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Seim BE, Holt MF, Ratajska A, Michelsen A, Ringseth MM, Halvorsen BE, Skjelland M, Kvitting JPE, Lundblad R, Krohg-Sørensen K, Osnes LTN, Aukrust P, Paus B, Ueland T. Markers of extracellular matrix remodeling and systemic inflammation in patients with heritable thoracic aortic diseases. Front Cardiovasc Med 2022; 9:1073069. [PMID: 36606286 PMCID: PMC9808784 DOI: 10.3389/fcvm.2022.1073069] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 11/29/2022] [Indexed: 01/07/2023] Open
Abstract
Background In approximately 20% of patients with thoracic aortic aneurysms or dissections a heritable thoracic aortic disease (HTAD) is suspected. Several monogenic connective tissue diseases imply high risk of aortic disease, including both non-syndromic and syndromic forms. There are some studies assessing inflammation and extracellular matrix remodeling in patients with non-hereditary aortic disease, but such studies in patients with hereditary diseases are scarce. Aims To quantify markers of extracellular matrix (ECM) and inflammation in patients with vascular connective tissue diseases versus healthy controls. Methods Patients with Loeys-Dietz syndrome (LDS, n = 12), Marfan syndrome (MFS, n = 11), and familial thoracic aortic aneurysm 6 (FTAA6, n = 9), i.e., actin alpha 2 (ACTA2) pathogenic variants, were recruited. Exome or genome sequencing was performed for genetic diagnosis. Several markers of inflammation and ECM remodeling were measured in plasma by enzyme immunoassays. Flow cytometry of T-cell subpopulations was performed on a subgroup of patients. For comparison, blood samples were drawn from 14 healthy controls. Results (i) All groups of HTAD patients had increased levels matrix metalloproteinase-9 (MMP-9) as compared with healthy controls, also in adjusted analyses, reflecting altered ECM remodeling. (ii) LDS patients had increased levels of pentraxin 3 (PTX3), reflecting systemic inflammation. (iii) LDS patients have increased levels of soluble CD25, a marker of T-cell activation. Conclusion Our data suggest that upregulated MMP-9, a matrix degrading enzyme, is a common feature of several subgroups of HTAD. In addition, LDS patients have increased levels of PTX3 reflecting systemic and in particular vascular inflammation.
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Affiliation(s)
- Bjørn Edvard Seim
- Department of Cardiothoracic Surgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Margrethe Flesvig Holt
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway,Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway,Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway,*Correspondence: Margrethe Flesvig Holt,
| | | | - Annika Michelsen
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway,Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway
| | | | - Bente Evy Halvorsen
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway,Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway
| | - Mona Skjelland
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway,Department of Neurology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - John-Peder Escobar Kvitting
- Department of Cardiothoracic Surgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Runar Lundblad
- Department of Cardiothoracic Surgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Kirsten Krohg-Sørensen
- Department of Cardiothoracic Surgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Liv T. N. Osnes
- Department of Immunology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Pål Aukrust
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway,Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway,Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital, Rikshospitalet, Oslo, Norway,Faculty of Health Sciences, K. G. Jebsen Thrombosis Research Center, University of Tromsø – The Arctic University of Norway, Tromsø, Norway
| | - Benedicte Paus
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway,Department of Medical Genetics, Oslo University Hospital, Oslo, Norway
| | - Thor Ueland
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway,Faculty of Health Sciences, K. G. Jebsen Thrombosis Research Center, University of Tromsø – The Arctic University of Norway, Tromsø, Norway
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2
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Boyd AJ. Intraluminal thrombus: Innocent bystander or factor in abdominal aortic aneurysm pathogenesis? JVS Vasc Sci 2021; 2:159-169. [PMID: 34617066 PMCID: PMC8489244 DOI: 10.1016/j.jvssci.2021.02.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 02/20/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Abdominal aortic aneurysms (AAAs) represent a complex multifactorial hemodynamic, thrombotic, and inflammatory process that can ultimately result in aortic rupture and death. Despite improved screening and surgical management of AAAs, the mortality rates have remained high after rupture, and little progress has occurred in the development of nonoperative treatments. Intraluminal thrombus (ILT) is present in most AAAs and might be involved in AAA pathogenesis. The present review examined the latest clinical and experimental evidence for possible involvement of the ILT in AAA growth and rupture. METHODS A literature review was performed after a search of the PubMed database from 2012 to June 2020 using the terms "abdominal aortic aneurysm" and "intraluminal thrombus." RESULTS The structure, composition, and hemodynamics of ILT formation and propagation were reviewed in relation to the hemostatic and proteolytic factors favoring ILT deposition. The potential effects of the ILT on AAA wall degeneration and rupture, including a review of the current controversies regarding the position, thickness, and composition of ILT, are presented. Although initially potentially protective against increased wall stress, increasing evidence has shown that an increased volume and greater age of the ILT have direct detrimental effects on aortic wall integrity, which might predispose to an increased rupture risk. CONCLUSIONS ILT does not appear to be an innocent bystander in AAA pathophysiology. However, its exact role remains elusive and controversial. Despite computational evidence of a possible protective role of the ILT in reducing wall stress, increasing evidence has shown that the ILT promotes AAA wall degeneration in humans and in animal models. Further research, with large animal models and with more chronic ILT is crucial for a better understanding of the role of the ILT in AAAs and for the potential development of targeted therapies to slow or halt AAA progression.
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Affiliation(s)
- April J. Boyd
- Department of Vascular Surgery, University of Manitoba, Winnipeg, Manitoba, Canada
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3
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Siennicka A, Zuchowski M, Kaczmarczyk M, Cnotliwy M, Clark JS, Jastrzębska M. Tissue factor levels and the fibrinolytic system in thin and thick intraluminal thrombus and underlying walls of abdominal aortic aneurysms. J Vasc Surg 2018; 68:30S-37S. [PMID: 29571624 DOI: 10.1016/j.jvs.2017.12.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 12/08/2017] [Indexed: 10/17/2022]
Abstract
BACKGROUND The hemostatic system cooperates with proteolytic degradation in processes allowing abdominal aortic aneurysm (AAA) formation. In previous studies, it has been suggested that aneurysm rupture depends on intraluminal thrombus (ILT) thickness, which varies across each individual aneurysm. We hypothesized that hemostatic components differentially accumulate in AAA tissue in relation to ILT thickness. Thick (A1) and thin (B1) segments of ILTs and aneurysm wall sections A (adjacent to A1) and B (adjacent to B1) from one aneurysm sac were taken from 35 patients undergoing elective repair. METHODS Factor levels were measured using enzyme-linked immunosorbent assay of protein extract. RESULTS Tissue factor (TF) activities were significantly higher in thinner segments of AAA (B1 vs A1, P = .003; B vs A, P < .001; B vs A1, P < .001; B vs B1, P = .001). Significantly higher tissue plasminogen activator was found in thick thrombus-covered wall segments (A) than in B, A1, and B1 (P = .015, P < .001, and P < .001, respectively). Plasminogen concentrations were highest in ILT. Concentrations of α2-antiplasmin in thin ILT adjacent walls (B) were higher compared with wall (A) adjacent to thick ILT (P = .021) and thick ILT (A1; P < .001). Significant correlations between levels of different factors were mostly found in thick ILT (A1). However, no correlations were found at B sites, except for a correlation between plasmin and TF activities (r = 0.55; P = .004). CONCLUSIONS These results suggest that higher TF activities are present in thinner AAA regions. These parameters and local fibrinolysis may be part of the processes leading to destruction of the aneurysm wall.
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Affiliation(s)
- Aldona Siennicka
- Department of Laboratory Diagnostics, Pomeranian Medical University, Szczecin, Poland.
| | - Marta Zuchowski
- Department of Laboratory Diagnostics, Pomeranian Medical University, Szczecin, Poland
| | - Mariusz Kaczmarczyk
- Department of Clinical and Molecular Biochemistry, Pomeranian Medical University, Szczecin, Poland
| | - Miłosław Cnotliwy
- Department of Vascular Surgery and Angiology, Pomeranian Medical University, Szczecin, Poland
| | - Jeremy Simon Clark
- Department of Clinical and Molecular Biochemistry, Pomeranian Medical University, Szczecin, Poland
| | - Maria Jastrzębska
- Department of Laboratory Diagnostics, Pomeranian Medical University, Szczecin, Poland
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4
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Bridge KI, Bollen L, Zhong J, Hesketh M, Macrae FL, Johnson A, Philippou H, Scott DJ, Gils A, Ariёns RAS. Thrombin-activatable fibrinolysis inhibitor in human abdominal aortic aneurysm disease. J Thromb Haemost 2017; 15:2218-2225. [PMID: 28834317 DOI: 10.1111/jth.13804] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Indexed: 12/01/2022]
Abstract
Essentials Patients with abdominal aortic aneurysms (AAA) develop dense clots that are resistant to lysis. This study explores the role of thrombin-activatable fibrinolysis inhibitor (TAFI) in human AAA. There is evidence of chronically increased TAFI activation in patients with AAA. TAFI may represent a pharmacological target for cardiovascular risk reduction in AAA. SUMMARY Background Intra-luminal thrombosis is a key factor in growth of abdominal aortic aneurysms (AAAs). Patients with AAA form dense clots that are resistant to fibrinolysis. Thrombin-activatable fibrinolysis inhibitor (TAFI) has been shown to influence AAA development in murine models. Objective The aim of this study is to characterize the role of TAFI in human AAA. Methods Plasma levels of TAFI, TAFI activation peptide (TAFI-AP), activated/inactivated TAFI (TAFIa/ai) and plasmin-α2-antiplasmin complex were measured by ELISAs in patients with AAA (n = 202) and controls (n = 188). Results TAFIa/ai and TAFI-AP levels were higher in patients than controls (median [IQR], 20.3 [14.6-32.8] ng mL-1 vs. 14.2 [11.2-19.3] ng mL-1 and 355.0 [232.4-528.1] ng mL-1 vs. 248.6 [197.1-328.1] ng mL-1 ). TAFIa/ai was positively correlated with TAFI-AP (r = 0.164). Intact TAFI levels were not different between patients and controls (13.4 [11.2-16.1] μg mL-1 vs. 12.8 [10.6-15.4] μg mL-1 ). Plasmin-α2-antiplasmin was higher in AAA patients than controls (690.0 [489.1-924.3] ng mL-1 vs. 480.7 [392.6-555.3] ng mL-1 ). Conclusions The increase in TAFIa/ai and TAFI-AP suggests an increased TAFI activation in patients with AAA. Prospective studies are required to further elucidate the role of TAFI and fibrinolysis in AAA pathogenesis.
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Affiliation(s)
- K I Bridge
- Thrombosis and Tissue Repair Group, Division of Cardiovascular and Diabetes Research, Leeds Institute of Cardiovascular and Metabolic Medicine, School of Medicine, University of Leeds, Leeds, UK
| | - L Bollen
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven-University of Leuven, Laboratory for Therapeutic and Diagnostic Antibodies, Leuven, Belgium
| | - J Zhong
- Department of Radiology, Leeds General Infirmary, Leeds, UK
| | - M Hesketh
- Thrombosis and Tissue Repair Group, Division of Cardiovascular and Diabetes Research, Leeds Institute of Cardiovascular and Metabolic Medicine, School of Medicine, University of Leeds, Leeds, UK
| | - F L Macrae
- Thrombosis and Tissue Repair Group, Division of Cardiovascular and Diabetes Research, Leeds Institute of Cardiovascular and Metabolic Medicine, School of Medicine, University of Leeds, Leeds, UK
| | - A Johnson
- Thrombosis and Tissue Repair Group, Division of Cardiovascular and Diabetes Research, Leeds Institute of Cardiovascular and Metabolic Medicine, School of Medicine, University of Leeds, Leeds, UK
- The Leeds Vascular Institute, Leeds General Infirmary, Leeds, UK
| | - H Philippou
- Thrombosis and Tissue Repair Group, Division of Cardiovascular and Diabetes Research, Leeds Institute of Cardiovascular and Metabolic Medicine, School of Medicine, University of Leeds, Leeds, UK
| | - D J Scott
- Thrombosis and Tissue Repair Group, Division of Cardiovascular and Diabetes Research, Leeds Institute of Cardiovascular and Metabolic Medicine, School of Medicine, University of Leeds, Leeds, UK
- The Leeds Vascular Institute, Leeds General Infirmary, Leeds, UK
| | - A Gils
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven-University of Leuven, Laboratory for Therapeutic and Diagnostic Antibodies, Leuven, Belgium
| | - R A S Ariёns
- Thrombosis and Tissue Repair Group, Division of Cardiovascular and Diabetes Research, Leeds Institute of Cardiovascular and Metabolic Medicine, School of Medicine, University of Leeds, Leeds, UK
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Wang X, Shen B, Sun D, Cui X. Aspirin ameliorates cerebral infarction through regulation of TLR4/NF‑κB‑mediated endoplasmic reticulum stress in mouse model. Mol Med Rep 2017; 17:479-487. [PMID: 29115440 DOI: 10.3892/mmr.2017.7879] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 08/14/2017] [Indexed: 11/06/2022] Open
Abstract
Cerebral infarction is a cerebrovascular disease caused by local brain ischemic necrosis or softening, which is associated with diabetes, obesity, hypertension and rheumatic heart arrhythmia. Previous studies have indicated that aspirin is a potential oral anticoagulant in the treatment of cerebral ischemic stroke. However, the potential mechanism mediated by aspirin in cerebral infarction therapy is not well understood. The present study analyzed the therapeutic effects of aspirin on cerebral infarction and investigated the underlying molecular mechanism of aspirin‑ameliorated benefits for thrombolysis. The results demonstrated that aspirin inhibited inflammation and apoptosis of cerebrovascular endothelial cells in a mouse model of cerebral infarction. Aspirin treatment suppressed toll‑like receptor (TLR)4 and nuclear factor (NF)‑κB expression in cerebrovascular endothelial cells. Endoplasmic reticulum (ER) stress was suppressed by aspirin treatment through the downregulation of protein kinase R‑like endoplasmic reticulum kinase, eukaryotic translation initiation factor 2 subunit 1 and C/EBP homologous protein expression levels in cerebrovascular endothelial cells. It was identified that knockdown of TLR4 inhibited aspirin‑mediated downregulation of NF‑κB signaling pathway and ER stress in cerebrovascular endothelial cells. Expression levels of adenosine diphosphate plasminogen activator inhibitors, von Willebrand factor and thromboxane were downregulated in cerebrovascular endothelial cells and in serum in experimental mice. The results demonstrated that aspirin was beneficial forthrombolysis by decreasing thrombin‑activatable fibrinolysis inhibitor and plasminogen activator inhibitor‑1 expression in a mouse model of cerebral infarction. These results suggested that aspirin may improve cerebral infarction by downregulating TLR4/NF‑κB‑mediated ER stress in a mouse model.
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Affiliation(s)
- Xin Wang
- Department of Neurosurgery, Dezhou People's Hospital, Dezhou, Shandong 420065, P.R. China
| | - Bin Shen
- Department of Neurosurgery, Dezhou People's Hospital, Dezhou, Shandong 420065, P.R. China
| | - Dezhou Sun
- Department of Neurosurgery, Dezhou People's Hospital, Dezhou, Shandong 420065, P.R. China
| | - Xiangyu Cui
- Department of Neurosurgery, Dezhou People's Hospital, Dezhou, Shandong 420065, P.R. China
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6
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Ma J, Li X, Wang Y, Yang Z, Luo J. Rivaroxaban attenuates thrombosis by targeting the NF-κB signaling pathway in a rat model of deep venous thrombus. Int J Mol Med 2017; 40:1869-1880. [PMID: 29039441 PMCID: PMC5716436 DOI: 10.3892/ijmm.2017.3166] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2016] [Accepted: 09/04/2017] [Indexed: 11/21/2022] Open
Abstract
Anticoagulant therapy is commonly used for the prevention and treatment of patients with deep venous thrombus. Evidence has shown that rivaroxaban is a potential oral anticoagulant drug for the acute treatment of venous thromboembolism. However, the rivaroxaban-mediated molecular mechanism involved in the progression of deep venous thrombosis has not been investigated. In the present study, we investigated the efficacy of rivaroxaban and the underlying signaling pathways in the prevention and treatment of rats with deep venous thrombosis. A rat model with deep vein thrombus formation was established and received treatment with rivaroxaban or PBS as control. The thrombin-activatable fibrinolysis inhibitor (TAFI) and plasminogen activator inhibitor-1 (PAI-1) were analyzed both in vitro and in vivo. The progression of thrombosis and stroke was evaluated after treatment with rivaroxaban or PBS. Nuclear factor-κB (NF-κB) signaling pathway in venous endothelial cells and in the rat model of deep venous thrombus was assessed. The therapeutic effects of rivaroxaban were evaluated as determined by changes in deep venous thrombosis in the rat model. Our results showed that rivaroxaban markedly inhibited TAFI and PAI-1 expression levels, neutrophils, tissue factor, neutrophil extracellular traps (NETs), myeloperoxidase and macrophages in venous endothelial cells and in the rat model of deep venous thrombus. Expression levels of ADP, PAIs, von Willebrand factor (vWF) and thromboxane were downregulated in vein endothelial cells and in serum from the experimental rats. Importantly, the incidences of inferior vena cava filter thrombus were protected by rivaroxaban during heparin-induced thrombolysis deep venous thrombosis in the rat model. We observed that activity of the NF-κB signaling pathway was inhibited by rivaroxaban in vein endothelial cells both in vitro and in vivo. Notably, immunohistology indicated that rivaroxaban attenuated deep venous thrombosis and the accumulation of inflammatory factors in the lesions in venous thrombus. Matrix metalloproteinase (MMP) expression and activity were downregulated in rivaroxaban-treated rats with deep venous thrombus. Rivaroxaban inhibited the elasticity of the extracellular matrix and collagen-elastin fibers. On the whole, these results indicate that rivaroxaban attenuates deep venous thrombus through MMP-9-mediated NF-κB signaling pathway.
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Affiliation(s)
- Junhao Ma
- Department of Blood Vessels of Thyroid Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumchi, Xinjiang 830000, P.R. China
| | - Xinxi Li
- Department of Blood Vessels of Thyroid Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumchi, Xinjiang 830000, P.R. China
| | - Yang Wang
- Department of Blood Vessels of Thyroid Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumchi, Xinjiang 830000, P.R. China
| | - Zhenwei Yang
- Department of Blood Vessels of Thyroid Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumchi, Xinjiang 830000, P.R. China
| | - Jun Luo
- Department of Blood Vessels of Thyroid Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumchi, Xinjiang 830000, P.R. China
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7
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Bridge K, Revill C, Macrae F, Bailey M, Yuldasheva N, Wheatcroft S, Butlin R, Foster R, Scott DJ, Gils A, Ariёns R. Inhibition of plasmin-mediated TAFI activation may affect development but not progression of abdominal aortic aneurysms. PLoS One 2017; 12:e0177117. [PMID: 28472123 PMCID: PMC5417566 DOI: 10.1371/journal.pone.0177117] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 04/21/2017] [Indexed: 12/02/2022] Open
Abstract
Objective Thrombin-activatable fibrinolysis inhibitor (TAFI) reduces the breakdown of fibrin clots through its action as an indirect inhibitor of plasmin. Studies in TAFI-deficient mice have implicated a potential role for TAFI in Abdominal Aortic Aneurysm (AAA) disease. The role of TAFI inhibition on AAA formation in adult ApoE-/- mice is unknown. The aim of this paper was to investigate the effects of TAFI inhibition on AAA development and progression. Methods Using the Angiotensin II model of AAA, male ApoE-/- mice were infused with Angiotensin II 750ng/kg/min with or without a monoclonal antibody inhibitor of plasmin-mediated activation of TAFI, MA-TCK26D6, or a competitive small molecule inhibitor of TAFI, UK-396082. Results Inhibition of TAFI in the Angiotensin II model resulted in a decrease in the mortality associated with AAA rupture (from 40.0% to 16.6% with MA-TCK26D6 (log-rank Mantel Cox test p = 0.16), and 8.3% with UK-396082 (log-rank Mantel Cox test p = 0.05)). Inhibition of plasmin-mediated TAFI activation reduced the incidence of AAA from 52.4% to 30.0%. However, late treatment with MA-TCK26D6 once AAA were already established had no effect on the progression of AAA in this model. Conclusions The formation of intra-mural thrombus is responsible for the dissection and early rupture in the angiotensin II model of AAA, and this process can be prevented through inhibition of TAFI. Late treatment with a TAFI inhibitor does not prevent AAA progression. These data may indicate a role for inhibition of plasmin-mediated TAFI activation in the early stages of AAA development, but not in its progression.
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Affiliation(s)
- Katherine Bridge
- Thrombosis and Tissue Repair Group, Division of Cardiovascular and Diabetes Research, Leeds institute for Cardiovascular and Metabolic Research, University of Leeds, Leeds, United Kingdom
- The Leeds Vascular Institute, Leeds General Infirmary, Leeds, United Kingdom
| | | | - Fraser Macrae
- Thrombosis and Tissue Repair Group, Division of Cardiovascular and Diabetes Research, Leeds institute for Cardiovascular and Metabolic Research, University of Leeds, Leeds, United Kingdom
| | - Marc Bailey
- Thrombosis and Tissue Repair Group, Division of Cardiovascular and Diabetes Research, Leeds institute for Cardiovascular and Metabolic Research, University of Leeds, Leeds, United Kingdom
- The Leeds Vascular Institute, Leeds General Infirmary, Leeds, United Kingdom
| | - Nadira Yuldasheva
- Thrombosis and Tissue Repair Group, Division of Cardiovascular and Diabetes Research, Leeds institute for Cardiovascular and Metabolic Research, University of Leeds, Leeds, United Kingdom
| | - Stephen Wheatcroft
- Thrombosis and Tissue Repair Group, Division of Cardiovascular and Diabetes Research, Leeds institute for Cardiovascular and Metabolic Research, University of Leeds, Leeds, United Kingdom
| | - Roger Butlin
- School of Chemistry, University of Leeds, Leeds, United Kingdom
| | - Richard Foster
- School of Chemistry, University of Leeds, Leeds, United Kingdom
| | - D. Julian Scott
- Thrombosis and Tissue Repair Group, Division of Cardiovascular and Diabetes Research, Leeds institute for Cardiovascular and Metabolic Research, University of Leeds, Leeds, United Kingdom
- The Leeds Vascular Institute, Leeds General Infirmary, Leeds, United Kingdom
| | - Ann Gils
- KU Leuven- University of Leuven, Department of Pharmaceutical and Pharmacological Sciences, Laboratory for Therapeutic and Diagnostic Antibodies, Leuven, Belgium
| | - Robert Ariёns
- Thrombosis and Tissue Repair Group, Division of Cardiovascular and Diabetes Research, Leeds institute for Cardiovascular and Metabolic Research, University of Leeds, Leeds, United Kingdom
- * E-mail:
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8
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Wyseure T, Declerck PJ. Novel or expanding current targets in fibrinolysis. Drug Discov Today 2014; 19:1476-82. [PMID: 24886765 DOI: 10.1016/j.drudis.2014.05.025] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Accepted: 05/23/2014] [Indexed: 12/27/2022]
Abstract
Globally the leading cause of long-term disability and mortality stems from cardiovascular diseases, which creates an enormous economic burden. Currently available treatments for intravascular thrombosis consist of a large repertoire of antithrombotic agents targeting coagulation and platelet function. However, the only agents available to enhance fibrinolysis are recombinant or modified forms of plasminogen activators. Their clinical use is limited by low efficacy, life-threatening side-effects (primarily caused by the high systemic dose required) and the inapplicability for prophylactic use. This review provides an update on the latest advances in targeting the antifibrinolytic proteins, plasminogen activator inhibitor-1 and thrombin-activatable fibrinolysis inhibitor, and will highlight novel therapeutic avenues to enhance fibrinolysis.
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Affiliation(s)
- Tine Wyseure
- Laboratory for Therapeutic and Diagnostic Antibodies, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
| | - Paul J Declerck
- Laboratory for Therapeutic and Diagnostic Antibodies, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium.
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