, Karavokyros I, Georgopoulos S. Tissue-specific relaxin-2 is differentially associated with the presence/size of an arterial aneurysm and the severity of atherosclerotic disease in humans. Acta Pharmacol Sin 2020; 41:745-752. [PMID: 32024951 PMCID: PMC7471450 DOI: 10.1038/s41401-019-0350-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 12/12/2019] [Indexed: 12/31/2022] Open
Abstract
Circulating or tissue-related biomarkers are of clinical value for risk stratification in patients with abdominal aortic aneurysms. Relaxin-2 (RL2) has been linked to the presence and size of arterial aneurysms, and to the extent of atherosclerosis in human subjects. Here, we assessed the expression levels of RL2 in aneurysmal (AA, n = 16) and atherosclerotic (ATH, n = 22) arteries, and established the correlation between RL2 levels and the presence/size of AA and the clinical severity of atherosclerosis. The expression levels of metalloproteinases (MMPs) and endothelial nitric oxide synthetase (eNOS) were also detected for correlations with different phenotypes of atherosclerosis and AA. Temporal artery biopsy specimens (n = 6) and abdominal aortic tissues harvested from accident victims during autopsy (n = 10) were used as controls. Quantitative tissue biomarker analysis revealed that tissue-specific RL2 was increased in patients with larger or symptomatic AA compared to subjects with atherosclerotic disease and healthy controls. In situ RL2 levels were proportional to the size and the severity of aneurysmatic disease, and were substantially elevated in patients with symptomatic aneurysm of any diameter or asymptomatic aneurysm of a diameter >350% of that of the normal artery. In contrast, tissue RL2 was inversely associated with the clinical severity of atherosclerotic lesions. Correlation between RL2 and MMP2 was different between ATH1 and ATH2, depending on atherosclerosis grade. Overall, tissue RL2 is differentially associated with discrete phenotypes of arterial disease and might exert multipotent biological effects on vascular wall integrity and remodeling in human subjects.
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8
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Lane BA, Wang X, Lessner SM, Vyavahare NR, Eberth JF. Targeted Gold Nanoparticles as an Indicator of Mechanical Damage in an Elastase Model of Aortic Aneurysm. Ann Biomed Eng 2020; 48:2268-2278. [PMID: 32240423 DOI: 10.1007/s10439-020-02500-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 03/27/2020] [Indexed: 12/23/2022]
Abstract
Elastin is a key structural protein and its pathological degradation deterministic in aortic aneurysm (AA) outcomes. Unfortunately, using current diagnostic and clinical surveillance techniques the integrity of the elastic fiber network can only be assessed invasively. To address this, we employed fragmented elastin-targeting gold nanoparticles (EL-AuNPs) as a diagnostic tool for the evaluation of unruptured AAs. Electron dense EL-AuNPs were visualized within AAs using micro-computed tomography (micro-CT) and the corresponding Gold-to-Tissue volume ratios quantified. The Gold-to-Tissue volume ratios correlated strongly with the concentration (0, 0.5, or 10 U/mL) of infused porcine pancreatic elastase and therefore the degree of elastin damage. Hyperspectral mapping confirmed the spatial targeting of the EL-AuNPs to the sites of damaged elastin. Nonparametric Spearman's rank correlation indicated that the micro-CT-based Gold-to-Tissue volume ratios had a strong correlation with loaded (ρ = 0.867, p-val = 0.015) and unloaded (ρ = 0.830, p-val = 0.005) vessel diameter, percent dilation (ρ = 0.976, p-val = 0.015), circumferential stress (ρ = 0.673, p-val = 0.007), loaded (ρ = - 0.673, p-val = 0.017) and unloaded (ρ = - 0.697, p-val = 0.031) wall thicknesses, circumferential stretch (ρ = - 0.7234, p-val = 0.018), and lumen area compliance (ρ = - 0.831, p-val = 0.003). Likewise, in terms of axial force and axial stress vs. stretch, the post-elastase vessels were stiffer. Collectively, these findings suggest that, when combined with CT imaging, EL-AuNPs can be used as a powerful tool in the non-destructive estimation of mechanical and geometric features of AAs.
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Affiliation(s)
- Brooks A Lane
- Biomedical Engineering Program, University of South Carolina, Columbia, SC, 29208, USA
| | - Xiaoying Wang
- Bioengineering Department, Clemson University, Clemson, SC, USA
| | - Susan M Lessner
- Biomedical Engineering Program, University of South Carolina, Columbia, SC, 29208, USA.,Cell Biology and Anatomy Department, University of South Carolina, Columbia, SC, USA
| | | | - John F Eberth
- Biomedical Engineering Program, University of South Carolina, Columbia, SC, 29208, USA. .,Cell Biology and Anatomy Department, University of South Carolina, Columbia, SC, USA.
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9
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Liu B, Granville DJ, Golledge J, Kassiri Z. Pathogenic mechanisms and the potential of drug therapies for aortic aneurysm. Am J Physiol Heart Circ Physiol 2020; 318:H652-H670. [PMID: 32083977 PMCID: PMC7099451 DOI: 10.1152/ajpheart.00621.2019] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 02/13/2020] [Accepted: 02/13/2020] [Indexed: 12/14/2022]
Abstract
Aortic aneurysm is a permanent focal dilation of the aorta. It is usually an asymptomatic disease but can lead to sudden death due to aortic rupture. Aortic aneurysm-related mortalities are estimated at ∼200,000 deaths per year worldwide. Because no pharmacological treatment has been found to be effective so far, surgical repair remains the only treatment for aortic aneurysm. Aortic aneurysm results from changes in the aortic wall structure due to loss of smooth muscle cells and degradation of the extracellular matrix and can form in different regions of the aorta. Research over the past decade has identified novel contributors to aneurysm formation and progression. The present review provides an overview of cellular and noncellular factors as well as enzymes that process extracellular matrix and regulate cellular functions (e.g., matrix metalloproteinases, granzymes, and cathepsins) in the context of aneurysm pathogenesis. An update of clinical trials focusing on therapeutic strategies to slow abdominal aortic aneurysm growth and efforts underway to develop effective pharmacological treatments is also provided.
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Affiliation(s)
- Bo Liu
- University of Wisconsin, Madison, Department of Surgery, Madison Wisconsin
| | - David J Granville
- International Collaboration on Repair Discoveries Centre and University of British Columbia Centre for Heart Lung Innovation, Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jonathan Golledge
- The Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Department of Vascular and Endovascular Surgery, Townsville Hospital and Health Services, Townsville, Queensland, Australia
| | - Zamaneh Kassiri
- University of Alberta, Department of Physiology, Cardiovascular Research Center, Faculty of Medicine and Dentistry, Edmonton, Alberta, Canada
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10
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Cione E, Piegari E, Gallelli G, Caroleo MC, Lamirata E, Curcio F, Colosimo F, Cannataro R, Ielapi N, Colosimo M, de Franciscis S, Gallelli L. Expression of MMP-2, MMP-9, and NGAL in Tissue and Serum of Patients with Vascular Aneurysms and Their Modulation by Statin Treatment: A Pilot Study. Biomolecules 2020; 10:biom10030359. [PMID: 32111073 PMCID: PMC7175213 DOI: 10.3390/biom10030359] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 02/20/2020] [Accepted: 02/23/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Matrix metalloproteinases (MMPs) are involved in vascular wall degradation, and drugs able to modulate MMP activity can be used to prevent or treat aneurysmal disease. In this study, we evaluated the effects of statins on MMP-2, MMP-9, and neutrophil gelatinase-associated lipocalin (NGAL) in both plasma and tissue in patients with aneurysmal disease. METHODS We performed a prospective, single-blind, multicenter, control group clinical drug trial on 184 patients of both sexes >18 years old with a diagnosis of arterial aneurysmal disease. Enrolled patients were divided into two groups: Group I under statin treatment and Group II not taking statins. In addition, 122 patients without aneurysmal disease and under statin treatment were enrolled as a control group (Group III). The expression of MMPs and NGAL in plasma was evaluated using ELISA, while their expression in endothelial tissues was evaluated using Western blot. RESULTS The ELISA test revealed greater plasma levels (p < 0.01) of MMPs and NGAL in Groups I and II vs. Group III. Western blot analysis showed higher expression (p < 0.01) of MMPs and NGAL in Group II vs. Group I, and this increase was significantly higher (p < 0.01) in patients treated with low potency statins compared to high potency ones. CONCLUSIONS MMPs and NGAL seem to play a major role in the development of aneurysms, and their modulation by statins suggests that these drugs could be used to prevent arterial aneurysmal disease.
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Affiliation(s)
- Erika Cione
- Department of Pharmacy, Health and Nutritional Sciences, Department of Excellence 2018-2022, University of Calabria, 87036 Rende, Italy; (E.C.); (M.C.C.); (R.C.)
| | - Elena Piegari
- Department of Experimental Medicine, Section of Pharmacology, University of Campania “Luigi Vanvitelli”, 80138 Napoli, Italy;
| | - Giuseppe Gallelli
- Unit of Vascular Surgery, Department of Surgery, “Pugliese Ciaccio” Hospital, 88100 Catanzaro, Italy;
| | - Maria Cristina Caroleo
- Department of Pharmacy, Health and Nutritional Sciences, Department of Excellence 2018-2022, University of Calabria, 87036 Rende, Italy; (E.C.); (M.C.C.); (R.C.)
| | - Elena Lamirata
- Department of Experimental Medicine, University of Catanzaro, and Vascular Surgery Unit, 88100 Mater Domini Hospital, 88100 Catanzaro, Italy; (E.L.); (F.C.); (S.d.F.)
| | - Francesca Curcio
- Department of Experimental Medicine, University of Catanzaro, and Vascular Surgery Unit, 88100 Mater Domini Hospital, 88100 Catanzaro, Italy; (E.L.); (F.C.); (S.d.F.)
| | - Federica Colosimo
- National Institution of Social Insurance, Department of Medical Law, 88100 Catanzaro, Italy;
| | - Roberto Cannataro
- Department of Pharmacy, Health and Nutritional Sciences, Department of Excellence 2018-2022, University of Calabria, 87036 Rende, Italy; (E.C.); (M.C.C.); (R.C.)
| | - Nicola Ielapi
- Department of Public Health and Infectious Disease, “Sapienza” University of Rome 5, 00185 Roma, Italy;
| | - Manuela Colosimo
- Unit of Microbiology and Virology, “Pugliese Ciaccio” Hospital, 88100 Catanzaro, Italy;
| | - Stefano de Franciscis
- Department of Experimental Medicine, University of Catanzaro, and Vascular Surgery Unit, 88100 Mater Domini Hospital, 88100 Catanzaro, Italy; (E.L.); (F.C.); (S.d.F.)
| | - Luca Gallelli
- Department of Health Sciences, University of Catanzaro, and Clinical Pharmacology and Pharmacovigilance Unit, Mater Domini Hospital, 88100 Catanzaro, Italy
- Correspondence: ; Tel.: +39-030961712322
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11
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Salhi L, Rompen E, Sakalihasan N, Laleman I, Teughels W, Michel JB, Lambert F. Can Periodontitis Influence the Progression of Abdominal Aortic Aneurysm? A Systematic Review. Angiology 2018; 70:479-491. [DOI: 10.1177/0003319718821243] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Leila Salhi
- Department of Periodontology and Oral Surgery, Faculty of Medicine, University of Liège, Liège, Belgium
| | - Eric Rompen
- Department of Periodontology and Oral Surgery, Faculty of Medicine, University of Liège, Liège, Belgium
| | - Natzi Sakalihasan
- Department of Cardiovascular and Thoracic Surgery, Surgical Research Centre, GIGA-Cardiovascular Science Unit, University of Liège, Liège, Belgium
| | - Isabelle Laleman
- Department of Oral Health Sciences, KU Leuven & Dentistry University Hospitals Leuven, Leuven, Belgium
| | - Wim Teughels
- Department of Periodontology, Research Group for Microbial Adhesion, Catholic University Leuven, Leuven, Belgium
| | - Jean-Baptiste Michel
- DRE Laboratory for Translational Vascular Science, Inserm Denis Diderot University, Paris, France
| | - France Lambert
- Dental Biomaterials Research Unit, Head of Clinic, Department of Periodontology and Oral Surgery, University of Liège, Liège, Belgium
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12
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Kurianiuk A, Socha K, Gacko M, Błachnio-Zabielska A, Karwowska A. The Relationship between the Concentration of Cathepsin A, D, and E and the Concentration of Copper and Zinc, and the Size of the Aneurysmal Enlargement in the Wall of the Abdominal Aortic Aneurysm. Ann Vasc Surg 2018; 55:182-188. [PMID: 30278264 DOI: 10.1016/j.avsg.2018.07.043] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 07/02/2018] [Accepted: 07/07/2018] [Indexed: 11/15/2022]
Abstract
BACKGROUND Despite advances in diagnostics and treatment, aortic aneurysms are an important clinical problem, mainly due to the accompanying complications that may lead to direct loss of life, also the number of diagnosed and operated aneurysms is constantly increasing. The aim of this study is to determine the relationship between the concentration of lysosomal peptidases cathepsin A, D, and E in the wall of the abdominal aortic aneurysm and the concentration of copper and zinc, and the size of the aneurysm widening in the wall of the abdominal aortic aneurysm. METHODS The study included 27 patients with abdominal aortic aneurysm from the Department of Vascular Surgery and Transplantation of the University Clinical Hospital in Bialystok. The research material was the wall of the abdominal aortic aneurysm collected intraoperatively. The control material consisted of fragments of the abdominal aorta obtained from organ donors for transplantation. The concentration of cathepsin A, D, and E was determined using enzyme-linked immunosorbent assays. Concentrations of copper and zinc were determined by flame atomic absorption spectrometry after prior mineralization of the samples. All patients were interviewed and asked about basic demographic data, comorbidities, and risk factors for cardiovascular disease to which they were exposed in the past. The statistical analysis was performed using Statistica 10 statistical package. Mann-Whitney U-tests were used and also Spearman's r correlation assuming a significance level of P < 0.05. RESULTS The concentration of cathepsin A, D, and E was higher in the aortic wall altered by the aneurysm than in the wall of the control aorta (P < 0.05). The analysis of the data showed that there was a positive correlation between the concentration of cathepsin A and D and the width of the aneurysmal widening (r = 0.699 and 0.750, respectively). There was no correlation between cathepsin E concentration and aneurysm width. CONCLUSIONS The higher contents of cathepsin A, D, and E in the wall of the aortic aneurysm than in the normal aortic wall, as well as a positive correlation between the concentration of cathepsin A and D and the width of the aneurysmal widening, allow to assume the participation of these enzymes in the pathogenesis of the aneurysm.
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Affiliation(s)
- Adam Kurianiuk
- Department of Hygiene, Epidemiology and Metabolic Disorders, Medical University of Bialystok, Bialystok, Poland
| | - Katarzyna Socha
- Department of Bromatology, Medical University of Bialystok, Bialystok, Poland
| | - Marek Gacko
- Department of Vascular Surgery and Transplantation, Medical University of Bialystok, Bialystok, Poland
| | | | - Alicja Karwowska
- Department of Hygiene, Epidemiology and Metabolic Disorders, Medical University of Bialystok, Bialystok, Poland.
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Expresión proteica de metaloproteinasa-2 (MMP-2) y su inhibidor tisular (TIMP-2) en aorta, fascia y plasma de pacientes con aneurisma de aorta abdominal. ANGIOLOGIA 2015. [DOI: 10.1016/j.angio.2014.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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14
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Owens AP, Edwards TL, Antoniak S, Geddings JE, Jahangir E, Wei WQ, Denny JC, Boulaftali Y, Bergmeier W, Daugherty A, Sampson UK, Mackman N. Platelet Inhibitors Reduce Rupture in a Mouse Model of Established Abdominal Aortic Aneurysm. Arterioscler Thromb Vasc Biol 2015; 35:2032-2041. [PMID: 26139462 PMCID: PMC4552620 DOI: 10.1161/atvbaha.115.305537] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Accepted: 06/17/2015] [Indexed: 01/26/2023]
Abstract
OBJECTIVE Rupture of abdominal aortic aneurysms causes a high morbidity and mortality in the elderly population. Platelet-rich thrombi form on the surface of aneurysms and may contribute to disease progression. In this study, we used a pharmacological approach to examine a role of platelets in established aneurysms induced by angiotensin II infusion into hypercholesterolemic mice. APPROACH AND RESULTS Administration of the platelet inhibitors aspirin or clopidogrel bisulfate to established abdominal aortic aneurysms dramatically reduced rupture. These platelet inhibitors reduced abdominal aortic platelet and macrophage recruitment resulting in decreased active matrix metalloproteinase-2 and matrix metalloproteinase-9. Platelet inhibitors also resulted in reduced plasma concentrations of platelet factor 4, cytokines, and components of the plasminogen activation system in mice. To determine the validity of these findings in human subjects, a cohort of aneurysm patients were retrospectively analyzed using developed and validated algorithms in the electronic medical record database at Vanderbilt University. Similar to mice, administration of aspirin or P2Y12 inhibitors was associated with reduced death among patients with abdominal aortic aneurysm. CONCLUSIONS These results suggest that platelets contribute to abdominal aortic aneurysm progression and rupture.
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Affiliation(s)
- A. Phillip Owens
- Department of Medicine Division of Hematology and Oncology, UNC McAllister Heart Institute University of North Carolina at Chapel Hill Chapel Hill, NC 27599, USA Phone: 919-843-3961
| | - Todd L Edwards
- Department of Medicine, Vanderbilt University Medical Center Nashville, TN 37203 Phone: 615-322-3652
- Division of Epidemiology, Vanderbilt University Medical Center Nashville, TN 37203 Phone: 615-322-3652
| | - Silvio Antoniak
- Department of Medicine Division of Hematology and Oncology, UNC McAllister Heart Institute University of North Carolina at Chapel Hill Chapel Hill, NC 27599, USA Phone: 919-843-3961
| | - Julia E. Geddings
- Department of Medicine Division of Hematology and Oncology, UNC McAllister Heart Institute University of North Carolina at Chapel Hill Chapel Hill, NC 27599, USA Phone: 919-843-3961
| | - Eiman Jahangir
- Department of Cardiovascular Diseases John Ochsner Heart and Vascular Institute Ochsner Clinical School - The University of Queensland School of Medicine New Orleans, LA 70115 Phone: 504-392-3131
| | - Wei-Qi Wei
- Department of Biomedical Informatics, Vanderbilt University Medical Center Nashville, TN 37203 Phone: 615-322-3652
| | - Joshua C. Denny
- Department of Biomedical Informatics, Vanderbilt University Medical Center Nashville, TN 37203 Phone: 615-322-3652
| | - Yacine Boulaftali
- Department of Medicine Division of Hematology and Oncology, UNC McAllister Heart Institute University of North Carolina at Chapel Hill Chapel Hill, NC 27599, USA Phone: 919-843-3961
| | - Wolfgang Bergmeier
- Department of Biochemistry and Biophysics, UNC McAllister Heart Institute University of North Carolina at Chapel Hill Chapel Hill, NC 27599, USA Phone: 919-843-3961
| | - Alan Daugherty
- Saha Cardiovascular Research Center University of Kentucky Lexington, KY 40536 Phone: 859-323-3512
| | - Uchechukwu K.A. Sampson
- Department of Medicine, Vanderbilt University Medical Center Nashville, TN 37203 Phone: 615-322-3652
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center Nashville, TN 37203 Phone: 615-322-3652
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center Nashville, TN 37203 Phone: 615-322-3652
| | - Nigel Mackman
- Department of Medicine Division of Hematology and Oncology, UNC McAllister Heart Institute University of North Carolina at Chapel Hill Chapel Hill, NC 27599, USA Phone: 919-843-3961
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15
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Courtois A, Nusgens BV, Hustinx R, Namur G, Gomez P, Kuivaniemi H, Defraigne JO, Colige AC, Sakalihasan N. Gene expression study in positron emission tomography-positive abdominal aortic aneurysms identifies CCL18 as a potential biomarker for rupture risk. Mol Med 2015; 20:697-706. [PMID: 25517227 DOI: 10.2119/molmed.2014.00065] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Accepted: 12/09/2014] [Indexed: 11/06/2022] Open
Abstract
Rupture of abdominal aortic aneurysm (AAA) is a cause of significant mortality and morbidity in aging populations. Uptake of 18-fluorodeoxyglucose (FDG) detected by positron emission tomography (PET) is observed in the wall of 12% of AAA (A+), with most of them being symptomatic. We previously showed that the metabolically active areas displayed adventitial inflammation, medial degeneration and molecular alterations prefacing wall rupture. The aim of this study was to identify new factors predictive of rupture. Transcriptomic analyses were performed in the media and adventitia layers from three types of samples: AAA with-out FDG uptake (A0) and with FDG uptake (A+), both at the positive spot (A+(Pos)) and at a paired distant negative site (A+(Neg)) of the same aneurysm. Follow-up studies included reverse-transcriptase-polymerase chain reaction (RT-PCR), immunohistochemical staining and enzyme-linked immunosorbent assay (ELISA). A large number of genes, including matrix metalloproteinases, collagens and cytokines as well as genes involved in osteochondral development, were differentially expressed in the A+(Pos) compared with A+(Neg). Moreover, a series of genes (notably CCL18) was differentially expressed both in the A+(Neg) and A+(Pos) compared with the A0. A significant increase of CCL18 was also found at the protein level in the aortic wall and in peripheral blood of A+ patients compared with A0. In conclusion, new factors, including CCL18, involved in the progression of AAA and, potentially, in their rupture were identified by a genome-wide analysis of PET-positive and -negative human aortic tissue samples. Further work is needed to study their role in AAA destabilization and weakening.
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Affiliation(s)
- Audrey Courtois
- Surgical Research Center, GIGA-Cardiovascular Science Unit, University of Liège, Liège, Belgium.,Laboratory of Connective Tissues Biology, GIGA-Research (GIGA-R), University of Liège, Liège, Belgium.,Department of Cardiovascular and Thoracic Surgery, University Hospital of Liège (CHU), University of Liège, Liège, Belgium
| | - Betty V Nusgens
- Laboratory of Connective Tissues Biology, GIGA-Research (GIGA-R), University of Liège, Liège, Belgium
| | - Roland Hustinx
- Department of Nuclear Medicine, University Hospital of Liège (CHU), University of Liège, Liège, Belgium
| | - Gauthier Namur
- Department of Nuclear Medicine, University Hospital of Liège (CHU), University of Liège, Liège, Belgium.,Department of Nuclear Medicine, St Joseph Hospital (CHC), Liège, Belgium
| | - Pierre Gomez
- Department of Nuclear Medicine, St Joseph Hospital (CHC), Liège, Belgium
| | - Helena Kuivaniemi
- The Sigfried and Janet Weis Center for Research, Geisinger Health System, Danville, Pennsylvania, United States of America.,Department of Surgery, Temple University School of Medicine, Philadelphia, Pennsylvania, United States of America
| | - Jean-Olivier Defraigne
- Department of Cardiovascular and Thoracic Surgery, University Hospital of Liège (CHU), University of Liège, Liège, Belgium
| | - Alain C Colige
- Laboratory of Connective Tissues Biology, GIGA-Research (GIGA-R), University of Liège, Liège, Belgium
| | - Natzi Sakalihasan
- Surgical Research Center, GIGA-Cardiovascular Science Unit, University of Liège, Liège, Belgium.,Department of Nuclear Medicine, University Hospital of Liège (CHU), University of Liège, Liège, Belgium
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16
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Increased 18F-FDG uptake is predictive of rupture in a novel rat abdominal aortic aneurysm rupture model. Ann Surg 2015; 261:395-404. [PMID: 24651130 DOI: 10.1097/sla.0000000000000602] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To determine whether F-fluorodeoxyglucose (F-FDG) micro-positron emission tomography (micro-PET) can predict abdominal aortic aneurysm (AAA) rupture. BACKGROUND An infrarenal AAA model is needed to study inflammatory mechanisms that drive rupture. F-FDG PET can detect vascular inflammation in animal models and patients. METHODS After exposing Sprague-Dawley rats to intra-aortic porcine pancreatic elastase (PPE) (12 U/mL), AAA rupture was induced by daily, subcutaneous, β-aminopropionitrile (BAPN, 300 mg/kg, N = 24) administration. Negative control AAA animals (N = 15) underwent daily saline subcutaneous injection after PPE exposure. BAPN-exposed animals that did not rupture served as positive controls [nonruptured AAA (NRAAA) 14d, N = 9]. Rupture was witnessed using radiotelemetry. Maximum standard uptakes for F-FDG micro-PET studies were determined. Aortic wall PAI-1, uPA, and tPA concentrations were determined by western blot analyses. Interleukin (IL)-1β, IL-6, IL-10, and MIP-2 were determined by Bio-Plex bead array. Neutrophil and macrophage populations per high-power field were quantified. Matrix metalloproteinase (MMP) activities were determined by zymography. RESULTS When comparing ruptured AAA (RAAA) to NRAAA 14d animals, increased focal F-FDG uptakes were detected at subsequent sites of rupture (P = 0.03). PAI-1 expression was significantly less in RAAA tissue (P = 0.01), with comparable uPA and decreased tPA levels (P = 0.02). IL-1β (P = 0.04), IL-6 (P = 0.001), IL-10 (P = 0.04), and MIP-2 (P = 0.02) expression, neutrophil (P = 0.02) and macrophage presence (P = 0.002), and MMP9 (P < 0.0001) activity were increased in RAAA tissue. CONCLUSIONS With this AAA rupture model, increased prerupture F-FDG uptake on micro-PET imaging was associated with increased inflammation in the ruptured AAA wall. F-FDG PET imaging may be used to monitor inflammatory changes before AAA rupture.
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17
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Serra R, Grande R, Montemurro R, Butrico L, Caliò FG, Mastrangelo D, Scarcello E, Gallelli L, Buffone G, de Franciscis S. The role of matrix metalloproteinases and neutrophil gelatinase-associated lipocalin in central and peripheral arterial aneurysms. Surgery 2015; 157:155-62. [DOI: 10.1016/j.surg.2014.06.008] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2013] [Accepted: 06/12/2014] [Indexed: 12/23/2022]
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18
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Reeps C, Kehl S, Tanios F, Biehler J, Pelisek J, Wall WA, Eckstein HH, Gee MW. Biomechanics and gene expression in abdominal aortic aneurysm. J Vasc Surg 2014; 60:1640-7.e1-2. [DOI: 10.1016/j.jvs.2014.08.076] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Accepted: 08/17/2014] [Indexed: 01/31/2023]
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19
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Villard C, Eriksson P, Swedenborg J, Hultgren R. Differences in Elastin and Elastolytic Enzymes between Men and Women with Abdominal Aortic Aneurysm. AORTA : OFFICIAL JOURNAL OF THE AORTIC INSTITUTE AT YALE-NEW HAVEN HOSPITAL 2014; 2:179-85. [PMID: 26798738 DOI: 10.12945/j.aorta.2014.14-017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Accepted: 09/04/2014] [Indexed: 11/18/2022]
Abstract
BACKGROUND Abdominal aortic aneurysms (AAAs) in women differ in some important aspects from those in men. The lower prevalence rate, higher rupture rate and potentially increased growth rate in women with AAA suggest gender to be of importance for aneurysm development and progression. The aim of the study was to analyze wall properties with respect to synthesis and destruction of elastin in men and women with AAA, with and without an intraluminal thrombus. METHODS Patient characteristics and aneurysm wall biopsies were collected from all women (n = 14) treated with open repair for AAA, 2008-2012, and men with similar aneurysm diameter and similar age (n = 23) treated during the same time period. The expressions of elastin, matrix metalloproteinase (MMP)-2 and -9, and cathepsin K were quantified by immunohistochemistry, Western blot, and gene expression analysis on the aneurysm wall. RESULTS The protein expression of elastin was less in women than in men in the non-thrombus-covered aneurysm wall. In addition, the protein and mRNA expressions of MMP-9 were higher in women (-0.83 versus 0.09, P = 0.041). There was no difference in elastin and elastolytic enzymes between men and women in the thrombus-covered aneurysm wall. CONCLUSION Less elastin in the non-thrombus-covered aneurysm wall in women than that in men, and the simultaneous higher level of MMP-9, suggest differences in the elastolytic process in AAA between the sexes.
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Affiliation(s)
| | - Per Eriksson
- Atherosclerosis Research Unit, Center for Molecular Medicine, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Jesper Swedenborg
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
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Stather PW, Sidloff DA, Dattani N, Gokani VJ, Choke E, Sayers RD, Bown MJ. Meta-analysis and meta-regression analysis of biomarkers for abdominal aortic aneurysm. Br J Surg 2014; 101:1358-72. [DOI: 10.1002/bjs.9593] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Revised: 03/05/2014] [Accepted: 05/19/2014] [Indexed: 12/30/2022]
Abstract
Abstract
Background
Many studies have investigated the systemic and local expression of biomarkers in patients with abdominal aortic aneurysm (AAA). The natural history of AAA varies between patients, and predictors of the presence and diameter of AAA have not been determined consistently. The aim of this study was to perform a systematic review, meta-analysis and meta-regression of studies comparing biomarkers in patients with and without AAA, with the aim of summarizing the association of identified markers with both AAA presence and size.
Methods and results
Literature review identified 106 studies suitable for inclusion. Meta-analysis demonstrated a significant difference between matrix metalloproteinase (MMP) 9, tissue inhibitor of matrix metalloproteinase 1, interleukin (IL) 6, C-reactive protein (CRP), α1-antitrypsin, triglycerides, lipoprotein(a), apolipoprotein A and high-density lipoprotein in patients with and without AAA. Although meta-analysis was not possible for MMP-2 in aortic tissue, tumour necrosis factor α, osteoprotegerin, osteopontin, interferon γ, intercellular cell adhesion molecule 1 and vascular cell adhesion molecule 1, systematic review suggested an increase in these biomarkers in patients with AAA. Meta-regression analysis identified a significant positive linear correlation between aortic diameter and CRP level.
Conclusion
A wide variety of biomarkers are dysregulated in patients with AAA, but their clinical value is yet to be established. Future research should focus on the most relevant biomarkers of AAA, and how they could be used clinically.
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Affiliation(s)
- P W Stather
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
| | - D A Sidloff
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
| | - N Dattani
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
| | - V J Gokani
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
| | - E Choke
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
| | - R D Sayers
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
| | - M J Bown
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
- National Institute for Health Research Leicester Biomedical Research Unit, University of Leicester, Leicester, UK
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Dilmé JF, Bellmunt S, Camacho M, Solà-Villà D, Romero JM, Escudero JR, Vila L. Influence of cardiovascular risk factors on levels of matrix metalloproteinases 2 and 9 in human abdominal aortic aneurysms. Eur J Vasc Endovasc Surg 2014; 48:374-81. [PMID: 24980077 DOI: 10.1016/j.ejvs.2014.05.023] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Accepted: 05/27/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To evaluate the influence of cardiovascular risk factors on levels of matrix metalloproteinases (MMP) 2 and 9 in human abdominal aortic aneurysms (AAA). METHODS Aortic samples were collected from patients who underwent AAA repair (n = 89). Patients were stratified according to the maximum transverse aorta diameter: small diameter (<55 mm), moderate diameter (55-69.9 mm) and large diameter (≥70 mm). Aortic walls were studied using real-time PCR and immunohistochemistry. MMP-2, MMP-9, α-actin, CD45, and CD68 transcript levels were determined relative to β-actin. Quantitative data were expressed as median (IQ-range). RESULTS No differences were found in MMP-2 expression between the patient groups, which was mainly associated with vascular smooth muscle cells (VSMC); however, MMP-9 displayed the maximum level in the moderate-diameter group, associated with infiltrating macrophages. Current smoking (CS) and renal insufficiency (RI) significantly increased local levels of MMP-2 (CS 349.5 [219.5-414.1] vs. no-CS 184.4 [100.0-320.5]; p < .008; RI 286.8 [189.6-410.8] vs. no-RI 177.3 [99.3-326.9]; p = .047). Nevertheless, after stepwise linear regression analysis only CS remained as an independent variable predicting local levels of MMP-2 (p = .002). No risk factors influenced local levels of MMP-9. CONCLUSIONS The results show that local levels of MMP-2, an important factor for AAA development, were increased in current smoking AAA patients. MMP-2 was mainly associated with VSMC. It is suggested that MMP-2 could contribute significantly to the increased AAA growth rate observed in current smoking patients. These findings support inclusion of smokers in screening for aneurysmal disease, and emphasize the need for more aggressive monitoring of aneurysmal disease outside the surgical range in patients who smoke at the time of diagnosis and in those who continue to smoke during follow-up.
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Affiliation(s)
- J-F Dilmé
- Angiology, Vascular Biology and Inflammation Laboratory, Institute of Biomedical Research (II-B Sant Pau), Barcelona, Spain; Vascular Surgery Department, Institute of Biomedical Research (II-B Sant Pau), Barcelona, Spain
| | - S Bellmunt
- Angiology, Vascular Biology and Inflammation Laboratory, Institute of Biomedical Research (II-B Sant Pau), Barcelona, Spain; Vascular Surgery Department, Institute of Biomedical Research (II-B Sant Pau), Barcelona, Spain
| | - M Camacho
- Angiology, Vascular Biology and Inflammation Laboratory, Institute of Biomedical Research (II-B Sant Pau), Barcelona, Spain.
| | - D Solà-Villà
- Autonomous University of Barcelona, Institute of Biomedical Research (II-B Sant Pau), Barcelona, Spain
| | - J-M Romero
- Angiology, Vascular Biology and Inflammation Laboratory, Institute of Biomedical Research (II-B Sant Pau), Barcelona, Spain; Vascular Surgery Department, Institute of Biomedical Research (II-B Sant Pau), Barcelona, Spain
| | - J-R Escudero
- Angiology, Vascular Biology and Inflammation Laboratory, Institute of Biomedical Research (II-B Sant Pau), Barcelona, Spain; Vascular Surgery Department, Institute of Biomedical Research (II-B Sant Pau), Barcelona, Spain
| | - L Vila
- Angiology, Vascular Biology and Inflammation Laboratory, Institute of Biomedical Research (II-B Sant Pau), Barcelona, Spain
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Zhang X, Wu D, Choi JC, Minard CG, Hou X, Coselli JS, Shen YH, LeMaire SA. Matrix metalloproteinase levels in chronic thoracic aortic dissection. J Surg Res 2014; 189:348-58. [PMID: 24746253 DOI: 10.1016/j.jss.2014.03.027] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Revised: 03/05/2014] [Accepted: 03/12/2014] [Indexed: 12/25/2022]
Abstract
BACKGROUND Imbalance between matrix metalloproteinases (MMPs) and tissue inhibitors of MMPs (TIMPs) can lead to aortic wall failure. We hypothesized that patients with aneurysms resulting from chronic descending thoracic aortic dissection have elevated tissue and plasma levels of specific MMPs and decreased tissue levels of TIMPs. MATERIALS AND METHODS Aortic tissue was obtained from 25 patients who required surgical repair of descending thoracic aortic aneurysm due to chronic aortic dissection and from 17 organ-donor controls without aortic disease. Tissue levels of MMP-1, -2, -3, -9, -12, and -13 and TIMP-1 and -2 were measured by colorimetric activity assay or enzyme-linked immunosorbent assay and confirmed by Western blot and immunohistochemistry. Blood obtained from the 25 patients and 15 controls without aortic diseases was used to compare plasma levels of MMP-3, -9, and -12. RESULTS Total MMP-1, total MMP-9, and active MMP-9 levels were higher and total MMP-2 levels were lower in dissection tissue than in control tissue. Additionally, the MMP-9 to TIMP-1 and active to total MMP-2 ratios were higher and the MMP-2 to TIMP-2 ratio was lower in dissection tissue. Furthermore, patients had higher plasma active to total MMP-9 ratios than the controls. Age and hypertension were associated with increased MMP levels. CONCLUSIONS Increased levels of several MMPs and increased MMP to TIMP ratios in aortic tissue from patients suggest an environment that favors proteolysis, which may promote progressive extracellular matrix destruction and medial degeneration after aortic dissection. An elevated active to total MMP-9 ratio in plasma may be a biomarker for end-stage aneurysm development in patients with chronic thoracic aortic disease.
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Affiliation(s)
- Xiaoming Zhang
- Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas; Department of Cardiovascular Surgery, Texas Heart Institute, Houston, Texas; Department of Pathophysiology, Shandong University School of Medicine, Jinan, Shandong, China
| | - Darrell Wu
- Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas; Department of Cardiovascular Surgery, Texas Heart Institute, Houston, Texas; Department of Molecular Physiology and Biophysics, Baylor College of Medicine, Houston, Texas
| | - Justin C Choi
- Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas; Department of Cardiovascular Surgery, Texas Heart Institute, Houston, Texas
| | - Charles G Minard
- Dan L. Duncan Institute for Clinical and Translational Research, Baylor College of Medicine, Houston, Texas
| | - Xinguo Hou
- Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas; Department of Cardiovascular Surgery, Texas Heart Institute, Houston, Texas
| | - Joseph S Coselli
- Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas; Department of Cardiovascular Surgery, Texas Heart Institute, Houston, Texas
| | - Ying H Shen
- Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas; Department of Cardiovascular Surgery, Texas Heart Institute, Houston, Texas
| | - Scott A LeMaire
- Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas; Department of Cardiovascular Surgery, Texas Heart Institute, Houston, Texas; Department of Molecular Physiology and Biophysics, Baylor College of Medicine, Houston, Texas.
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Ju X, Ijaz T, Sun H, Lejeune W, Vargas G, Shilagard T, Recinos A, Milewicz DM, Brasier AR, Tilton RG. IL-6 regulates extracellular matrix remodeling associated with aortic dilation in a fibrillin-1 hypomorphic mgR/mgR mouse model of severe Marfan syndrome. J Am Heart Assoc 2014; 3:e000476. [PMID: 24449804 PMCID: PMC3959679 DOI: 10.1161/jaha.113.000476] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Background Development of thoracic aortic aneurysms is the most significant clinical phenotype in patients with Marfan syndrome. An inflammatory response has been described in advanced stages of the disease. Because the hallmark of vascular inflammation is local interleukin‐6 (IL‐6) secretion, we explored the role of this proinflammatory cytokine in the formation of aortic aneurysms and rupture in hypomorphic fibrillin‐deficient mice (mgR/mgR). Methods and Results MgR/mgR mice developed ascending aortic aneurysms with significant dilation of the ascending aorta by 12 weeks (2.7±0.1 and 1.3±0.1 for mgR/mgR versus wild‐type mice, respectively; P<0.001). IL‐6 signaling was increased in mgR/mgR aortas measured by increases in IL‐6 and SOCS3 mRNA transcripts (P<0.05) and in cytokine secretion of IL‐6, MCP‐1, and GM‐CSF (P<0.05). To investigate the role of IL‐6 signaling, we generated mgR homozygous mice with IL‐6 deficiency (DKO). The extracellular matrix of mgR/mgR mice showed significant disruption of elastin and the presence of dysregulated collagen deposition in the medial‐adventitial border by second harmonic generation multiphoton autofluorescence microscopy. DKO mice exhibited less elastin and collagen degeneration than mgR/mgR mice, which was associated with decreased activity of matrix metalloproteinase‐9 and had significantly reduced aortic dilation (1.0±0.1 versus 1.6±0.2 mm change from baseline, DKO versus mgR/mgR, P<0.05) that did not affect rupture and survival. Conclusion Activation of IL‐6‐STAT3 signaling contributes to aneurysmal dilation in mgR/mgR mice through increased MMP‐9 activity, aggravating extracellular matrix degradation.
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Affiliation(s)
- Xiaoxi Ju
- Department of Biochemistry and Molecular Biology, University of Texas Medical Branch, Galveston, TX
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Assar AN. Pharmacological therapy for patients with abdominal aortic aneurysm. Expert Rev Cardiovasc Ther 2014; 7:999-1009. [DOI: 10.1586/erc.09.56] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Courtois A, Nusgens BV, Hustinx R, Namur G, Gomez P, Somja J, Defraigne JO, Delvenne P, Michel JB, Colige AC, Sakalihasan N. 18F-FDG Uptake Assessed by PET/CT in Abdominal Aortic Aneurysms Is Associated with Cellular and Molecular Alterations Prefacing Wall Deterioration and Rupture. J Nucl Med 2013; 54:1740-7. [DOI: 10.2967/jnumed.112.115873] [Citation(s) in RCA: 92] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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Deckert V, Kretz B, Habbout A, Raghay K, Labbé J, Abello N, Desrumaux C, Gautier T, Lemaire-Ewing S, Maquart G, Le Guern N, Masson D, Steinmetz E, Lagrost L. Development of abdominal aortic aneurysm is decreased in mice with plasma phospholipid transfer protein deficiency. THE AMERICAN JOURNAL OF PATHOLOGY 2013; 183:975-86. [PMID: 23830874 DOI: 10.1016/j.ajpath.2013.05.018] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2012] [Revised: 04/12/2013] [Accepted: 05/13/2013] [Indexed: 12/13/2022]
Abstract
Plasma phospholipid transfer protein (PLTP) increases the circulating levels of proatherogenic lipoproteins, accelerates blood coagulation, and modulates inflammation. The role of PLTP in the development of abdominal aortic aneurysm (AAA) was investigated by using either a combination of mechanical and elastase injury at one site of mouse aorta (elastase model) or continuous infusion of angiotensin II in hyperlipidemic ApoE-knockout mice (Ang II model). With the elastase model, complete PLTP deficiency was associated with a significantly lower incidence and a lesser degree of AAA expansion. With the Ang II model, findings were consistent with those in the elastase model, with a lower severity grade in PLTP-deficient mice, an intermediate phenotype in PLTP-deficient heterozygotes, and a blunted effect of the PLTP-deficient trait when restricted to bone marrow-derived immune cells. The protective effect of whole-body PLTP deficiency in AAA was illustrated further by a lesser degree of adventitia expansion, reduced elastin degradation, fewer recruited macrophages, and less smooth muscle cell depletion in PLTP-deficient than in wild-type mice, as evident from comparative microscopic analysis of aorta sections. Finally, cumulative evidence supports the association of PLTP deficiency with reduced expression and activity levels of matrix metalloproteinases, known to degrade elastin and collagen. We conclude that PLTP can play a significant role in the pathophysiology of AAA.
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Duellman T, Warren CL, Peissig P, Wynn M, Yang J. Matrix metalloproteinase-9 genotype as a potential genetic marker for abdominal aortic aneurysm. ACTA ACUST UNITED AC 2012; 5:529-37. [PMID: 22942228 DOI: 10.1161/circgenetics.112.963082] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND Degradation of extracellular matrix support in the large abdominal arteries contribute to abnormal dilation of aorta, leading to abdominal aortic aneurysms, and matrix metalloproteinase-9 (MMP-9) is the predominant enzyme targeting elastin and collagen present in the walls of the abdominal aorta. Previous studies have suggested a potential association between MMP-9 genotype and abdominal aortic aneurysm, but these studies have been limited only to the p-1562 and (CA) dinucleotide repeat microsatellite polymorphisms in the promoter region of the MMP-9 gene. We determined the functional alterations caused by 15 MMP-9 single-nucleotide polymorphisms (SNPs) reported to be relatively abundant in the human genome through Western blots, gelatinase, and promoter-reporter assays and incorporated this information to perform a logistic-regression analysis of MMP-9 SNPs in 336 human abdominal aortic aneurysm cases and controls. METHODS AND RESULTS Significant functional alterations were observed for 6 exon SNPs and 4 promoter SNPs. Genotype analysis of frequency-matched (age, sex, history of hypertension, hypercholesterolemia, and smoking) cases and controls revealed significant genetic heterogeneity exceeding 20% observed for 6 SNPs in our population of mostly white subjects from Northern Wisconsin. A step-wise logistic-regression analysis with 6 functional SNPs, where weakly contributing confounds were eliminated using Akaike information criteria, gave a final 2 SNP (D165N and p-2502) model with an overall odds ratio of 2.45 (95% confidence interval, 1.06-5.70). CONCLUSIONS The combined approach of direct experimental confirmation of the functional alterations of MMP-9 SNPs and logistic-regression analysis revealed significant association between MMP-9 genotype and abdominal aortic aneurysm.
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Affiliation(s)
- Tyler Duellman
- Molecular and Cellular Pharmacology Graduate Program, University of Wisconsin School of Medicine and Public Health, 1300 University Ave, Madison, WI 53706, USA
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Martufi G, Gasser TC. Turnover of fibrillar collagen in soft biological tissue with application to the expansion of abdominal aortic aneurysms. J R Soc Interface 2012; 9:3366-77. [PMID: 22896562 DOI: 10.1098/rsif.2012.0416] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
A better understanding of the inherent properties of vascular tissue to adapt to its mechanical environment is crucial to improve the predictability of biomechanical simulations. Fibrillar collagen in the vascular wall plays a central role in tissue adaptation owing to its relatively short lifetime. Pathological alterations of collagen turnover may fail to result in homeostasis and could be responsible for abdominal aortic aneurysm (AAA) growth at later stages of the disease. For this reason our previously reported multiscale constitutive framework (Martufi, G. & Gasser, T. C. 2011 J. Biomech. 44, 2544-2550 (doi:10.1016/j.jbiomech.2011.07.015)) has been enriched by a collagen turnover model. Specifically, the framework's collagen fibril level allowed a sound integration of vascular wall biology, and the impact of collagen turnover on the macroscopic properties of AAAs was studied. To this end, model parameters were taken from the literature and/or estimated from clinical follow-up data of AAAs (on average 50.7 mm-large). Likewise, the in vivo stretch of the AAA wall was set, such that 10 per cent of collagen fibres were engaged. Results showed that the stretch spectrum, at which collagen fibrils are deposed, is the most influential parameter, i.e. it determines whether the vascular geometry grows, shrinks or remains stable over time. Most importantly, collagen turnover also had a remarkable impact on the macroscopic stress field. It avoided high stress gradients across the vessel wall, thus predicted a physiologically reasonable stress field. Although the constitutive model could be successfully calibrated to match the growth of small AAAs, a rigorous validation against experimental data is crucial to further explore the model's descriptive and predictive capabilities.
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Affiliation(s)
- Giampaolo Martufi
- Department of Solid Mechanics, School of Engineering Sciences, Royal Institute of Technology (KTH), Osquars Backe 1, 100 44 Stockholm, Sweden.
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Oya K, Sakamoto N, Ohashi T, Sato M. Combined stimulation with cyclic stretching and hypoxia increases production of matrix metalloproteinase-9 and cytokines by macrophages. Biochem Biophys Res Commun 2011; 412:678-82. [PMID: 21867689 DOI: 10.1016/j.bbrc.2011.08.024] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2011] [Accepted: 08/08/2011] [Indexed: 10/17/2022]
Abstract
Macrophages in the vessel wall of advanced abdominal aortic aneurysms (AAAs) are subjected to cyclic stretching and hypoxia because of pulsatile blood flow and intraluminal thrombi, respectively. It is possible that these conditions induce abnormal changes in macrophage functions, such as increased production of matrix metalloproteinase-2 (MMP-2), MMP-9, and inflammatory cytokines, leading to weakening of the aortic wall through excessive extracellular matrix disruption. Here we show the effects of cyclic stretching and hypoxia on the production of MMP-9 and inflammatory cytokines by macrophages. Gelatin zymography revealed that MMP-9 production by macrophages was significantly increased by 5% and 10% cyclic stretching under hypoxia (2.2% O(2)). Using enzyme-linked immunosorbent assay, we also evaluated the production of 12 different inflammatory cytokines and found that there was a tendency toward higher expressions of interleukin-8 and tumor necrosis factor-α by macrophages subjected to 10% cyclic stretching under normoxia and hypoxia. Next, we evaluated apoptosis of smooth muscle cells (SMCs) in medium conditioned by macrophages cultured under the 2 conditions described above. SMC apoptosis increased significantly when exposed to media harvested from macrophages subjected to 10% cyclic stretching under normoxia and hypoxia. On the basis of these results, we believe that macrophages produce cytokines that induce SMC apoptosis. Our results suggest that the combination of cyclic stretching and hypoxia stimulates MMP-9 and cytokine production in macrophages, which may result in weakening of AAA walls.
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Affiliation(s)
- Koki Oya
- Department of Biomedical Engineering, Graduate School of Biomedical Engineering, Tohoku University, Aoba-ku, Sendai, Japan.
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Muehling B, Oberhuber A, Schelzig H, Bischoff G, Marx N, Sunder-Plassmann L, Orend KH. Effect of statin therapy on serum activity of proteinases and cytokines in patients with abdominal aortic aneurysm. Vasc Health Risk Manag 2009; 4:1433-7. [PMID: 19337556 PMCID: PMC2663432 DOI: 10.2147/vhrm.s3855] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background and aims: Metalloproteinases (MMPs) are considered to be key enzymes in the pathogenesis of abdominal aortic aneurysms (AAA), with elevated levels in diseased aorta and in patient sera. Statins seem to exert an inhibitory effect on MMP activity in the aortic wall. No data exist on the effect of statins on serum activity of MMPs and inflammatory cytokines (interleukins, IL). Methods: The serum activities of MMP2 and MMP9, osteoprotegerin (OPG), and IL6 and IL10 in 63 patients undergoing elective infrarenal aneurysm repair were measured on the day before surgery. Levels were correlated to statin therapy and aneurysm diameter. Results: There was no significant difference between the two groups in the activity of circulating levels of MMP2/9, OPG, and IL6/10 in patients with infrarenal aortic aneurysm. IL6 levels in patients with AAA larger than 6 cm were significantly elevated; differences in serum activities of MMP2/9, OPG, and IL10 were not related to AAA diameter. Conclusion: Serum activities of MMP2/9, OPG, and IL6/10 are not correlated to statin therapy; IL6 levels are higher in patients with large aneurysms. Hence the effect of statin therapy in the treatment of aneurismal disease remains to be elucidated.
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Affiliation(s)
- Bernd Muehling
- Department of Thoracic and Vascular Surgery, University of Ulm, Steinhövelstrasse 9, Ulm, Germany.
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Wilson WRW, Choke EC, Dawson J, Loftus IM, Thompson MM. Plasma matrix metalloproteinase levels do not predict tissue levels in abdominal aortic aneurysms suitable for elective repair. Vascular 2009; 16:248-52. [PMID: 19238864 DOI: 10.2310/6670.2008.00043] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The role of matrix metalloproteinases (MMPs) in abdominal aortic aneurysm (AAA) pathogenesis is well described. However, a clear role for the MMPs in disease prediction has not been established. The aim of this study was to determine if circulating levels of MMPs correlated with AAA diameter and with MMP concentrations within the aneurysm wall. Preoperative plasma samples and intraoperative infrarenal AAA sac biopsies were taken in a standard fashion from 31 patients undergoing elective repair.The concentrations of MMP-1, MMP-2, MMP-3, MMP-9, tissue inhibitor of matrix metalloproteinase (TIMP)-1, and TIMP-2 were quantified in plasma and aneurysm wall homogenates using enzyme-linked immunosorbent assay. Comparison used the Spearman correlation. There were no correlations between the paired plasma and aneurysm wall concentrations for any MMP or TIMP. Correlation between MMP-9 levels in the aneurysm wall and aneurysm diameter was negative (r = -.42, p = .019). Other correlations between plasma and tissue levels with aneurysm diameter were nonsignificant.
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Mateos-Cáceres PJ, López-Farré AJ, Morata PC, Ramos-Mozo P, Macaya C, Serrano FJ, Moñux G. Pravastatin increases the expression of the tissue inhibitor of matrix metalloproteinase-1 and the oncogeneBaxin human aortic abdominal aneurysms. Can J Physiol Pharmacol 2008; 86:431-7. [DOI: 10.1139/y08-060] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The effect of pravastatin on matrix metalloproteinase-9 (MMP-9) and the level of tissue inhibitor of metalloproteinase (TIMP)-1 and TIMP-2 was studied in explants of human abdominal aortic aneurysm (AAA) obtained from 13 patients. The effect of pravastatin on the apoptotic status of human AAA explants was also examined. Total MMP-9 content did not differ in human AAA explants incubated in vitro in the presence or absence of pravastatin (10−6mol/L) for 48 h. TIMP-1 levels were significantly increased in pravastatin-incubated AAA explants, but TIMP-2 production was not modified by pravastatin. Western blot experiments showed that, whereas Bax expression was increased in pravastatin-incubated AAA explants, the expression of Bcl-2 was not modified. On the other hand, the ratio of the expression of Bax to Bcl-2, an apoptotic index, was not modified by pravastatin. In the human AAA explants, the increase in Bax expression, but not the increase in TIMP-1 expression elicited by pravastatin, was reversed by l-mevalonate, a downstream HMG-CoA reductase metabolite, suggesting that the expression of Bax and TIMP-1 followed HMG-CoA reductase-dependent and -independent pathways, respectively. In conclusion, pravastatin increases both TIMP-1 and Bax expression in human AAA explants without changes in either MMP-9 activity or the apoptotic status.
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Affiliation(s)
- Petra J. Mateos-Cáceres
- Vascular Surgery Department, Cardiovascular Institute, Hospital Clínico San Carlos, C/Profesor Martín Lagos s/n, Madrid 28040, Spain
- Cardiovascular Research Unit, Cardiovascular Institute, Hospital Clínico San Carlos, Madrid 28040, Spain
| | - Antonio J. López-Farré
- Vascular Surgery Department, Cardiovascular Institute, Hospital Clínico San Carlos, C/Profesor Martín Lagos s/n, Madrid 28040, Spain
- Cardiovascular Research Unit, Cardiovascular Institute, Hospital Clínico San Carlos, Madrid 28040, Spain
| | - Pilar C. Morata
- Vascular Surgery Department, Cardiovascular Institute, Hospital Clínico San Carlos, C/Profesor Martín Lagos s/n, Madrid 28040, Spain
- Cardiovascular Research Unit, Cardiovascular Institute, Hospital Clínico San Carlos, Madrid 28040, Spain
| | - Priscila Ramos-Mozo
- Vascular Surgery Department, Cardiovascular Institute, Hospital Clínico San Carlos, C/Profesor Martín Lagos s/n, Madrid 28040, Spain
- Cardiovascular Research Unit, Cardiovascular Institute, Hospital Clínico San Carlos, Madrid 28040, Spain
| | - Carlos Macaya
- Vascular Surgery Department, Cardiovascular Institute, Hospital Clínico San Carlos, C/Profesor Martín Lagos s/n, Madrid 28040, Spain
- Cardiovascular Research Unit, Cardiovascular Institute, Hospital Clínico San Carlos, Madrid 28040, Spain
| | - Francisco J. Serrano
- Vascular Surgery Department, Cardiovascular Institute, Hospital Clínico San Carlos, C/Profesor Martín Lagos s/n, Madrid 28040, Spain
- Cardiovascular Research Unit, Cardiovascular Institute, Hospital Clínico San Carlos, Madrid 28040, Spain
| | - Guillermo Moñux
- Vascular Surgery Department, Cardiovascular Institute, Hospital Clínico San Carlos, C/Profesor Martín Lagos s/n, Madrid 28040, Spain
- Cardiovascular Research Unit, Cardiovascular Institute, Hospital Clínico San Carlos, Madrid 28040, Spain
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Reeps C, Essler M, Pelisek J, Seidl S, Eckstein HH, Krause BJ. Increased 18F-fluorodeoxyglucose uptake in abdominal aortic aneurysms in positron emission/computed tomography is associated with inflammation, aortic wall instability, and acute symptoms. J Vasc Surg 2008; 48:417-23; discussion 424. [PMID: 18572354 DOI: 10.1016/j.jvs.2008.03.059] [Citation(s) in RCA: 120] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2007] [Revised: 03/03/2008] [Accepted: 03/16/2008] [Indexed: 10/21/2022]
Abstract
OBJECTIVE With the established computed tomographic (CT)- morphologic parameters, only the relative, but not the individual rupture risk of abdominal aortic aneurysm (AAA), can be determined. So far, increased aortic 18F-fluorodeoxyglucose (FDG) metabolism measured by positron emission tomography (PET) has been reported in AAA with increased rupture risk. The aim of the study was to analyze the histopathologic changes in AAA wall correlated with increased FDG uptake for further implications on aortic wall stability and AAA rupture risk. METHODS Fifteen patients with asymptomatic (n = 12) and symptomatic (n = 3) AAA underwent FDG-PET/CT, followed by open AAA repair. FDG-PET/CT was used for precise localization of maximum FDG uptake, and the maximum standard uptake values (SUV(max)) were calculated. Biopsies of the AAA wall were operatively collected from areas with maximum FDG uptake, immunohistologically stained, and semiquantitatively analyzed for inflammatory infiltrates, vascular smooth muscle cells (VSMC), matrix metalloproteinase (MMP)-2 and -9 expression, as well as for elastin and collagenous fibers. RESULTS Symptomatic AAA showed significantly increased FDG uptake compared with asymptomatic AAA (SUV(max), 3.5 +/- 0.6 vs 7.5 +/- 3; P < .001). Thus, increased FDG uptake was correlated with higher densities of inflammatory infiltrates (r = +0.87, P < .01) and macrophage and T-cell infiltrations (r = +0.95, P < .01 and r = +0.66, P < .05), with higher MMP-9 expressions (r = +0.86; P < .01), and with reduction of collagen fiber (r = -0.76; P < .01) and VSMCs (r = -0.71; P < .01). Consecutive correlations were found for total inflammatory infiltrates, T lymphocytes, and macrophages with MMP-9 expression (r = +0.79, +0.79 and +0.74; P < .01). Moreover, MMP-9 expression was correlated with decreasing collagen fiber content (r = -0.53, P < .05) and VSMC density (r = -0.57, P < .05). CONCLUSIONS Maximum aortic FDG uptake correlated significantly with inflammation, followed by increased MMP expression and histopathologic characteristics of aneurysm wall instability and clinical symptoms. Therefore, FDG-PET/CT might be a new diagnostic technique to study AAA disease in vivo and may contribute to improve prediction of individual AAA rupture risk.
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Affiliation(s)
- Christian Reeps
- Department of Vascular Surgery, University Hospital rechts der Isar, Technical University of Munich, Munich, Germany.
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Beller CJ, Maurer T, Labrosse MR, Mesana T, Karck M, Veinot JP. Gender-specific differences in aortic sinus curvature during aging: an anatomical and computational study. Cardiovasc Pathol 2008; 18:148-55. [PMID: 18436456 DOI: 10.1016/j.carpath.2008.03.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2007] [Revised: 02/15/2008] [Accepted: 03/06/2008] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION Our goal was to investigate the potential impact of aortic sinus wall curvature on the risk for type A aortic dissection. METHODS We measured the curvature and carried out histological tests of the aortic noncoronary sinus in 46 patients who did not die from cardiac disease. Based on observed curvature values, we investigated the mechanical stress in the aortic root using finite element analysis. RESULTS Sinus curvature was found to experience a more than fourfold increase with age in males and reached the higher, age-independent values measured in females by age 65. The histological tests revealed that degenerative alterations did not significantly increase with aging in either gender, although fibrosis did in older women. Finite element analysis illustrated that the risk for a circumferential tear to occur was smallest when sinus curvature was highest. CONCLUSIONS We established significant gender-specific disparities in the aortic root during aging: while aortic sinus curvature was high in females throughout their lives, it experienced a more than fourfold increase in the lifetime of males, matching values in females only by age 65. Our mechanical analyses confirmed the overall potential protective role of higher sinus wall curvature with respect to type A aortic dissection, and geometry alone could not account for the known gender difference in aortic dissection prevalence.
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Affiliation(s)
- Carsten J Beller
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany
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Chung AWY, Yang HHC, Radomski MW, van Breemen C. Long-term doxycycline is more effective than atenolol to prevent thoracic aortic aneurysm in marfan syndrome through the inhibition of matrix metalloproteinase-2 and -9. Circ Res 2008; 102:e73-85. [PMID: 18388324 DOI: 10.1161/circresaha.108.174367] [Citation(s) in RCA: 157] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Beta-blockers, eg, atenolol, are the cornerstone therapy for thoracic aortic aneurysm (TAA) in patients with Marfan syndrome; however, continued aortic dilatation has been reported. We have demonstrated that matrix metalloproteinase (MMP)-2 and -9 were upregulated during progression of TAA in Marfan syndrome, accompanied with degenerated elastic fibers and vasomotor dysfunction. We hypothesized that doxycycline, a nonspecific inhibitor of MMPs, would ameliorate TAA by attenuating elastic fiber degeneration and improving vasomotor function. A well-characterized mouse model of Marfan syndrome (Fbn1(C1039G/+)) was used. Mice were untreated (n=40), given doxycycline (0.24 g/L, n=30), or given atenolol (0.5 g/L, n=30) in drinking water at 6 weeks of age. The Fbn1(+/+) mice served as control (n=40). At 3, 6, and 9 months, aortic segments from the ascending, arch, and descending portions were used to obtain the "average" value of the whole thoracic aorta. TAA was prevented in the doxycycline group, whereas mild aneurysm was evident in the atenolol group. Doxycycline improved elastic fiber integrity, normalized aortic stiffness, and prevented vessel weakening. The impairment of vasocontraction and endothelium-dependent relaxation in the untreated and atenolol groups were improved by doxycycline. The upregulation of transforming growth factor-beta in the Marfan aorta was suppressed by doxycycline. Doxycycline augmented expression ratios of tissue inhibitors of MMP to MMPs. Intraperitoneally injected neutralizing antibodies against MMP-2 and -9 yielded similar effects to doxycycline. We concluded that long-term treatment with doxycycline, through the inhibition of MMP-2 and -9, is more effective than atenolol in preventing TAA in Marfan syndrome by preserving elastic fiber integrity, normalizing vasomotor function, and reducing transforming growth factor-beta activation.
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Affiliation(s)
- Ada W Y Chung
- Child and Family Research Institute, Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, Canada.
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Cheuk BLY, Cheng SWK. Can local secretion of prostaglandin E2, thromboxane B2, and interleukin-6 play a role in ruptured abdominal aortic aneurysm? World J Surg 2008; 32:55-61. [PMID: 17992560 DOI: 10.1007/s00268-007-9279-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Our laboratory has previously shown that the levels of secreted prostaglandin E(2) (PGE(2)), Thromboxane B(2) (TxB(2)), and interleukin-6 (IL-6) by aortic explant cultures were high in patients with ruptured abdominal aortic aneurysm (AAA). In the present study, we sought to examine the secretory levels of these inflammatory mediators in aortic explant cultured from a group of AAAs rupturing at a certain size and a group that did not rupture at that size. It was thought that such a comparison might reveal the contribution of those inflammatory mediators to the risk of AAA rupture. MATERIALS AND METHODS All subjects had abdominal computed tomography (CT) scans to determine the size of the aneurysm, and surgical aortic tissue was collected from both nonruptured AAAs (18 with a mean size of 6 + 0.5 cm [range: 5-7 cm] and 12 with a mean size of 8 + 0.1 cm [range: 7.01-10 cm]) and ruptured AAAs (10 with a mean size of 5.8 + 0.3 cm [range: 5-7 cm] and 10 with a mean size of 7.8 + 0.1 cm [range: 7.01-10 cm]). Aortic explant cultures from different sizes of aneurysms were immediately established and the culture media were collected 72 h later. RESULTS The levels of PGE(2), TxB(2), and IL-6 secreted in the cultured medium were quantified by specific enzyme-linked immunosorbent assays (ELISA). The secretary levels of PGE(2), TxB(2), and IL-6 were significantly higher in ruptured AAAs than in nonruptured AAAs of similar diameter. However, there was no correlation between these three inflammatory mediators and the size of AAA. CONCLUSIONS This study shows that these inflammatory mediators may play a role in the progression toward rupture but may not be responsible for the expansion of AAA.
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Affiliation(s)
- Bernice L Y Cheuk
- Department of Surgery, The University of Hong Kong, 14/F, South Wing, Block K, Queen Mary Hospital, 102 Pofkulam, Hong Kong, HKSAR, 852, Hong Kong
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Wilson WRW, Anderton M, Choke EC, Dawson J, Loftus IM, Thompson MM. Elevated plasma MMP1 and MMP9 are associated with abdominal aortic aneurysm rupture. Eur J Vasc Endovasc Surg 2008; 35:580-4. [PMID: 18226564 DOI: 10.1016/j.ejvs.2007.12.004] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2007] [Accepted: 12/11/2007] [Indexed: 11/27/2022]
Abstract
BACKGROUND The role of matrix metalloproteinases (MMPs) in abdominal aortic aneurysm (AAA) formation is well established. However the changes in plasma MMP levels with AAA rupture have not been reported. The aim of this study was to determine circulating levels of MMPs in non-ruptured and ruptured AAA immediately prior to open repair. METHODS Concentrations of MMPs and their endogenous tissue inhibitors (TIMPs) were quantified using ELISA in pre-operative plasma samples from non-ruptured and ruptured AAA. RESULTS MMP1 and MMP9 were elevated in the plasma of ruptured AAA versus non-ruptured AAA. A four-fold elevation in pre-operative plasma MMP9 was associated with non-survival at 30 days from rupture surgery compared with those surviving for greater than 30 days. CONCLUSION In conclusion, these findings support the role of MMPs in AAA pathogenesis. Elevation of MMP9 was associated with ruptured aneurysm related 30-day mortality and may represent a survival indicator in this group.
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Affiliation(s)
- W R W Wilson
- Department of Surgery, University of Leicester, United Kingdom
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Novel insight into the pathobiology of abdominal aortic aneurysm and potential future treatment concepts. Prog Cardiovasc Dis 2007; 50:209-17. [PMID: 17976505 DOI: 10.1016/j.pcad.2007.05.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The patient with abdominal aortic aneurysm (AAA) commonly is a nondiabetic, white man with a history of smoking. Moreover, AAA represents a leading cause of death in elderly men in Western countries. The purpose of this manuscript is to review current evidence as to the pathobiology of AAA as well as potential future drug targets to prevent progression of AAA.
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Aziz F, Kuivaniemi H. Role of matrix metalloproteinase inhibitors in preventing abdominal aortic aneurysm. Ann Vasc Surg 2007; 21:392-401. [PMID: 17484978 PMCID: PMC2128752 DOI: 10.1016/j.avsg.2006.11.001] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2006] [Accepted: 11/28/2006] [Indexed: 11/22/2022]
Abstract
Abdominal aortic aneurysm (AAA) is a significant health problem in the United States, with approximately 30,000 repair operations annually. Treatment of AAA is associated with more than 150,000 hospital admissions per year. The development of AAA is characterized by destruction of the elastic media of the aortic wall. A large body of evidence suggests that a group of enzymes called matrix metalloproteinases (MMPs) plays a significant role in the destruction of extracellular matrix in the aortic wall. MMP inhibition has, therefore, been viewed as an alternative pharmacotherapeutic approach to slow down the development and progression of small AAAs, thus reducing the need for surgical intervention.
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Affiliation(s)
- Faisal Aziz
- Department of Surgery, New York Medical College, Valhalla, NY, USA
| | - Helena Kuivaniemi
- Center for Molecular Medicine and Genetics, Wayne State University School of Medicine, Detroit, MI, USA
- Department of Surgery, Wayne State University School of Medicine, Detroit, MI, USA
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Xiong W, Knispel R, Mactaggart J, Baxter BT. Effects of tissue inhibitor of metalloproteinase 2 deficiency on aneurysm formation. J Vasc Surg 2006; 44:1061-6. [PMID: 17098543 DOI: 10.1016/j.jvs.2006.06.036] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2006] [Accepted: 06/27/2006] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Matrix metalloproteinase (MMP)-2 has been shown to play a pivotal role in aortic aneurysm formation. Its activation requires formation of a trimolecular complex of MMP-2, tissue inhibitor of metalloproteinase-2 (TIMP-2), and membrane type 1 (MT1)-MMP, which is attached to the cell surface. At higher concentrations, TIMP-2 becomes an inhibitor of MMP-2. Thus, TIMP-2 could both augment and inhibit matrix degradation. This study was undertaken to define the net effect of TIMP-2 on matrix destruction and aneurysm formation. METHODS The abdominal aortas of wild-type and TIMP-2-deficient (TIMP-2 -/-) mice were exposed to 0.25 mol/L CaCl2 or 0.9% NaCl for 15 minutes after laparotomy. Aortic diameters were measured before treatment and 6 weeks after aneurysm induction. In addition, aortic tissues were studied for MMP-2 activation by zymography, and matrix structure was studied by connective tissue staining. RESULTS The aortic diameter increased in both wild-type and TIMP-2-/- mice. The increase in the TIMP-2 -/- mice was significantly smaller after CaCl2 treatment (51% +/- 3%) compared with the diameter of wild-type mice (67% +/- 4%). Connective staining of aortic sections from the CaCl2-treated mice revealed disruption and fragmentation of the medial elastic lamellae in both wild-type and TIMP-2 -/- mice. Zymographic analysis showed that active MMP-2 levels were decreased in TIMP-2 -/- aortas compared with wild-type mice. CONCLUSIONS Targeted deletion of TIMP-2 results in attenuation of aneurysm development. Despite its name as an inhibitor of MMPs, TIMP-2 promotes aortic enlargement in vivo, presumably through its role as a cofactor in the activation of MMP-2. CLINICAL RELEVANCE Abdominal aortic aneurysmal (AAA) disease is a potentially fatal disorder that screening studies have detected in 2% to 9% of the general population. Medical therapy designed to inhibit the progression of small aneurysms includes control of hypertension and smoking cessation; neither of these measures is of proven benefit. Effective and directed medical treatments for small AAAs await elucidation of key etiologic factors. Understanding precisely which molecules mediate AAA development, and blocking the activity of these molecules, could lead to important new therapies. Through our research, we have found that tissue inhibitor of metalloproteinase (TIMP)-2 has a role in this process in an experimental model of aortic aneurysms. We believe that TIMP-2 promotes aortic enlargement in vivo by activating matrix metalloproteinase 2.
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Affiliation(s)
- Wanfen Xiong
- Department of Surgery, University of Nebraska Medical Center, Omaha, NE 68198-7690, USA.
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Chen L, Wang X, Carter SA, Shen YH, Bartsch HR, Thompson RW, Coselli JS, Wilcken DL, Wang XL, LeMaire SA. A single nucleotide polymorphism in the matrix metalloproteinase 9 gene (-8202A/G) is associated with thoracic aortic aneurysms and thoracic aortic dissection. J Thorac Cardiovasc Surg 2006; 131:1045-52. [PMID: 16678588 PMCID: PMC2604130 DOI: 10.1016/j.jtcvs.2006.01.003] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2005] [Revised: 12/27/2005] [Accepted: 01/03/2006] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Matrix metalloproteinase 9 plays an important role in the maintenance of the aortic extracellular matrix. Genetic variations that affect protease expression or activity might contribute to thoracic aortic disease. The purpose of this study was to determine whether 3 single nucleotide polymorphisms in the matrix metalloproteinase 9 gene are associated with thoracic aortic aneurysms and dissection. METHODS Genomic DNA was isolated from blood or aortic tissue from 28 patients with degenerative thoracic aortic aneurysms, 60 patients with thoracic aortic dissection, and 111 control patients. The frequency distributions of 3 matrix metalloproteinase 9 single nucleotide polymorphisms (-8202A/G, IVS4+3G/T, and 2003A/G [Q668R]) were determined by using genotyping accomplished with a real-time detection system. Associations between polymorphisms and disease were estimated with odds ratios and their 95% confidence intervals. RESULTS The frequency of the -8202G allele was significantly higher in patients with thoracic aortic aneurysms and aortic dissection (0.52 and 0.56, respectively) than in control subjects (0.36, P < .001). Patients with thoracic aortic aneurysms or dissection were nearly 5 times more likely than control subjects to have the G allele (adjusted odds ratio, 4.87; 95% confidence interval, 2.04-11.64). There were no significant associations between the IVS4+3G/T or 2003A/G polymorphisms and thoracic aortic disease. CONCLUSIONS The matrix metalloproteinase 9 -8202A/G polymorphism is associated with thoracic aortic aneurysms and dissection. Further studies are warranted to elucidate the functional role of the -8202A/G variant in matrix metalloproteinase 9 expression.
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Affiliation(s)
- Li Chen
- Cardiovascular Surgery Service, the Texas Heart Institute at St Luke's Episcopal Hospital, and the Division of Cardiothoracic Surgery, Baylor College of Medicine, Houston, Tex
| | - Xinwen Wang
- Cardiovascular Surgery Service, the Texas Heart Institute at St Luke's Episcopal Hospital, and the Division of Cardiothoracic Surgery, Baylor College of Medicine, Houston, Tex
| | - Stacey A. Carter
- Cardiovascular Surgery Service, the Texas Heart Institute at St Luke's Episcopal Hospital, and the Division of Cardiothoracic Surgery, Baylor College of Medicine, Houston, Tex
| | - Ying H. Shen
- Cardiovascular Surgery Service, the Texas Heart Institute at St Luke's Episcopal Hospital, and the Division of Cardiothoracic Surgery, Baylor College of Medicine, Houston, Tex
| | - Heather R. Bartsch
- Cardiovascular Surgery Service, the Texas Heart Institute at St Luke's Episcopal Hospital, and the Division of Cardiothoracic Surgery, Baylor College of Medicine, Houston, Tex
| | - Robert W. Thompson
- Departments of Surgery (Section of Vascular Surgery), Radiology, and Cell Biology and Physiology, Washington University School of Medicine, St Louis, Mo
| | - Joseph S. Coselli
- Cardiovascular Surgery Service, the Texas Heart Institute at St Luke's Episcopal Hospital, and the Division of Cardiothoracic Surgery, Baylor College of Medicine, Houston, Tex
| | - David L. Wilcken
- Cardiovascular Genetics Laboratory, Eastern Heart Clinic, Centre for Thrombosis and Vascular Research, University of New South Wales, Sydney, Australia
| | - Xing Li Wang
- Cardiovascular Surgery Service, the Texas Heart Institute at St Luke's Episcopal Hospital, and the Division of Cardiothoracic Surgery, Baylor College of Medicine, Houston, Tex
| | - Scott A. LeMaire
- Cardiovascular Surgery Service, the Texas Heart Institute at St Luke's Episcopal Hospital, and the Division of Cardiothoracic Surgery, Baylor College of Medicine, Houston, Tex
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Di Martino ES, Bohra A, Vande Geest JP, Gupta N, Makaroun MS, Vorp DA. Biomechanical properties of ruptured versus electively repaired abdominal aortic aneurysm wall tissue. J Vasc Surg 2006; 43:570-6; discussion 576. [PMID: 16520175 DOI: 10.1016/j.jvs.2005.10.072] [Citation(s) in RCA: 151] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2005] [Accepted: 10/30/2005] [Indexed: 10/24/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate and compare the biomechanical properties of abdominal aortic aneurysm (AAA) wall tissue from patients who experienced AAA rupture with that of those who received elective repair. METHODS Rectangular, circumferentially oriented AAA wall specimens (approximately 2.5 cm x 7 mm) were obtained fresh from the operating room from patients undergoing surgical repair. The width and thickness were measured for each specimen by using a laser micrometer before testing to failure with a uniaxial tensile testing system. The force and deformation applied to each specimen were measured continuously during testing, and the data were converted to stress and stretch ratio. The tensile strength was taken as the peak stress obtained before specimen failure, and the distensibility was taken as the stretch ratio at failure. The maximum tangential modulus and average modulus were also computed according to the peak and average slope of the stress-stretch ratio curve. RESULTS Twenty-six specimens were obtained from 16 patients (aged 73 +/- 3 years [mean +/- SEM]) undergoing elective repair of their AAA (diameter, 7.0 +/- 0.5 cm). Thirteen specimens were resected from nine patients (aged 73 +/- 3 years; P = not significant in comparison to the electively repaired AAAs) during repair of their ruptured AAA (diameter, 7.8 +/- 0.6 cm; P = not significant). A significant difference was noted in wall thickness between ruptured and elective AAAs: 3.6 +/- 0.3 mm vs 2.5 +/- 0.1 mm, respectively (P < .001). The tensile strength of the ruptured tissue was found to be lower than that for the electively repaired tissue (54 +/- 6 N/cm2 vs 82 +/- 9.0 N/cm2; P = .04). Considering all specimens, no significant correlation was noted between tensile strength and diameter (R = -0.10; P = .55). Tensile strength, however, had a significant negative correlation with wall thickness (R = -0.42; P < .05) and a significant positive correlation with the tissue maximum tangential modulus (R = 0.76; P < .05). CONCLUSIONS Our data suggest that AAA rupture is associated with aortic wall weakening, but not with wall stiffening. A widely accepted indicator for risk of aneurysm rupture is the maximum transverse diameter. Our results suggest that AAA wall strength, in large aneurysms, is not related to the maximum transverse diameter. Rather, wall thickness or stiffness may be a better predictor of rupture for large AAAs.
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Affiliation(s)
- Elena S Di Martino
- Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15219, USA
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Keeling WB, Armstrong PA, Stone PA, Bandyk DF, Shames ML. An overview of matrix metalloproteinases in the pathogenesis and treatment of abdominal aortic aneurysms. Vasc Endovascular Surg 2006; 39:457-64. [PMID: 16382266 DOI: 10.1177/153857440503900601] [Citation(s) in RCA: 87] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Recent basic and clinical research has established a link between the pathogenesis of abdominal aortic aneurysms (AAA) and matrix metalloproteinases (MMP). The discovery of the influence of MMPs on in vitro and in vivo aneurysm development has yielded promising information that may eventually decode the pathogenetic factors affecting the initiation and growth rate of AAAs. In this review, an analysis of MMPs involved in AAA disease is presented, including the data from recent research studies and planned clinical drug trails designed to retard the AAA growth by inhibiting MMP activity.
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Affiliation(s)
- W Brent Keeling
- Division of Vascular and Endovascular Surgery, University of South Florida College of Medicine, Tampa, FL 33606, USA
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Wilson WRW, Anderton M, Schwalbe EC, Jones JL, Furness PN, Bell PRF, Thompson MM. Matrix Metalloproteinase-8 and -9 Are Increased at the Site of Abdominal Aortic Aneurysm Rupture. Circulation 2006; 113:438-45. [PMID: 16432074 DOI: 10.1161/circulationaha.105.551572] [Citation(s) in RCA: 158] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background—
Abdominal aortic aneurysm (AAA) expansion is characterized by extracellular matrix degradation and widespread inflammation. In contrast, the processes that characterize AAA rupture are not well understood. The aim of this study was to investigate the proteolytic and cellular activity of ruptured AAA, focusing on matrix metalloproteinases (MMPs) and their inhibitors (TIMPs).
Methods and Results—
Anterior aneurysm wall biopsies were taken from 55 nonruptured and 21 ruptured AAAs. A further biopsy from the site of rupture was taken from 12 of the ruptured AAAs. MMP-1, -2, -3, -8, -9, and -13, as well as TIMP-1 and -2, were quantified in each biopsy with ELISA. A comparison of anterior aneurysm biopsies showed no difference in MMP or TIMP concentrations between nonruptured and ruptured AAA. In a comparison of ruptured AAA biopsies, MMP-8 and -9 levels were significantly elevated in the 12 rupture site biopsies compared with their 12 paired anterior wall biopsies, whereas other MMPs and TIMPs showed no difference (MMP-8,
P
<0.001; MMP-9,
P
=0.01). MMP-8 and -9 expression was mediated by native mesenchymal cells and was independent of the inflammatory infiltrate.
Conclusions—
A localized increase in MMP-8 and –9, mediated by native mesenchymal cells, presents a potential pathway for collagen breakdown and AAA rupture.
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Kaufmann TJ, Marx WF, Kallmes DF. A failure of matrix metalloproteinase inhibition in the prevention of rat intracranial aneurysm formation. Neuroradiology 2006; 48:190-5. [PMID: 16391918 DOI: 10.1007/s00234-005-0025-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2005] [Accepted: 10/08/2005] [Indexed: 10/25/2022]
Abstract
We tested the hypothesis that nonspecific matrix metalloproteinase (MMP) inhibition with doxycycline would decrease the incidence of intracranial aneurysm formation in a rat aneurysm model. We performed common carotid artery ligation on 96 Long-Evans rats. A treatment group of 48 animals was chosen at random to receive oral doxycycline (3 mg/kg) in addition to standard rat chow, and the control group of 48 animals received standard rat chow only. The major circle of Willis arteries was dissected at 1 year following carotid ligation, and the proportions of animals with aneurysms were compared between groups using Fisher's exact test. Four animals given oral doxycycline and ten control animals expired before 1 year. Of the examined animals, eight saccular intracranial aneurysms were found in 8 of 45 animals which had received doxycycline (17.8%) and seven saccular intracranial aneurysms were found in 7 of 37 control animals (18.9%). There was no significant difference in aneurysm formation between the doxycycline-treated and control groups (P=0.894). Nonspecific MMP inhibition with doxycycline is not effective in preventing intracranial aneurysm formation in a rat model.
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Affiliation(s)
- T J Kaufmann
- Department of Radiology, Mayo Clinic and Foundation, Mayo Building, E2, Rochester, MN 55905, USA.
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Miwa K, Nakashima H, Aoki M, Miyake T, Kawasaki T, Iwai M, Oishi M, Kataoka K, Ohgi S, Ogihara T, Kaneda Y, Morishita R. Inhibition of ets, an essential transcription factor for angiogenesis, to prevent the development of abdominal aortic aneurysm in a rat model. Gene Ther 2005; 12:1109-18. [PMID: 15800662 DOI: 10.1038/sj.gt.3302496] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The pathophysiology of abdominal aortic aneurysms (AAA) is considered to be complicated. As matrix degradation contributes to the progression of AAA, the destruction and degradation of elastin fibers caused by an increase in matrix metalloproteinases (MMPs) plays a pivotal role in the development of AAA. Although ets, an essential transcription factor for angiogenesis, regulates MMPs, the role of ets in the development of AAA has not yet been clarified. Thus, we evaluated the role of ets in a rat AAA model using a decoy strategy. Transfection of ODN into AAA was performed by transient aortic perfusion of elastase and by wrapping the AAA in a delivery sheet containing decoy ODN. The inhibitory effect of ets decoy ODN on ets binding activity was confirmed by gel mobility shift assay. MMPs expression was decreased in the aorta transfected with ets decoy ODN as compared to scrambled decoy ODN. Also, ultrasound study demonstrated that elastase-induced aneurismal dilation was significantly suppressed by transfection of ets decoy ODN at 4 weeks after treatment as compared to scrambled decoy ODN. Moreover, the destruction of elastin fibers was inhibited in the aorta transfected with ets decoy ODN, accompanied by a reduction of MMPs expression. An inhibitory effect of decoy ODN on MMP expression was confirmed by ex vivo experiments showing that transfection of decoy ODN into an organ culture of human aorta resulted in significant inhibition of the secretion of both MMP-1 and MMP-9. Here, we demonstrated that ets may play a pivotal role in the progression of AAA through the activation of MMPs in a rat model. Ets might be a potential target to develop pharmacotherapy/gene therapy to treat AAA through the inhibition of MMPs.
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Affiliation(s)
- K Miwa
- Division of Clinical Gene Therapy, Osaka University, Suita, Osaka, Japan
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Wilson WRW, Evans J, Bell PRF, Thompson MM. HMG-CoA reductase inhibitors (statins) decrease MMP-3 and MMP-9 concentrations in abdominal aortic aneurysms. Eur J Vasc Endovasc Surg 2005; 30:259-62. [PMID: 16009575 DOI: 10.1016/j.ejvs.2005.02.044] [Citation(s) in RCA: 75] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2004] [Accepted: 02/09/2005] [Indexed: 11/27/2022]
Abstract
BACKGROUND An imbalance in matrix metalloproteinases (MMPs) and their inhibitors (TIMPs) are implicated in AAA formation. 3-Hydroxy-3-methylglutaryl coenzyme-A reductase inhibitors (statins) are known to reduce MMP levels. The aim of this study was to investigate the in vivo effect of statins on MMP levels in AAA. METHODS Infra-renal aortic biopsies were obtained from the anterior sac of 63 patients undergoing asymptomatic repair. Seventeen patients were taking a statin pre-operatively, while 46 were not. The concentrations of MMP-1, -2, -3, -8, -9, -13, TIMP-1 and TIMP-2 were quantified using ELISA. RESULTS There was no difference in the concentration of MMP-1, -2, -8, -13, TIMP-1 or -2 in patients taking versus not taking a statin pre-operatively. In contrast levels of MMP-9 and MMP-3 were significantly lower in patients taking a statin. CONCLUSIONS These data demonstrate that statins decrease MMP-9 and MMP-3 levels and represent a potential pharmacotherapy in established AAA.
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Affiliation(s)
- W R W Wilson
- Department of Surgery, University of Leicester, Leicester, UK
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Vallabhaneni SR, Gilling-Smith GL, How TV, Carter SD, Brennan JA, Harris PL. Heterogeneity of tensile strength and matrix metalloproteinase activity in the wall of abdominal aortic aneurysms. J Endovasc Ther 2005; 11:494-502. [PMID: 15298501 DOI: 10.1583/04-1239.1] [Citation(s) in RCA: 72] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PURPOSE To measure the tensile strength of the aneurysm wall and the matrix metalloproteinase (MMP) activity in similar samples of aortic tissue. METHODS Detailed mechanical testing was conducted on 124 standardized specimens of aneurysm wall harvested from 24 patients undergoing elective aneurysm repair. The intrasac pressure required to cause aneurysm rupture was calculated based upon the Law of Laplace. In addition, MMP-2 and 9 were assayed from these specimens. Sixty specimens of nonaneurysmal aorta from 6 cadaveric organ donors served as controls. Intrasubject and intersubject variations were analyzed. RESULTS In the aneurysm specimens, the Young's modulus was 1.80x10(6) N/m(2), the load at break was 6.36 N, the strain at break was 0.30, the ultimate strength was 0.53x10(6) N/ m(2), and the MMP activity was 312 for MMP-2 and 460 for MMP-9. In the controls, the circumferential measurements were a Young's modulus of 1.82x10(6) N/m(2), a load at break of 5.43 N, strain at break of 0.29, ultimate strength of 0.61x10(6) N/m(2), and MMP activity of 395 for MMP-2 and 2019 for MMP-9. Longitudinal measurements in controls were a Young's modulus of 1.38x10(6) N/m(2), a load at break of 11.39 N, a strain at break of 0.33, and ultimate strength of 1.30x10(6) N/m(2). Intra and intersubject variation of all parameters was very high. Based upon the lowest measured tensile strength for each aneurysm, the intrasac pressure required to cause rupture varied from 142 to 982 mmHg. CONCLUSIONS Localized "hot spots" of MMP hyperactivity could lead to focal weakening of the aneurysm wall and rupture at relatively low levels of intraluminal pressure. These data suggest that tensile strength of the sac is just as important as intrasac tension in determining the risk of rupture. Moreover, these observations may explain why some small aneurysms rupture and larger aneurysms do not. Assessment of rupture risk based on computation or measurement of wall stress may be subject to error and inaccuracy due to variations in wall tensile strength.
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