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Totten V, Teixido-Tura G, Lopez-Grondona F, Fernandez-Alvarez P, Lasa-Aranzasti A, Muñoz-Cabello P, Kosaki R, Tizzano EF, Dewals W, Borràs E, Cañas EG, Almoguera B, Loeys B, Valenzuena I. Arterial aneurysm and dissection: toward the evolving phenotype of Tatton-Brown-Rahman syndrome. J Med Genet 2024; 61:870-877. [PMID: 38960581 DOI: 10.1136/jmg-2024-109861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 06/17/2024] [Indexed: 07/05/2024]
Abstract
BACKGROUND Tatton-Brown-Rahman syndrome (TBRS) is a rare disorder, caused by DNMT3A heterozygous pathogenic variants, and first described in 2014. TBRS is characterised by overgrowth, intellectual disability, facial dysmorphism, hypotonia and musculoskeletal features, as well as neurological and psychiatric features. Cardiac manifestations have also been reported, mainly congenital malformations such as atrial septal defect, ventricular septal defect and cardiac valvular disease. Aortic dilatation has rarely been described. METHODS Here we have undertaken a detailed clinical and molecular description of eight previously unreported individuals, who had TBRS and arterial dilatation and/or dissection, mainly thoracic aortic aneurysm (TAA). We have also reviewed the seven previously published cases of TAA in individuals with TBRS to try to better delineate the vascular phenotype and to determine specific follow-up for this condition. RESULTS We include eight new patients with TBRS who presented with arterial aneurysms mainly involving aorta. Three of these patients presented with dissection that required critical surgery. CONCLUSIONS Arterial aneurysms and dissections are a potentially lethal, age-dependent manifestation. The prevalence of aortic disease in individuals with TBRS is far in excess of that expected in the general population. This cohort, together with individuals previously published, illustrates the importance to consider dilatation/dissection, mainly in aorta but also in other arteries. Arterial vascular weakness may therefore also be a cardinal feature of TBRS and vascular surveillance is recommended.
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Affiliation(s)
- Vicken Totten
- Kaweah Health System, Visalia, California, USA
- Kayenta Health Center of the Indian Health Service, Kayenta, Arizona, USA
| | - Gisela Teixido-Tura
- Department of Cardiology, Hospital Universitari Vall d'Hebron, CIBER-CV, Vall d'Hebron institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain
- Department of Genetics and Genomics, Hospital Universitario Fundacion Jimenez Diaz (IIS-FJD), Madrid, Spain
| | - Fermina Lopez-Grondona
- European Reference Network for Rare Multisystemic Vascular Disease (VASCERN), HTAD Rare Disease Working Group, Barcelona, Spain
| | - Paula Fernandez-Alvarez
- Department of Clinical and Molecular Genetics, Vall d'Hebron University Hospital. Medicine Genetics Group, Vall d'Hebron Research Institute, Barcelona, Spain
- European Reference Network on Rare Congenital Malformations and Rare Intellectual Disability (ERN-ITHACA), Barcelona, Spain
| | - Amaia Lasa-Aranzasti
- Department of Clinical and Molecular Genetics, Vall d'Hebron University Hospital. Medicine Genetics Group, Vall d'Hebron Research Institute, Barcelona, Spain
- European Reference Network on Rare Congenital Malformations and Rare Intellectual Disability (ERN-ITHACA), Barcelona, Spain
| | - Patricia Muñoz-Cabello
- Department of Clinical and Molecular Genetics, Vall d'Hebron University Hospital. Medicine Genetics Group, Vall d'Hebron Research Institute, Barcelona, Spain
- European Reference Network on Rare Congenital Malformations and Rare Intellectual Disability (ERN-ITHACA), Barcelona, Spain
| | - Rika Kosaki
- Division of Medical Genetics, National Center for Child Health and Development, Tokyo, Japan
| | - Eduardo F Tizzano
- Department of Clinical and Molecular Genetics, Vall d'Hebron University Hospital. Medicine Genetics Group, Vall d'Hebron Research Institute, Barcelona, Spain
- European Reference Network on Rare Congenital Malformations and Rare Intellectual Disability (ERN-ITHACA), Barcelona, Spain
| | - Wendy Dewals
- Pediatric Cardiology Department, Antwerp University Hospital, Edegem, Belgium
| | - Emma Borràs
- Molecular Genetics Unit, Consorci Sanitari de Terrassa, Terrassa, Spain
| | - Elena Gonzalez Cañas
- Angiology and Vascular Surgery, Hospital Universitari Parc Tauli, Sabadell, Spain
| | - Berta Almoguera
- European Reference Network for Rare Multisystemic Vascular Disease (VASCERN), HTAD Rare Disease Working Group, Barcelona, Spain
- Centro de Investigacion Biomedica en Red de Enfermedades Raras, Instituto de Salud Carlos III, Madrid, Spain
| | - Bart Loeys
- Center for Medical Genetics, Antwerp University Hospital/University of Antwerp, Antwerp, Belgium
| | - Irene Valenzuena
- Department of Clinical and Molecular Genetics, Vall d'Hebron University Hospital. Medicine Genetics Group, Vall d'Hebron Research Institute, Barcelona, Spain
- European Reference Network on Rare Congenital Malformations and Rare Intellectual Disability (ERN-ITHACA), Barcelona, Spain
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2
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Zhang J, Li Y, Fang F, Wan J, Xia Z, Han Y, Jiang S, Lv B, Zhi A, Tse G, Chan JSK, Zhang S, Pan X, Zhang G. Hemodynamics, anatomy, and outcomes of quadricuspid aortic valves: Multimodality imaging assessment. J Cardiovasc Comput Tomogr 2024; 18:179-186. [PMID: 38262851 DOI: 10.1016/j.jcct.2024.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 11/30/2023] [Accepted: 01/15/2024] [Indexed: 01/25/2024]
Abstract
BACKGROUND Quadricuspid aortic valve (QAV) is a rare congenital heart disease with a limited body of literature. This retrospective cohort study investigates QAV morphology, function, and clinical outcomes. METHODS Echocardiography was used to assess valvular function. Morphological characteristics such as phenotypes, raphe, regurgitant orifice area (ROA), and aortic dilation (diameter >40 mm) were assessed by cardiac CT. Patients were followed up for the combined event of all-cause death and aortic valve replacement (AVR). RESULTS Ninety QAV patients (screened from 322385 CT scans) were included (mean age 55.2 ± 13.6 years, 61.1 % male). Isolated significant aortic regurgitation (AR) was present in 75.6 % of patients. The cohort was dominated by type I (four equal leaflets, 37.8 %) and type II (3 larger and 1 smaller leaflets, 42.2 %) QAV. Fused raphe was present in 26.7 % of patients. ROACT was correlated with AR severity and aortic dilation (41.1 %, n = 37). Among patients without AVR at baseline (n = 60), one died and 17 underwent AVR during a median follow-up of 35.0 months (IQR:17.3-62.8). ROACT was associated with an increasing risk of combined event (as a categorical variable with a cut-off of 21.4 mm2, HR = 4.25, 95%CI 1.49-12.17, p = 0.007; as a continuous variable (per mm2 increment), HR = 1.04, 95%CI 1.01-1.07, p = 0.003). Additionally, ROACT had incremental prognostic value when added to the AR severity model (area under the receiver-operating characteristic curve increased from 86.8 to 88.4, p = 0.004). CONCLUSION QAV is characterized by variable anatomy, progressive AR, concomitant cusp fusion and aortic enlargement. ROACT may be a potential ancillary prognostic marker in patients with QAV.
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Affiliation(s)
- Jingnan Zhang
- Department of Structural Heart Disease, National Center for Cardiovascular Disease, China &Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yihang Li
- Department of Structural Heart Disease, Central China Fuwai Hospital, Zhengzhou, China
| | - Fang Fang
- Department of Structural Heart Disease, National Center for Cardiovascular Disease, China &Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Junyi Wan
- Department of Structural Heart Disease, National Center for Cardiovascular Disease, China &Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Zhiyuan Xia
- Department of Structural Heart Disease, National Center for Cardiovascular Disease, China &Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yu Han
- Department of Structural Heart Disease, Central China Fuwai Hospital, Zhengzhou, China
| | - Shiliang Jiang
- Department of Radiology, National Center for Cardiovascular Disease, China & Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Bin Lv
- Department of Radiology, National Center for Cardiovascular Disease, China & Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Aihua Zhi
- Department of Radiology, National Center for Cardiovascular Disease, China & Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Gary Tse
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong, China
| | - Jeffrey Shi Kai Chan
- Structural Heart Disease and Heart Failure Research Unit, Cardiovascular Analytics Group, Prince of Wales Hospital, Hong Kong, China
| | - Shaoxiong Zhang
- Department of Diagnostic Radiology, Cleveland Clinic, Ohio, USA
| | - Xiangbin Pan
- Department of Structural Heart Disease, National Center for Cardiovascular Disease, China &Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Gejun Zhang
- Department of Structural Heart Disease, National Center for Cardiovascular Disease, China &Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
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3
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Rega S, Farina F, Bouhuis S, de Donato S, Chiesa M, Poggio P, Cavallotti L, Bonalumi G, Giambuzzi I, Pompilio G, Perrucci GL. Multi-omics in thoracic aortic aneurysm: the complex road to the simplification. Cell Biosci 2023; 13:131. [PMID: 37475058 DOI: 10.1186/s13578-023-01080-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 07/05/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND Thoracic aortic aneurysm (TAA) is a serious condition that affects the aorta, characterized by the dilation of its first segment. The causes of TAA (e.g., age, hypertension, genetic syndromes) are heterogeneous and contribute to the weakening of the aortic wall. This complexity makes treating this life-threatening aortopathy challenging, as there are currently no etiological therapy available, and pharmacological strategies, aimed at avoiding surgical aortic replacement, are merely palliative. Recent studies on novel therapies for TAA have focused on identifying biological targets and etiological mechanisms of the disease by using advanced -omics techniques, including epigenomics, transcriptomics, proteomics, and metabolomics approaches. METHODS This review presents the latest findings from -omics approaches and underscores the importance of integrating multi-omics data to gain more comprehensive understanding of TAA. RESULTS Literature suggests that the alterations in TAA mediators frequently involve members of pro-fibrotic process (i.e., TGF-β signaling pathways) or proteins associated with cell/extracellular structures (e.g., aggrecans). Further analyses often reported the importance in TAA of processes as inflammation (PCR, CD3, leukotriene compounds), oxidative stress (chromatin OXPHOS, fatty acids), mitochondrial respiration and glycolysis/gluconeogenesis (e.g., PPARs and HIF1a). Of note, more recent metabolomics studies added novel molecular markers to the list of TAA-specific detrimental mediators (proteoglycans). CONCLUSION It is increasingly clear that integrating data from different -omics branches, along with clinical data, is essential as well as complicated both to reveal hidden relevant information and to address complex diseases such as TAA. Importantly, recent progresses in metabolomics highlighted novel potential and unprecedented marks in TAA diagnosis and therapy.
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Affiliation(s)
- Sara Rega
- Unit of Vascular Biology and Regenerative Medicine, Centro Cardiologico Monzino IRCCS, Milan, Italy
- Unit for the Study of Aortic, Valvular and Coronary Pathologies, Centro Cardiologico Monzino IRCCS, Milan, Italy
| | - Floriana Farina
- Institute for Cardiovascular Prevention (IPEK), Ludwig-Maximillians-Universität (LMU) München, Munich, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany
| | - Silvia Bouhuis
- Unit of Vascular Biology and Regenerative Medicine, Centro Cardiologico Monzino IRCCS, Milan, Italy
| | - Silvia de Donato
- Unit of Vascular Biology and Regenerative Medicine, Centro Cardiologico Monzino IRCCS, Milan, Italy
| | - Mattia Chiesa
- Bioinformatics and Artificial Intelligence Facility, Centro Cardiologico Monzino IRCCS, Milan, Italy
- Department of Electronics, Information and Biomedical Engineering, Politecnico Di Milano, Milan, Italy
| | - Paolo Poggio
- Unit for the Study of Aortic, Valvular and Coronary Pathologies, Centro Cardiologico Monzino IRCCS, Milan, Italy
| | - Laura Cavallotti
- Department of Cardiovascular Surgery, Centro Cardiologico Monzino IRCCS, Milan, Italy
| | - Giorgia Bonalumi
- Department of Cardiovascular Surgery, Centro Cardiologico Monzino IRCCS, Milan, Italy
| | - Ilaria Giambuzzi
- Department of Cardiovascular Surgery, Centro Cardiologico Monzino IRCCS, Milan, Italy
- Department of Clinical Sciences and Community Health, Università Degli Studi Di Milano, Milan, Italy
| | - Giulio Pompilio
- Unit of Vascular Biology and Regenerative Medicine, Centro Cardiologico Monzino IRCCS, Milan, Italy
- Department of Cardiovascular Surgery, Centro Cardiologico Monzino IRCCS, Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, Università Degli Studi Di Milano, Milan, Italy
| | - Gianluca L Perrucci
- Unit of Vascular Biology and Regenerative Medicine, Centro Cardiologico Monzino IRCCS, Milan, Italy.
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4
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Benson TW, Conrad KA, Li XS, Wang Z, Helsley RN, Schugar RC, Coughlin TM, Wadding-Lee C, Fleifil S, Russell HM, Stone T, Brooks M, Buffa JA, Mani K, Björck M, Wanhainen A, Sangwan N, Biddinger S, Bhandari R, Ademoya A, Pascual C, Tang WW, Tranter M, Cameron SJ, Brown JM, Hazen SL, Owens AP. Gut Microbiota-Derived Trimethylamine N-Oxide Contributes to Abdominal Aortic Aneurysm Through Inflammatory and Apoptotic Mechanisms. Circulation 2023; 147:1079-1096. [PMID: 37011073 PMCID: PMC10071415 DOI: 10.1161/circulationaha.122.060573] [Citation(s) in RCA: 28] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 02/07/2023] [Indexed: 04/05/2023]
Abstract
BACKGROUND Large-scale human and mechanistic mouse studies indicate a strong relationship between the microbiome-dependent metabolite trimethylamine N-oxide (TMAO) and several cardiometabolic diseases. This study aims to investigate the role of TMAO in the pathogenesis of abdominal aortic aneurysm (AAA) and target its parent microbes as a potential pharmacological intervention. METHODS TMAO and choline metabolites were examined in plasma samples, with associated clinical data, from 2 independent patient cohorts (N=2129 total). Mice were fed a high-choline diet and underwent 2 murine AAA models, angiotensin II infusion in low-density lipoprotein receptor-deficient (Ldlr-/-) mice or topical porcine pancreatic elastase in C57BL/6J mice. Gut microbial production of TMAO was inhibited through broad-spectrum antibiotics, targeted inhibition of the gut microbial choline TMA lyase (CutC/D) with fluoromethylcholine, or the use of mice genetically deficient in flavin monooxygenase 3 (Fmo3-/-). Finally, RNA sequencing of in vitro human vascular smooth muscle cells and in vivo mouse aortas was used to investigate how TMAO affects AAA. RESULTS Elevated TMAO was associated with increased AAA incidence and growth in both patient cohorts studied. Dietary choline supplementation augmented plasma TMAO and aortic diameter in both mouse models of AAA, which was suppressed with poorly absorbed oral broad-spectrum antibiotics. Treatment with fluoromethylcholine ablated TMAO production, attenuated choline-augmented aneurysm initiation, and halted progression of an established aneurysm model. In addition, Fmo3-/- mice had reduced plasma TMAO and aortic diameters and were protected from AAA rupture compared with wild-type mice. RNA sequencing and functional analyses revealed choline supplementation in mice or TMAO treatment of human vascular smooth muscle cells-augmented gene pathways associated with the endoplasmic reticulum stress response, specifically the endoplasmic reticulum stress kinase PERK. CONCLUSIONS These results define a role for gut microbiota-generated TMAO in AAA formation through upregulation of endoplasmic reticulum stress-related pathways in the aortic wall. In addition, inhibition of microbiome-derived TMAO may serve as a novel therapeutic approach for AAA treatment where none currently exist.
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Affiliation(s)
- Tyler W. Benson
- Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH 45267-0542, USA
- Division of Cardiovascular Health & Disease, University of Cincinnati College of Medicine, Cincinnati, OH 45267-0542, USA
| | - Kelsey A. Conrad
- Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH 45267-0542, USA
- Division of Cardiovascular Health & Disease, University of Cincinnati College of Medicine, Cincinnati, OH 45267-0542, USA
- Pathobiology and Molecular Medicine Graduate Program, University of Cincinnati College of Medicine, Cincinnati, OH 45267-0542, USA
| | - Xinmin S. Li
- Department of Cardiovascular and Metabolic Sciences, Learner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA
- Center for Microbiome & Human Health, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Zeneng Wang
- Department of Cardiovascular and Metabolic Sciences, Learner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA
- Center for Microbiome & Human Health, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Robert N. Helsley
- Department of Cardiovascular and Metabolic Sciences, Learner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Rebecca C. Schugar
- Department of Cardiovascular and Metabolic Sciences, Learner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Taylor M. Coughlin
- Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH 45267-0542, USA
- Division of Cardiovascular Health & Disease, University of Cincinnati College of Medicine, Cincinnati, OH 45267-0542, USA
- Pathobiology and Molecular Medicine Graduate Program, University of Cincinnati College of Medicine, Cincinnati, OH 45267-0542, USA
| | - Caris Wadding-Lee
- Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH 45267-0542, USA
- Division of Cardiovascular Health & Disease, University of Cincinnati College of Medicine, Cincinnati, OH 45267-0542, USA
- Pathobiology and Molecular Medicine Graduate Program, University of Cincinnati College of Medicine, Cincinnati, OH 45267-0542, USA
| | - Salma Fleifil
- Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH 45267-0542, USA
- Division of Cardiovascular Health & Disease, University of Cincinnati College of Medicine, Cincinnati, OH 45267-0542, USA
| | - Hannah M. Russell
- Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH 45267-0542, USA
- Division of Cardiovascular Health & Disease, University of Cincinnati College of Medicine, Cincinnati, OH 45267-0542, USA
- Pathobiology and Molecular Medicine Graduate Program, University of Cincinnati College of Medicine, Cincinnati, OH 45267-0542, USA
| | - Timothy Stone
- Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH 45267-0542, USA
- Division of Biostatistics and Bioinformatics, University of Cincinnati College of Medicine, Cincinnati, OH 45267-0542, USA
| | - Michael Brooks
- Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH 45267-0542, USA
- Division of Cardiovascular Health & Disease, University of Cincinnati College of Medicine, Cincinnati, OH 45267-0542, USA
| | - Jennifer A. Buffa
- Department of Cardiovascular and Metabolic Sciences, Learner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA
- Center for Microbiome & Human Health, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Kevin Mani
- Section of Vascular Surgery, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Martin Björck
- Section of Vascular Surgery, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Anders Wanhainen
- Section of Vascular Surgery, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Naseer Sangwan
- Department of Cardiovascular and Metabolic Sciences, Learner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA
- Center for Microbiome & Human Health, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Sudha Biddinger
- Division of Endocrinology, Boston Children’s Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Rohan Bhandari
- Department of Cardiovascular and Metabolic Sciences, Learner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA
- Department of Cardiovascular Medicine, Hearth, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Akiirayi Ademoya
- Department of Cardiovascular and Metabolic Sciences, Learner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Crystal Pascual
- Department of Cardiovascular and Metabolic Sciences, Learner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - W.H. Wilson Tang
- Department of Cardiovascular and Metabolic Sciences, Learner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA
- Center for Microbiome & Human Health, Cleveland Clinic, Cleveland, OH 44195, USA
- Department of Cardiovascular Medicine, Hearth, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Michael Tranter
- Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH 45267-0542, USA
- Division of Cardiovascular Health & Disease, University of Cincinnati College of Medicine, Cincinnati, OH 45267-0542, USA
- Pathobiology and Molecular Medicine Graduate Program, University of Cincinnati College of Medicine, Cincinnati, OH 45267-0542, USA
| | - Scott J. Cameron
- Department of Cardiovascular and Metabolic Sciences, Learner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA
- Department of Cardiovascular Medicine, Hearth, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - J. Mark Brown
- Department of Cardiovascular and Metabolic Sciences, Learner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA
- Center for Microbiome & Human Health, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Stanley L. Hazen
- Department of Cardiovascular and Metabolic Sciences, Learner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA
- Center for Microbiome & Human Health, Cleveland Clinic, Cleveland, OH 44195, USA
- Department of Cardiovascular Medicine, Hearth, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - A. Phillip Owens
- Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH 45267-0542, USA
- Division of Cardiovascular Health & Disease, University of Cincinnati College of Medicine, Cincinnati, OH 45267-0542, USA
- Pathobiology and Molecular Medicine Graduate Program, University of Cincinnati College of Medicine, Cincinnati, OH 45267-0542, USA
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5
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Weiss D, Long AS, Tellides G, Avril S, Humphrey JD, Bersi MR. Evolving Mural Defects, Dilatation, and Biomechanical Dysfunction in Angiotensin II-Induced Thoracic Aortopathies. Arterioscler Thromb Vasc Biol 2022; 42:973-986. [PMID: 35770665 PMCID: PMC9339505 DOI: 10.1161/atvbaha.122.317394] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 06/14/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Thoracic aortopathy associates with extracellular matrix remodeling and altered biomechanical properties. We sought to quantify the natural history of thoracic aortopathy in a common mouse model and to correlate measures of wall remodeling such as aortic dilatation or localized mural defects with evolving microstructural composition and biomechanical properties of the wall. METHODS We combined a high-resolution multimodality imaging approach (panoramic digital image correlation and optical coherence tomography) with histopathologic examinations and biaxial mechanical testing to correlate spatially, for the first time, macroscopic mural defects and medial degeneration within the ascending aorta with local changes in aortic wall composition and mechanical properties. RESULTS Findings revealed strong correlations between local decreases in elastic energy storage and increases in circumferential material stiffness with increasing proximal aortic diameter and especially mural defect size. Mural defects tended to exhibit a pronounced biomechanical dysfunction that is driven by an altered organization of collagen and elastic fibers. CONCLUSIONS While aneurysmal dilatation is often observed within particular segments of the aorta, dissection and rupture initiate as highly localized mechanical failures. We show that wall composition and material properties are compromised in regions of local mural defects, which further increases the dilatation and overall structural vulnerability of the wall. Identification of therapies focused on promoting robust collagen accumulation may protect the wall from these vulnerabilities and limit the incidence of dissection and rupture.
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Affiliation(s)
- Dar Weiss
- Department of Biomedical Engineering, Yale University, New Haven, CT, USA
| | - Aaron S. Long
- Department of Biomedical Engineering, Yale University, New Haven, CT, USA
| | - George Tellides
- Department of Surgery, Yale School of Medicine, New Haven, CT, USA
- Vascular Biology and Therapeutics Program, Yale School of Medicine, New Haven, CT, USA
| | - Stéphane Avril
- Mines Saint-Etienne, University of Lyon, University Jean Monnet, INSERM, Saint-Etienne, France
| | - Jay D. Humphrey
- Department of Biomedical Engineering, Yale University, New Haven, CT, USA
- Vascular Biology and Therapeutics Program, Yale School of Medicine, New Haven, CT, USA
| | - Matthew R. Bersi
- Department of Biomedical Engineering, Yale University, New Haven, CT, USA
- Department of Mechanical Engineering and Materials Science, Washington University in St. Louis, St. Louis, MO, USA
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6
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Abstract
Sex is a key risk factor for many types of cardiovascular disease. It is imperative to understand the mechanisms underlying sex differences to devise optimal preventive and therapeutic approaches for all individuals. Both biological sex (determined by sex chromosomes and gonadal hormones) and gender (social and cultural behaviors associated with femininity or masculinity) influence differences between men and women in disease susceptibility and pathology. Here, we focus on the application of experimental mouse models that elucidate the influence of 2 components of biological sex-sex chromosome complement (XX or XY) and gonad type (ovaries or testes). These models have revealed that in addition to well-known effects of gonadal hormones, sex chromosome complement influences cardiovascular risk factors, such as plasma cholesterol levels and adiposity, as well as the development of atherosclerosis and pulmonary hypertension. One mechanism by which sex chromosome dosage influences cardiometabolic traits is through sex-biased expression of X chromosome genes that escape X inactivation. These include chromatin-modifying enzymes that regulate gene expression throughout the genome. The identification of factors that determine sex-biased gene expression and cardiometabolic traits will expand our mechanistic understanding of cardiovascular disease processes and provide insight into sex differences that remain throughout the lifespan as gonadal hormone levels alter with age.
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Affiliation(s)
- Karen Reue
- Department of Human Genetics, David Geffen School of Medicine at UCLA
- Department of Medicine, David Geffen School of Medicine at UCLA
- Molecular Biology Institute, University of California, Los Angeles, CA 90095
| | - Carrie B. Wiese
- Department of Human Genetics, David Geffen School of Medicine at UCLA
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7
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Sawada H, Lu HS, Cassis LA, Daugherty A. Twenty Years of Studying AngII (Angiotensin II)-Induced Abdominal Aortic Pathologies in Mice: Continuing Questions and Challenges to Provide Insight Into the Human Disease. Arterioscler Thromb Vasc Biol 2022; 42:277-288. [PMID: 35045728 PMCID: PMC8866209 DOI: 10.1161/atvbaha.121.317058] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
AngII (angiotensin II) infusion in mice has been used to provide mechanistic insight into human abdominal aortic aneurysms for over 2 decades. This is a technically facile animal model that recapitulates multiple facets of the human disease. Although numerous publications have reported abdominal aortic aneurysms with AngII infusion in mice, there remain many fundamental unanswered questions such as uniformity of describing the pathological characteristics and which cell type is stimulated by AngII to promote abdominal aortic aneurysms. Extrapolation of the findings to provide insight into the human disease has been hindered by the preponderance of studies designed to determine the effects on initiation of abdominal aortic aneurysms, rather than a more clinically relevant scenario of determining efficacy on the established disease. The purpose of this review is to enhance understanding of AngII-induced abdominal aortic pathologies in mice, thereby providing greater insight into the human disease.
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Affiliation(s)
- Hisashi Sawada
- Saha Cardiovascular Research Center, University of Kentucky, Lexington, KY,Saha Aortic Center, University of Kentucky, Lexington, KY,Department of Physiology, University of Kentucky, Lexington, KY
| | - Hong S. Lu
- Saha Cardiovascular Research Center, University of Kentucky, Lexington, KY,Saha Aortic Center, University of Kentucky, Lexington, KY,Department of Physiology, University of Kentucky, Lexington, KY
| | - Lisa A. Cassis
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY
| | - Alan Daugherty
- Saha Cardiovascular Research Center, University of Kentucky, Lexington, KY,Saha Aortic Center, University of Kentucky, Lexington, KY,Department of Physiology, University of Kentucky, Lexington, KY
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8
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Sawada H, Beckner ZA, Ito S, Daugherty A, Lu HS. β-Aminopropionitrile-induced aortic aneurysm and dissection in mice. JVS Vasc Sci 2022; 3:64-72. [PMID: 35141570 PMCID: PMC8814647 DOI: 10.1016/j.jvssci.2021.12.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 12/01/2021] [Indexed: 11/23/2022] Open
Abstract
The mechanistic basis for the formation of aortic aneurysms and dissection needs to be elucidated to facilitate the development of effective medications. β-Aminopropionitrile administration in mice has been used frequently to study the pathologic features and mechanisms of aortic aneurysm and dissection. This mouse model mimics several facets of the pathology of human aortic aneurysms and dissection, although many variables exist in the experimental design and protocols that must be resolved to determine its application to the human disease. In the present brief review, we have introduced the development of this mouse model and provided insights into understanding its pathologic features.
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Affiliation(s)
- Hisashi Sawada
- Saha Cardiovascular Research Center, University of Kentucky, Lexington, Ky
- Saha Aortic Center, University of Kentucky, Lexington, Ky
- Department of Physiology, University of Kentucky, Lexington, Ky
| | - Zachary A. Beckner
- Saha Cardiovascular Research Center, University of Kentucky, Lexington, Ky
- Saha Aortic Center, University of Kentucky, Lexington, Ky
| | - Sohei Ito
- Saha Cardiovascular Research Center, University of Kentucky, Lexington, Ky
- Saha Aortic Center, University of Kentucky, Lexington, Ky
| | - Alan Daugherty
- Saha Cardiovascular Research Center, University of Kentucky, Lexington, Ky
- Saha Aortic Center, University of Kentucky, Lexington, Ky
- Department of Physiology, University of Kentucky, Lexington, Ky
| | - Hong S. Lu
- Saha Cardiovascular Research Center, University of Kentucky, Lexington, Ky
- Saha Aortic Center, University of Kentucky, Lexington, Ky
- Department of Physiology, University of Kentucky, Lexington, Ky
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9
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Rabin A, Palacio D, Saqib N, Bar-Yoseph P, Weiss D, Afifi RO. Aortic aneurysms and dissections: Unmet needs from physicians and engineers perspectives. J Biomech 2021; 122:110461. [PMID: 33901933 DOI: 10.1016/j.jbiomech.2021.110461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 03/31/2021] [Indexed: 10/21/2022]
Abstract
The treatment of aortic disease is complex, requiring cardiothoracic and vascular surgeons to make pre-, post- and intraoperative decisions directly influencing patient survival and well-being. Despite tremendous advancement in vascular surgery and endovascular techniques in the last two decades, along with the abundance of research in the field, many unmet needs and unanswered questions remain. Tight collaboration between engineers and physicians is a keystone in translating new tools, techniques, and devices into practice. Here, we have gathered our perspective, as physicians and engineers, in several pressing issues associated with the diagnosis and treatment of aortic aneurysms and dissection, referring to the current knowledge and practice, signifying unmet needs as well as future directions.
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Affiliation(s)
- Asaf Rabin
- Department of Vascular and Endovascular Surgery Unit, B. Padeh M.C, Poriya, Israel.
| | - Diana Palacio
- Cardiothoracic Imaging Division, Department of Medical Imaging, The University of Arizona Banner Medical Center, Tucson, AZ, USA
| | - Naveed Saqib
- Department of Cardiothoracic and Vascular Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Pinhas Bar-Yoseph
- Faculty of Mechanical Engineering, Technion-Israel Institute of Technology, Haifa, Israel
| | - Dar Weiss
- Department of Biomedical Engineering, Yale university, CT, USA
| | - Rana O Afifi
- Department of Cardiothoracic and Vascular Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
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10
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LOXL4 Abrogation Does Not Exaggerate Angiotensin II-Induced Thoracic or Abdominal Aortic Aneurysm in Mice. Genes (Basel) 2021; 12:genes12040513. [PMID: 33807332 PMCID: PMC8066229 DOI: 10.3390/genes12040513] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 03/22/2021] [Accepted: 03/30/2021] [Indexed: 01/03/2023] Open
Abstract
It has been shown that thoracic aortic aneurysm and dissection (TAAD) could be a Mendelian trait caused by a single gene mutation. The LOX gene mutation leads to the development of human TAAD. The LOXL4 gene is a member of the lysyl oxidase gene family. We identified seven variants in the LOXL4 gene in 219 unrelated patients with TAAD by whole-exome sequencing (WES). To further investigate whether LOXL4 is a candidate causative gene for human TAAD, a Loxl4 knockout mouse was generated, and the mutant mice were treated by subcutaneous infusion of angiotensin II. We found that abrogation of Loxl4 did not induce a more severe thoracic or abdominal aortic aneurysm compared with the wild-type C57BL/6J mice. Our results suggest that LOXL4 may not play a major role in the development of angiotensin II-induced aortic aneurysm. The functional study using this animal model system is important for the evaluation of candidate genes of TAAD identified by WES.
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11
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AlSiraj Y, Thatcher SE, Blalock E, Saintilnord WN, Daugherty A, Lu HS, Luo W, Shen YH, LeMaire SA, Arnold AP, Cassis LA. Monosomy X in Female Mice Influences the Regional Formation and Augments the Severity of Angiotensin II-Induced Aortopathies. Arterioscler Thromb Vasc Biol 2021; 41:269-283. [PMID: 33054396 PMCID: PMC8259710 DOI: 10.1161/atvbaha.120.314407] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
OBJECTIVE Turner syndrome women (monosomy X) have high risk of aortopathies consistent with a role for sex chromosomes in disease development. We demonstrated that sex chromosomes influence regional development of Ang II (angiotensin II)-induced aortopathies in mice. In this study, we determined if the number of X chromosomes regulates regional development of Ang II-induced aortopathies. Approach and Results: We used females with varying numbers of X chromosomes (XX female mice [XXF] or XO female mice [XOF]) on an C57BL/6J (ascending aortopathies) or low-density lipoprotein receptor deficient (Ldlr-/-) background (descending and abdominal aortopathies) compared with XY males (XYM). To induce aortopathies, mice were infused with Ang II. XOF (C57BL/6J) exhibited larger percent increases in ascending aortic lumen diameters than Ang II-infused XXF or XYM. Ang II-infused XOF (Ldlr-/-) exhibited similar incidences of thoracic (XOF, 50%; XYM, 71%) and abdominal aortopathies (XOF, 83%; XYM, 71%) as XYM, which were greater than XXF (XXF, 0%). Abdominal aortic lumen diameters and maximal external diameters were similar between XOF and XYM but greater than XXF, and these effects persisted with extended Ang II infusions. Larger aortic lumen diameters, abdominal aortopathy incidence (XXF, 20%; XOF, 75%), and maximal aneurysm diameters (XXF, 1.02±0.17; XOF, 1.96±0.32 mm; P=0.027) persisted in ovariectomized Ang II-infused XOF mice. Data from RNA-seq demonstrated that X chromosome genes that escape X-inactivation (histone lysine demethylases Kdm5c and Kdm6a) exhibited lower mRNA abundance in aortas of XOF than XXF (P=0.033 and 0.024, respectively). Conversely, DNA methylation was higher in aortas of XOF than XXF (P=0.038). CONCLUSIONS The absence of a second X chromosome promotes diffuse Ang II-induced aortopathies in females.
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MESH Headings
- Angiotensin II
- Animals
- Aorta, Abdominal/metabolism
- Aorta, Abdominal/pathology
- Aorta, Thoracic/metabolism
- Aorta, Thoracic/pathology
- Aortic Aneurysm, Abdominal/chemically induced
- Aortic Aneurysm, Abdominal/genetics
- Aortic Aneurysm, Abdominal/metabolism
- Aortic Aneurysm, Abdominal/pathology
- Aortic Aneurysm, Thoracic/chemically induced
- Aortic Aneurysm, Thoracic/genetics
- Aortic Aneurysm, Thoracic/metabolism
- Aortic Aneurysm, Thoracic/pathology
- DNA Methylation
- Disease Models, Animal
- Female
- Histone Demethylases/genetics
- Histone Demethylases/metabolism
- Mice, Inbred C57BL
- Mice, Knockout
- Ovariectomy
- Receptors, LDL/deficiency
- Receptors, LDL/genetics
- Severity of Illness Index
- Turner Syndrome/complications
- Turner Syndrome/genetics
- Mice
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Affiliation(s)
- Yasir AlSiraj
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington KY
| | - Sean E. Thatcher
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington KY
| | - Eric Blalock
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington KY
| | - Wesley N. Saintilnord
- Department of Molecular and Cellular Biochemistry, University of Kentucky, Lexington, KY
| | - Alan Daugherty
- Department of Physiology, University of Kentucky, Lexington KY
- Saha Cardiovascular Research Center, University of Kentucky, Lexington KY
| | - Hong S. Lu
- Department of Physiology, University of Kentucky, Lexington KY
- Saha Cardiovascular Research Center, University of Kentucky, Lexington KY
| | - Wei Luo
- Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, and Department of Cardiovascular Surgery, Texas Heart Institute, Houston TX
| | - Ying H. Shen
- Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, and Department of Cardiovascular Surgery, Texas Heart Institute, Houston TX
| | - Scott A. LeMaire
- Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, and Department of Cardiovascular Surgery, Texas Heart Institute, Houston TX
| | - Arthur P. Arnold
- Integrative Biology and Physiology, University of California, Los Angeles CA
| | - Lisa A. Cassis
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington KY
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12
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Tedjawirja VN, Nieuwdorp M, Yeung KK, Balm R, de Waard V. A Novel Hypothesis: A Role for Follicle Stimulating Hormone in Abdominal Aortic Aneurysm Development in Postmenopausal Women. Front Endocrinol (Lausanne) 2021; 12:726107. [PMID: 34721292 PMCID: PMC8548664 DOI: 10.3389/fendo.2021.726107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 09/02/2021] [Indexed: 12/24/2022] Open
Abstract
An abdominal aortic aneurysm (AAA) is a dilatation of the abdominal aorta, which can potentially be fatal due to exsanguination following rupture. Although AAA is less prevalent in women, women with AAA have a more severe AAA progression compared to men as reflected by enhanced aneurysm growth rates and a higher rupture risk. Women are diagnosed with AAA at an older age than men, and in line with increased osteoporosis and cardiovascular events, the delayed AAA onset has been attributed to the reduction of the protective effect of oestrogens during the menopausal transition. However, new insights have shown that a high follicle stimulating hormone (FSH) level during menopause may also play a key role in those diseases. In this report we hypothesize that FSH may aggravate AAA development and progression in postmenopausal women via a direct and/or indirect role, promoting aorta pathology. Since FSH receptors (FSHR) are reported on many other cell types than granulosa cells in the ovaries, it is feasible that FSH stimulation of FSHR-bearing cells such as aortic endothelial cells or inflammatory cells, could promote AAA formation directly. Indirectly, AAA progression may be influenced by an FSH-mediated increase in osteoporosis, which is associated with aortic calcification. Also, an FSH-mediated decrease in cholesterol uptake by the liver and an increase in cholesterol biosynthesis will increase the cholesterol level in the circulation, and subsequently promote aortic atherosclerosis and inflammation. Lastly, FSH-induced adipogenesis may lead to obesity-mediated dysfunction of the microvasculature of the aorta and/or modulation of the periaortic adipose tissue. Thus the long term increased plasma FSH levels during the menopausal transition may contribute to enhanced AAA disease in menopausal women and could be a potential novel target for treatment to lower AAA-related events in women.
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Affiliation(s)
- Victoria N. Tedjawirja
- Department of Surgery, Amsterdam University Medical Center (UMC), University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, Netherlands
- *Correspondence: Victoria N. Tedjawirja,
| | - Max Nieuwdorp
- Departments of Internal and Vascular Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Kak Khee Yeung
- Department of Surgery, Amsterdam University Medical Center (UMC), University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, Netherlands
| | - Ron Balm
- Department of Surgery, Amsterdam University Medical Center (UMC), University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, Netherlands
| | - Vivian de Waard
- Department of Medical Biochemistry, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, Netherlands
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13
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Jin T, Wang L, Li D, Yang T, Zhou Y. Testosterone aggravates cerebral vascular injury by reducing plasma HDL levels. Open Life Sci 2020; 15:1042-1048. [PMID: 33817290 PMCID: PMC7874553 DOI: 10.1515/biol-2020-0107] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 09/13/2020] [Accepted: 09/28/2020] [Indexed: 12/24/2022] Open
Abstract
Testosterone is often used to improve the physiological function. But increased testosterone levels affect blood lipids and cause inflammation and oxidative stress, which are risk factors for vascular diseases. This study aimed at investigating the effects of testosterone on cerebral vascular injury using an established intracranial aneurysm (IA) model. Sixteen-week-old female C57Bl/6 mice were subcutaneously infused with testosterone propionate (TP; 5 mg/kg day) or plain soybean oil (controls) for 6 weeks. After 2 weeks of treatment, mice were given angiotensin II-elastase for another 4 weeks. The results showed that TP significantly increased cell apoptosis and reactive oxygen species production in cerebral artery, together with increases in plasma tumor necrosis factor-α (TNF-α) levels and in urinary 8-isoprostane levels. Plasma assays showed that 2 weeks after TP or soybean oil administration, the high-density lipoprotein (HDL) level was higher in the TP group than in controls. In vitro studies showed that testosterone increased TNF-α and monocyte chemotactic protein-1 mRNA and protein expression levels in RAW 264.7 macrophages. In summary, by reducing the HDL level, TP aggravates cerebral artery injury by increasing cell apoptosis, inflammation, and oxidative stress.
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Affiliation(s)
- Tao Jin
- Department of Neurosurgery, Ankang Central Hospital, Ankang 725000, People's Republic of China
| | - Lu Wang
- Department of Neurosurgery, Ankang Central Hospital, Ankang 725000, People's Republic of China
| | - Dongbo Li
- Department of Neurosurgery, Ankang Central Hospital, Ankang 725000, People's Republic of China
| | - Tao Yang
- Department of Neurosurgery, Ankang Central Hospital, Ankang 725000, People's Republic of China
| | - Yuefei Zhou
- Department of Neurosurgery, Xijing Hospital, Fourth Military Medical Hospital, Xi'an 710032, Shanxi, People's Republic of China
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14
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Okuyama M, Jiang W, Javidan A, Chen JZ, Howatt DA, Yang L, Hamaguchi M, Yasugi T, Aono J, Vazquez-Padron RI, Subramanian V. Lysyl Oxidase Inhibition Ablates Sexual Dimorphism of Abdominal Aortic Aneurysm Formation in Mice. Circulation 2020; 142:1993-1995. [PMID: 33196308 DOI: 10.1161/circulationaha.119.044986] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Michihiro Okuyama
- Saha Cardiovascular Research Center (M.O., W.J., A.J., J.Z.C., D.A.H., L.Y., V.S.), University of Kentucky, Lexington
| | - Weihua Jiang
- Saha Cardiovascular Research Center (M.O., W.J., A.J., J.Z.C., D.A.H., L.Y., V.S.), University of Kentucky, Lexington
| | - Aida Javidan
- Saha Cardiovascular Research Center (M.O., W.J., A.J., J.Z.C., D.A.H., L.Y., V.S.), University of Kentucky, Lexington
| | - Jeff Zheying Chen
- Saha Cardiovascular Research Center (M.O., W.J., A.J., J.Z.C., D.A.H., L.Y., V.S.), University of Kentucky, Lexington.,Department of Physiology (J.Z.C., V.S.), University of Kentucky, Lexington
| | - Deborah A Howatt
- Saha Cardiovascular Research Center (M.O., W.J., A.J., J.Z.C., D.A.H., L.Y., V.S.), University of Kentucky, Lexington
| | - Lihua Yang
- Saha Cardiovascular Research Center (M.O., W.J., A.J., J.Z.C., D.A.H., L.Y., V.S.), University of Kentucky, Lexington
| | - Mika Hamaguchi
- Department of Cardiology, Pulmonology, Hypertension, and Nephrology (M.H., J.A.), Ehime University Graduate School of Medicine, Toon, Japan
| | - Takumi Yasugi
- Department of Cardiovascular and Thoracic Surgery (T.Y.), Ehime University Graduate School of Medicine, Toon, Japan
| | - Jun Aono
- Department of Cardiology, Pulmonology, Hypertension, and Nephrology (M.H., J.A.), Ehime University Graduate School of Medicine, Toon, Japan
| | | | - Venkateswaran Subramanian
- Saha Cardiovascular Research Center (M.O., W.J., A.J., J.Z.C., D.A.H., L.Y., V.S.), University of Kentucky, Lexington.,Department of Physiology (J.Z.C., V.S.), University of Kentucky, Lexington
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15
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Qi X, Wang F, Chun C, Saldarriaga L, Jiang Z, Pruitt EY, Arnaoutakis GJ, Upchurch GR, Jiang Z. A validated mouse model capable of recapitulating the protective effects of female sex hormones on ascending aortic aneurysms and dissections (AADs). Physiol Rep 2020; 8:e14631. [PMID: 33242364 PMCID: PMC7690909 DOI: 10.14814/phy2.14631] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 09/28/2020] [Accepted: 10/07/2020] [Indexed: 12/19/2022] Open
Abstract
Fewer females develop AADs (ascending aortic aneurysms and dissections) and the reasons for this protection remain poorly understood. The present study seeks to develop a mouse model that may be utilized to address this sexual dimorphism. Adult normolipidemic mice were challenged with BAPN (β-aminopropionitrile), AngII (angiotensin II), or BAPN + AngII. An initial protocol optimization found that 0.2% BAPN in drinking water plus AngII-infusion at 1,000 ng kg-1 min-1 produced favorable rates of AAD rupture (~50%) and dilation (~40%) in 28 days. Using these dosages, further experiments revealed that BAPN is toxic to naïve mature aortas and it acted synergistically with AngII to promote aortic tears and dissections. BAPN + AngII provoked early infiltration of myeloid cells and subsequent recruitment of lymphoid cells to the aortic wall. AADs established with BAPN + AngII, but not AngII alone, continued to expand after the cessation of AngII-infusion. This indefinite growth precipitated a 61% increase in the AAD diameter in 56 days. More importantly, with the optimized protocol, significant differences in AAD dilation (p = .012) and medial degeneration (p = .036) were detected between male and female mice. Treatment of ovariectomized mice with estradiol protected AAD formation (p = .014). In summary, this study developed a powerful mouse AAD model that can be used to study the sexual dimorphism in AAD formation.
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Affiliation(s)
- Xiaoyan Qi
- Division of Vascular Surgery and Endovascular TherapyUniversity of Florida College of MedicineGainesvilleFLUSA
- Institute of Cardiovascular DiseaseUniversity of South ChinaHengyangChina
| | - Fen Wang
- Division of Vascular Surgery and Endovascular TherapyUniversity of Florida College of MedicineGainesvilleFLUSA
| | - Changzoon Chun
- Division of Vascular Surgery and Endovascular TherapyUniversity of Florida College of MedicineGainesvilleFLUSA
| | - Lennon Saldarriaga
- Division of Vascular Surgery and Endovascular TherapyUniversity of Florida College of MedicineGainesvilleFLUSA
| | - Zhisheng Jiang
- Institute of Cardiovascular DiseaseUniversity of South ChinaHengyangChina
| | - Eric Y. Pruitt
- Division of Vascular Surgery and Endovascular TherapyUniversity of Florida College of MedicineGainesvilleFLUSA
| | - George J. Arnaoutakis
- Division of Vascular Surgery and Endovascular TherapyUniversity of Florida College of MedicineGainesvilleFLUSA
- Division of Thoracic and Cardiovascular SurgeryUniversity of Florida College of MedicineGainesvilleFLUSA
| | - Gilbert R. Upchurch
- Division of Vascular Surgery and Endovascular TherapyUniversity of Florida College of MedicineGainesvilleFLUSA
| | - Zhihua Jiang
- Division of Vascular Surgery and Endovascular TherapyUniversity of Florida College of MedicineGainesvilleFLUSA
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16
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Affiliation(s)
- Nicole K Anderson
- McKusick-Nathans Department of Genetic Medicine and Howard Hughes Medical Institute Johns Hopkins University School of Medicine Baltimore MD
| | - Emily E Juzwiak
- McKusick-Nathans Department of Genetic Medicine and Howard Hughes Medical Institute Johns Hopkins University School of Medicine Baltimore MD
| | - Harry C Dietz
- McKusick-Nathans Department of Genetic Medicine and Howard Hughes Medical Institute Johns Hopkins University School of Medicine Baltimore MD
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17
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Shen YH, LeMaire SA, Webb NR, Cassis LA, Daugherty A, Lu HS. Aortic Aneurysms and Dissections Series: Part II: Dynamic Signaling Responses in Aortic Aneurysms and Dissections. Arterioscler Thromb Vasc Biol 2020; 40:e78-e86. [PMID: 32208998 DOI: 10.1161/atvbaha.120.313804] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Aortic structure and function are controlled by the coordinated actions of different aortic cells and the extracellular matrix. Several pathways have been identified that control the aortic wall in a cell-type-specific manner and play diverse roles in various phases of aortic injury, repair, and remodeling. This complexity of signaling in the aortic wall poses challenges to the development of therapeutic strategies for treating aortic aneurysms and dissections. Here, in part II of this Recent Highlights series on aortic aneurysms and dissections, we will summarize recent studies published in Arteriosclerosis, Thrombosis, and Vascular Biology that have contributed to our knowledge of the signaling pathway-related mechanisms of aortic aneurysms and dissections.
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Affiliation(s)
- Ying H Shen
- From the Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX (Y.H.S., S.A.L.).,Department of Cardiovascular Surgery, Texas Heart Institute, Houston (Y.H.S., S.A.L.)
| | - Scott A LeMaire
- From the Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX (Y.H.S., S.A.L.).,Department of Cardiovascular Surgery, Texas Heart Institute, Houston (Y.H.S., S.A.L.)
| | - Nancy R Webb
- Department of Pharmacology and Nutritional Sciences (N.R.W., L.A.C.), University of Kentucky, Lexington
| | - Lisa A Cassis
- Department of Pharmacology and Nutritional Sciences (N.R.W., L.A.C.), University of Kentucky, Lexington
| | - Alan Daugherty
- Department of Physiology and Saha Cardiovascular Research Center (A.D., H.S.L.), University of Kentucky, Lexington
| | - Hong S Lu
- Department of Physiology and Saha Cardiovascular Research Center (A.D., H.S.L.), University of Kentucky, Lexington
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18
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White MC, Fleeman R, Arnold AC. Sex differences in the metabolic effects of the renin-angiotensin system. Biol Sex Differ 2019; 10:31. [PMID: 31262355 PMCID: PMC6604144 DOI: 10.1186/s13293-019-0247-5] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 06/18/2019] [Indexed: 02/07/2023] Open
Abstract
Obesity is a global epidemic that greatly increases risk for developing cardiovascular disease and type II diabetes. Sex differences in the obese phenotype are well established in experimental animal models and clinical populations. While having higher adiposity and obesity prevalence, females are generally protected from obesity-related metabolic and cardiovascular complications. This protection is, at least in part, attributed to sex differences in metabolic effects of hormonal mediators such as the renin-angiotensin system (RAS). Previous literature has predominantly focused on the vasoconstrictor arm of the RAS and shown that, in contrast to male rodent models of obesity and diabetes, females are protected from metabolic and cardiovascular derangements produced by angiotensinogen, renin, and angiotensin II. A vasodilator arm of the RAS has more recently emerged which includes angiotensin-(1-7), angiotensin-converting enzyme 2 (ACE2), mas receptors, and alamandine. While accumulating evidence suggests that activation of components of this counter-regulatory axis produces positive effects on glucose homeostasis, lipid metabolism, and energy balance in male animal models, female comparison studies and clinical data related to metabolic outcomes are lacking. This review will summarize current knowledge of sex differences in metabolic effects of the RAS, focusing on interactions with gonadal hormones and potential clinical implications.
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Affiliation(s)
- Melissa C White
- Department of Comparative Medicine, Pennsylvania State University College of Medicine, 500 University Drive, Hershey, PA, USA
| | - Rebecca Fleeman
- Department of Neural and Behavioral Sciences, Pennsylvania State University College of Medicine, 500 University Drive, Mail Code H109, Hershey, PA, 17033, USA
| | - Amy C Arnold
- Department of Neural and Behavioral Sciences, Pennsylvania State University College of Medicine, 500 University Drive, Mail Code H109, Hershey, PA, 17033, USA.
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19
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Ren X, Li F, Wang C, Hou Z, Gao Y, Yin W, Lu B. Age- and Sex-Related Aortic Valve Dysfunction and Aortopathy Difference in Patients with Bicuspid Aortic Valve. Int Heart J 2019; 60:637-642. [PMID: 31105146 DOI: 10.1536/ihj.18-363] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Bicuspid aortic valve (BAV) is the most common congenital heart disease. Different distribution of valve dysfunction was found in patients with BAV in different age and sex groups, but related difference was not well established. The aim of our study is to investigate age- and sex-related clinical characteristics differences in patients with BAV.Six hundred twenty patients with BAV who had moderate or severe aortic valve dysfunction were included in the study. Basic clinical data and image data were recorded. Patients were classified into four different age groups: (A: ≤ 50 years old; B: 50-60 years old; C: 60-70 years old; D: > 70 years old). The sex-related clinical difference in different age groups was compared. Association between incidence of aortic valve dysfunction and age was evaluated.Male patients had more frequent aortic regurgitation (AR) in patients younger than 70 years old (A: 52.3% versus 20.0%, P = 0.012; B: 43.2% versus 17.8%, P < 0.001; C: 17.0 versus 2.6%, P = 0.002), whereas female patients were more likely to have aortic stenosis (AS) (A: 75.0% versus 34.1%, P = 0.001; B: 77.8% versus 37.0%, P < 0.001; C: 93.6% versus 69.8%, P < 0.001). Frequency of AR in male patients decreased with age, whereas frequency of AS increased. Trend test showed a significant difference in incidence of aortic valve dysfunction as age increased in male patients (AR, P < 0.001; AS, P < 0.001). No trend was found in female patients.Male patients with BAV present more often with moderate/severe AR at a young age, and the frequency of AR decreases with age. Female patients with BAV had more frequent AS at first presentation regardless of age.
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Affiliation(s)
- Xinshuang Ren
- Department of Radiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College
| | - Fei Li
- Department of Surgery, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College
| | - Chuangshi Wang
- Medical Research and Biometrics Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College
| | - Zhihui Hou
- Department of Radiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College
| | - Yang Gao
- Department of Radiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College
| | - Weihua Yin
- Department of Radiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College
| | - Bin Lu
- Department of Radiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College
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20
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Boese AC, Chang L, Yin KJ, Chen YE, Lee JP, Hamblin MH. Sex differences in abdominal aortic aneurysms. Am J Physiol Heart Circ Physiol 2018; 314:H1137-H1152. [PMID: 29350999 DOI: 10.1152/ajpheart.00519.2017] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Abdominal aortic aneurysm (AAA) is a vascular disorder with a high case fatality rate in the instance of rupture. AAA is a multifactorial disease, and the etiology is still not fully understood. AAA is more likely to occur in men, but women have a greater risk of rupture and worse prognosis. Women are reportedly protected against AAA possibly by premenopausal levels of estrogen and are, on average, diagnosed at older ages than men. Here, we review the present body of research on AAA pathophysiology in humans, animal models, and cultured cells, with an emphasis on sex differences and sex steroid hormone signaling.
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Affiliation(s)
- Austin C Boese
- Department of Pharmacology, Tulane University School of Medicine , New Orleans, Louisiana
| | - Lin Chang
- Center for Advanced Models for Translational Sciences and Therapeutics, Department of Internal Medicine, University of Michigan , Ann Arbor, Michigan
| | - Ke-Jie Yin
- Department of Neurology, University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania
| | - Y Eugene Chen
- Center for Advanced Models for Translational Sciences and Therapeutics, Department of Internal Medicine, University of Michigan , Ann Arbor, Michigan
| | - Jean-Pyo Lee
- Department of Physiology, Tulane University School of Medicine , New Orleans, Louisiana.,Center for Stem Cell Research and Regenerative Medicine , New Orleans, Louisiana
| | - Milton H Hamblin
- Department of Pharmacology, Tulane University School of Medicine , New Orleans, Louisiana
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21
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Mathieu S, El Khoury N, Rivard K, Paradis P, Nemer M, Fiset C. Angiotensin II Overstimulation Leads to an Increased Susceptibility to Dilated Cardiomyopathy and Higher Mortality in Female Mice. Sci Rep 2018; 8:952. [PMID: 29343862 PMCID: PMC5772611 DOI: 10.1038/s41598-018-19436-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 11/15/2017] [Indexed: 11/09/2022] Open
Abstract
Heart failure (HF) is associated with high mortality and affects men and women differently. The underlying mechanisms for these sex-related differences remain largely unexplored. Accordingly, using mice with cardiac-specific overexpression of the angiotensin II (ANGII) type 1 receptor (AT1R), we explored male-female differences in the manifestations of hypertrophy and HF. AT1R mice of both sexes feature electrical and Ca2+ handling alterations, systolic dysfunction, hypertrophy and develop HF. However, females had much higher mortality (21.0%) rate than males (5.5%). In females, AT1R stimulation leads to more pronounced eccentric hypertrophy (larger increase in LV mass/body weight ratio [+31%], in cell length [+27%], in LV internal end-diastolic [LVIDd, +34%] and systolic [LVIDs, +67%] diameter) and dilation (larger decrease in LV posterior wall thickness, +17%) than males. In addition, in female AT1R mice the cytosolic Ca2+ extrusion mechanisms were more severely compromised and were associated with a specific increased in Ca2+ sparks (by 187%) and evidence of SR Ca2+ leak. Altogether, these results suggest that female AT1R mice have more severe eccentric hypertrophy, dysfunction and compromised Ca2+ dynamics. These findings indicate that females are more susceptible to the adverse effects of AT1R stimulation than males favouring the development of HF and increased mortality.
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Affiliation(s)
- Sophie Mathieu
- Research Center, Montreal Heart Institute, 5000 Bélanger, Montréal, Québec, Canada.,Faculty of Pharmacy, Université de Montréal, Montréal, Québec, Canada
| | - Nabil El Khoury
- Research Center, Montreal Heart Institute, 5000 Bélanger, Montréal, Québec, Canada.,Department of Pharmacology and Physiology, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
| | - Katy Rivard
- Research Center, Montreal Heart Institute, 5000 Bélanger, Montréal, Québec, Canada.,Faculty of Pharmacy, Université de Montréal, Montréal, Québec, Canada
| | - Pierre Paradis
- Lady Davis Institute, McGill University, Montreal, Québec, Canada
| | - Mona Nemer
- Ottawa University, Ottawa, Ontario, Canada
| | - Céline Fiset
- Research Center, Montreal Heart Institute, 5000 Bélanger, Montréal, Québec, Canada. .,Faculty of Pharmacy, Université de Montréal, Montréal, Québec, Canada.
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22
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Robinet P, Milewicz DM, Cassis LA, Leeper NJ, Lu HS, Smith JD. Consideration of Sex Differences in Design and Reporting of Experimental Arterial Pathology Studies-Statement From ATVB Council. Arterioscler Thromb Vasc Biol 2018; 38:292-303. [PMID: 29301789 DOI: 10.1161/atvbaha.117.309524] [Citation(s) in RCA: 197] [Impact Index Per Article: 32.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 12/20/2017] [Indexed: 12/15/2022]
Abstract
There are many differences in arterial diseases between men and women, including prevalence, clinical manifestations, treatments, and prognosis. The new policy of the National Institutes of Health, which requires the inclusion of sex as a biological variable for preclinical studies, aims to foster new mechanistic insights and to enhance our understanding of sex differences in human diseases. The purpose of this statement is to suggest guidelines for designing and reporting sex as a biological variable in animal models of atherosclerosis, thoracic and abdominal aortic aneurysms, and peripheral arterial disease. We briefly review sex differences of these human diseases and their animal models, followed by suggestions on experimental design and reporting of animal studies for these vascular pathologies.
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Affiliation(s)
- Peggy Robinet
- From the Department of Cellular and Molecular Medicine, Cleveland Clinic, OH (P.R., J.D.S.); Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School, University of Texas Health Science Center at Houston (D.M.M.); Department of Pharmacology and Nutritional Sciences (L.A.C.) and Saha Cardiovascular Research Center and Department of Physiology (H.S.L.), University of Kentucky, Lexington; and Division of Vascular Surgery, Department of Surgery, Stanford University, CA (N.J.L.)
| | - Dianna M Milewicz
- From the Department of Cellular and Molecular Medicine, Cleveland Clinic, OH (P.R., J.D.S.); Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School, University of Texas Health Science Center at Houston (D.M.M.); Department of Pharmacology and Nutritional Sciences (L.A.C.) and Saha Cardiovascular Research Center and Department of Physiology (H.S.L.), University of Kentucky, Lexington; and Division of Vascular Surgery, Department of Surgery, Stanford University, CA (N.J.L.)
| | - Lisa A Cassis
- From the Department of Cellular and Molecular Medicine, Cleveland Clinic, OH (P.R., J.D.S.); Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School, University of Texas Health Science Center at Houston (D.M.M.); Department of Pharmacology and Nutritional Sciences (L.A.C.) and Saha Cardiovascular Research Center and Department of Physiology (H.S.L.), University of Kentucky, Lexington; and Division of Vascular Surgery, Department of Surgery, Stanford University, CA (N.J.L.)
| | - Nicholas J Leeper
- From the Department of Cellular and Molecular Medicine, Cleveland Clinic, OH (P.R., J.D.S.); Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School, University of Texas Health Science Center at Houston (D.M.M.); Department of Pharmacology and Nutritional Sciences (L.A.C.) and Saha Cardiovascular Research Center and Department of Physiology (H.S.L.), University of Kentucky, Lexington; and Division of Vascular Surgery, Department of Surgery, Stanford University, CA (N.J.L.)
| | - Hong S Lu
- From the Department of Cellular and Molecular Medicine, Cleveland Clinic, OH (P.R., J.D.S.); Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School, University of Texas Health Science Center at Houston (D.M.M.); Department of Pharmacology and Nutritional Sciences (L.A.C.) and Saha Cardiovascular Research Center and Department of Physiology (H.S.L.), University of Kentucky, Lexington; and Division of Vascular Surgery, Department of Surgery, Stanford University, CA (N.J.L.)
| | - Jonathan D Smith
- From the Department of Cellular and Molecular Medicine, Cleveland Clinic, OH (P.R., J.D.S.); Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School, University of Texas Health Science Center at Houston (D.M.M.); Department of Pharmacology and Nutritional Sciences (L.A.C.) and Saha Cardiovascular Research Center and Department of Physiology (H.S.L.), University of Kentucky, Lexington; and Division of Vascular Surgery, Department of Surgery, Stanford University, CA (N.J.L.).
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23
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Alsiraj Y, Thatcher SE, Blalock E, Fleenor B, Daugherty A, Cassis LA. Sex Chromosome Complement Defines Diffuse Versus Focal Angiotensin II-Induced Aortic Pathology. Arterioscler Thromb Vasc Biol 2017; 38:143-153. [PMID: 29097367 DOI: 10.1161/atvbaha.117.310035] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Accepted: 10/19/2017] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Aortic pathologies exhibit sexual dimorphism, with aneurysms in both the thoracic and abdominal aorta (ie, abdominal aortic aneurysm [AAA]) exhibiting higher male prevalence. Women have lower prevalence of aneurysms, but when they occur, aneurysms progress rapidly. To define mechanisms for these sex differences, we determined the role of sex chromosome complement and testosterone on the location and progression of angiotensin II (AngII)-induced aortic pathologies. APPROACH AND RESULTS We used transgenic male mice expressing Sry (sex-determining region Y) on an autosome to create Ldlr (low-density lipoprotein receptor)-deficient male mice with an XY or XX sex chromosome complement. Transcriptional profiling was performed on abdominal aortas from XY or XX males, demonstrating 1746 genes influenced by sex chromosomes or sex hormones. Males (XY or XX) were either sham-operated or orchiectomized before AngII infusions. Diffuse aortic aneurysm pathology developed in XY AngII-infused males, whereas XX males developed focal AAAs. Castration reduced all AngII-induced aortic pathologies in XY and XX males. Thoracic aortas from AngII-infused XY males exhibited adventitial thickening that was not present in XX males. We infused male XY and XX mice with either saline or AngII and quantified mRNA abundance of key genes in both thoracic and abdominal aortas. Regional differences in mRNA abundance existed before AngII infusions, which were differentially influenced by AngII between genotypes. Prolonged AngII infusions resulted in aortic wall thickening of AAAs from XY males, whereas XX males had dilated focal AAAs. CONCLUSIONS An XY sex chromosome complement mediates diffuse aortic pathology, whereas an XX sex chromosome complement contributes to focal AngII-induced AAAs.
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Affiliation(s)
- Yasir Alsiraj
- From the Department of Pharmacology and Nutritional Sciences (Y.A., S.E.T., E.B., L.A.C.), Department of Kinesiology (B.F.), Department of Physiology (A.D.), and Saha Cardiovascular Research Center (A.D.), University of Kentucky, Lexington
| | - Sean E Thatcher
- From the Department of Pharmacology and Nutritional Sciences (Y.A., S.E.T., E.B., L.A.C.), Department of Kinesiology (B.F.), Department of Physiology (A.D.), and Saha Cardiovascular Research Center (A.D.), University of Kentucky, Lexington
| | - Eric Blalock
- From the Department of Pharmacology and Nutritional Sciences (Y.A., S.E.T., E.B., L.A.C.), Department of Kinesiology (B.F.), Department of Physiology (A.D.), and Saha Cardiovascular Research Center (A.D.), University of Kentucky, Lexington
| | - Bradley Fleenor
- From the Department of Pharmacology and Nutritional Sciences (Y.A., S.E.T., E.B., L.A.C.), Department of Kinesiology (B.F.), Department of Physiology (A.D.), and Saha Cardiovascular Research Center (A.D.), University of Kentucky, Lexington
| | - Alan Daugherty
- From the Department of Pharmacology and Nutritional Sciences (Y.A., S.E.T., E.B., L.A.C.), Department of Kinesiology (B.F.), Department of Physiology (A.D.), and Saha Cardiovascular Research Center (A.D.), University of Kentucky, Lexington
| | - Lisa A Cassis
- From the Department of Pharmacology and Nutritional Sciences (Y.A., S.E.T., E.B., L.A.C.), Department of Kinesiology (B.F.), Department of Physiology (A.D.), and Saha Cardiovascular Research Center (A.D.), University of Kentucky, Lexington.
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24
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Renard M, Muiño-Mosquera L, Manalo EC, Tufa S, Carlson EJ, Keene DR, De Backer J, Sakai LY. Sex, pregnancy and aortic disease in Marfan syndrome. PLoS One 2017; 12:e0181166. [PMID: 28708846 PMCID: PMC5510874 DOI: 10.1371/journal.pone.0181166] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 06/26/2017] [Indexed: 01/13/2023] Open
Abstract
Background Sex-related differences as well as the adverse effect of pregnancy on aortic disease outcome are well-established phenomena in humans with Marfan syndrome (MFS). The underlying mechanisms of these observations are largely unknown. Objectives In an initial (pilot) step we aimed to confirm the differences between male and female MFS patients as well as between females with and without previous pregnancy. We then sought to evaluate whether these findings are recapitulated in a pre-clinical model and performed in-depth cardiovascular phenotyping of mutant male and both nulliparous and multiparous female Marfan mice. The effect of 17β-estradiol on fibrillin-1 protein synthesis was compared in vitro using human aortic smooth muscle cells and fibroblasts. Results Our small retrospective study of aortic dimensions in a cohort of 10 men and 20 women with MFS (10 pregnant and 10 non-pregnant) confirmed that aortic root growth was significantly increased in the pregnant group compared to the non-pregnant group (0.64mm/year vs. 0.12mm/year, p = 0.018). Male MFS patients had significantly larger aortic root diameters compared to the non-pregnant and pregnant females at baseline and follow-up (p = 0.002 and p = 0.007, respectively), but no significant increase in aortic root growth was observed compared to the females after follow-up (p = 0.559 and p = 0.352). In the GT-8/+ MFS mouse model, multiparous female Marfan mice showed increased aortic diameters when compared to nulliparous females. Aortic dilatation in multiparous females was comparable to Marfan male mice. Moreover, increased aortic diameters were associated with more severe fragmentation of the elastic lamellae. In addition, 17β-estradiol was found to promote fibrillin-1 production by human aortic smooth muscle cells. Conclusions Pregnancy-related changes influence aortic disease severity in otherwise protected female MFS mice and patients. There may be a role for estrogen in the female sex protective effect.
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Affiliation(s)
- Marjolijn Renard
- Center for Medical Genetics Ghent, Ghent University, Ghent, Belgium
- * E-mail:
| | | | - Elise C. Manalo
- Department of Molecular & Medical Genetics and Biochemistry & Molecular Biology, Shriners Hospital for Children, Portland, Oregon, United States of America
| | - Sara Tufa
- Micro-Imaging Center, Shriners Hospital for Children, Portland, Oregon, United States of America
| | - Eric J. Carlson
- Department of Molecular & Medical Genetics and Biochemistry & Molecular Biology, Shriners Hospital for Children, Portland, Oregon, United States of America
| | - Douglas R. Keene
- Micro-Imaging Center, Shriners Hospital for Children, Portland, Oregon, United States of America
| | - Julie De Backer
- Center for Medical Genetics Ghent, Ghent University, Ghent, Belgium
| | - Lynn Y. Sakai
- Department of Molecular & Medical Genetics and Biochemistry & Molecular Biology, Shriners Hospital for Children, Portland, Oregon, United States of America
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25
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Boese AC, Kim SC, Yin KJ, Lee JP, Hamblin MH. Sex differences in vascular physiology and pathophysiology: estrogen and androgen signaling in health and disease. Am J Physiol Heart Circ Physiol 2017. [PMID: 28626075 DOI: 10.1152/ajpheart.00217.2016] [Citation(s) in RCA: 129] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Sex differences between women and men are often overlooked and underappreciated when studying the cardiovascular system. It has been long assumed that men and women are physiologically similar, and this notion has resulted in women being clinically evaluated and treated for cardiovascular pathophysiological complications as men. Currently, there is increased recognition of fundamental sex differences in cardiovascular function, anatomy, cell signaling, and pathophysiology. The National Institutes of Health have enacted guidelines expressly to gain knowledge about ways the sexes differ in both normal function and diseases at the various research levels (molecular, cellular, tissue, and organ system). Greater understanding of these sex differences will be used to steer future directions in the biomedical sciences and translational and clinical research. This review describes sex-based differences in the physiology and pathophysiology of the vasculature, with a special emphasis on sex steroid receptor (estrogen and androgen receptor) signaling and their potential impact on vascular function in health and diseases (e.g., atherosclerosis, hypertension, peripheral artery disease, abdominal aortic aneurysms, cerebral aneurysms, and stroke).
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Affiliation(s)
- Austin C Boese
- Department of Pharmacology, Tulane University School of Medicine, New Orleans, Louisiana
| | - Seong C Kim
- Department of Pharmacology, Tulane University School of Medicine, New Orleans, Louisiana
| | - Ke-Jie Yin
- Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Jean-Pyo Lee
- Department of Neurology, Tulane University School of Medicine, New Orleans, Louisiana; and.,Center for Stem Cell Research and Regenerative Medicine, New Orleans, Louisiana
| | - Milton H Hamblin
- Department of Pharmacology, Tulane University School of Medicine, New Orleans, Louisiana;
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26
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Kong WKF, Regeer MV, Ng ACT, McCormack L, Poh KK, Yeo TC, Shanks M, Parent S, Enache R, Popescu BA, Yip JW, Ma L, Kamperidis V, van der Velde ET, Mertens B, Ajmone Marsan N, Delgado V, Bax JJ. Sex Differences in Phenotypes of Bicuspid Aortic Valve and Aortopathy: Insights From a Large Multicenter, International Registry. Circ Cardiovasc Imaging 2017; 10:CIRCIMAGING.116.005155. [PMID: 28251911 DOI: 10.1161/circimaging.116.005155] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 12/29/2016] [Indexed: 02/06/2023]
Abstract
BACKGROUND This large multicenter, international bicuspid aortic valve (BAV) registry aimed to define the sex differences in prevalence, valve morphology, dysfunction (aortic stenosis/regurgitation), aortopathy, and complications (endocarditis and aortic dissection). METHODS AND RESULTS Demographic, clinical, and echocardiographic data at first presentation of 1992 patients with BAV (71.5% men) were retrospectively analyzed. BAV morphology and valve function were assessed; aortopathy configuration was defined as isolated dilatation of the sinus of Valsalva or sinotubular junction, isolated dilatation of the ascending aorta distal to the sinotubular junction, or diffuse dilatation of the aortic root and ascending aorta. New cases of endocarditis and aortic dissection were recorded. There were no significant sex differences regarding BAV morphology and frequency of normal valve function. When presenting with moderate/severe aortic valve dysfunction, men had more frequent aortic regurgitation than women (33.8% versus 22.2%, P<0.001), whereas women were more likely to have aortic stenosis (34.5% versus 44.1%, P<0.001). Men had more frequently isolated dilatation of the sinus of Valsalva or sinotubular junction (14.2% versus 6.7%, P<0.001) and diffuse dilatation of the aortic root and ascending aorta (16.2% versus 7.3%, P<0.001) than women. Endocarditis (4.5% versus 2.5%, P=0.037) and aortic dissections (0.5% versus 0%, P<0.001) occurred more frequently in men. CONCLUSIONS Although there is a male predominance among patients with BAV, men with BAV had more frequently moderate/severe aortic regurgitation at first presentation compared with women, whereas women presented more often with moderate/severe aortic stenosis compared with men. Furthermore, men had more frequent aortopathy than women.
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Affiliation(s)
- William K F Kong
- From the Department of Cardiology (W.K.F.K., M.V.R., V.K., E.T.v.d.V., N.A.M., V.D., J.J.B.) and Medical Statistics Department (B.M.), Leiden University Medical Center, The Netherlands; Department of Cardiology, National University Heart Centre, National University Health System, Singapore (W.K.F.K., K.K.P., T.C.Y., J.W.Y.); Department of Cardiology, Princess Alexandra Hospital, The University of Queensland, St Lucia, Australia (A.C.T.N., L.M.C., L.M.); Division of Cardiology, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (M.S., S.P.); University of Medicine and Pharmacy "Carol Davila", Department of Cardiology-Euroecolab, Institute of Cardiovascular Diseases "Prof. Dr. C. C. Iliescu", Bucharest, Romania (R.E., B.A.P.); and Department of Cardiology, AHEPA University Hospital, Thessaloniki, Greece (V.K.)
| | - Madelien V Regeer
- From the Department of Cardiology (W.K.F.K., M.V.R., V.K., E.T.v.d.V., N.A.M., V.D., J.J.B.) and Medical Statistics Department (B.M.), Leiden University Medical Center, The Netherlands; Department of Cardiology, National University Heart Centre, National University Health System, Singapore (W.K.F.K., K.K.P., T.C.Y., J.W.Y.); Department of Cardiology, Princess Alexandra Hospital, The University of Queensland, St Lucia, Australia (A.C.T.N., L.M.C., L.M.); Division of Cardiology, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (M.S., S.P.); University of Medicine and Pharmacy "Carol Davila", Department of Cardiology-Euroecolab, Institute of Cardiovascular Diseases "Prof. Dr. C. C. Iliescu", Bucharest, Romania (R.E., B.A.P.); and Department of Cardiology, AHEPA University Hospital, Thessaloniki, Greece (V.K.)
| | - Arnold C T Ng
- From the Department of Cardiology (W.K.F.K., M.V.R., V.K., E.T.v.d.V., N.A.M., V.D., J.J.B.) and Medical Statistics Department (B.M.), Leiden University Medical Center, The Netherlands; Department of Cardiology, National University Heart Centre, National University Health System, Singapore (W.K.F.K., K.K.P., T.C.Y., J.W.Y.); Department of Cardiology, Princess Alexandra Hospital, The University of Queensland, St Lucia, Australia (A.C.T.N., L.M.C., L.M.); Division of Cardiology, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (M.S., S.P.); University of Medicine and Pharmacy "Carol Davila", Department of Cardiology-Euroecolab, Institute of Cardiovascular Diseases "Prof. Dr. C. C. Iliescu", Bucharest, Romania (R.E., B.A.P.); and Department of Cardiology, AHEPA University Hospital, Thessaloniki, Greece (V.K.)
| | - Louise McCormack
- From the Department of Cardiology (W.K.F.K., M.V.R., V.K., E.T.v.d.V., N.A.M., V.D., J.J.B.) and Medical Statistics Department (B.M.), Leiden University Medical Center, The Netherlands; Department of Cardiology, National University Heart Centre, National University Health System, Singapore (W.K.F.K., K.K.P., T.C.Y., J.W.Y.); Department of Cardiology, Princess Alexandra Hospital, The University of Queensland, St Lucia, Australia (A.C.T.N., L.M.C., L.M.); Division of Cardiology, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (M.S., S.P.); University of Medicine and Pharmacy "Carol Davila", Department of Cardiology-Euroecolab, Institute of Cardiovascular Diseases "Prof. Dr. C. C. Iliescu", Bucharest, Romania (R.E., B.A.P.); and Department of Cardiology, AHEPA University Hospital, Thessaloniki, Greece (V.K.)
| | - Kian Keong Poh
- From the Department of Cardiology (W.K.F.K., M.V.R., V.K., E.T.v.d.V., N.A.M., V.D., J.J.B.) and Medical Statistics Department (B.M.), Leiden University Medical Center, The Netherlands; Department of Cardiology, National University Heart Centre, National University Health System, Singapore (W.K.F.K., K.K.P., T.C.Y., J.W.Y.); Department of Cardiology, Princess Alexandra Hospital, The University of Queensland, St Lucia, Australia (A.C.T.N., L.M.C., L.M.); Division of Cardiology, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (M.S., S.P.); University of Medicine and Pharmacy "Carol Davila", Department of Cardiology-Euroecolab, Institute of Cardiovascular Diseases "Prof. Dr. C. C. Iliescu", Bucharest, Romania (R.E., B.A.P.); and Department of Cardiology, AHEPA University Hospital, Thessaloniki, Greece (V.K.)
| | - Tiong Cheng Yeo
- From the Department of Cardiology (W.K.F.K., M.V.R., V.K., E.T.v.d.V., N.A.M., V.D., J.J.B.) and Medical Statistics Department (B.M.), Leiden University Medical Center, The Netherlands; Department of Cardiology, National University Heart Centre, National University Health System, Singapore (W.K.F.K., K.K.P., T.C.Y., J.W.Y.); Department of Cardiology, Princess Alexandra Hospital, The University of Queensland, St Lucia, Australia (A.C.T.N., L.M.C., L.M.); Division of Cardiology, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (M.S., S.P.); University of Medicine and Pharmacy "Carol Davila", Department of Cardiology-Euroecolab, Institute of Cardiovascular Diseases "Prof. Dr. C. C. Iliescu", Bucharest, Romania (R.E., B.A.P.); and Department of Cardiology, AHEPA University Hospital, Thessaloniki, Greece (V.K.)
| | - Miriam Shanks
- From the Department of Cardiology (W.K.F.K., M.V.R., V.K., E.T.v.d.V., N.A.M., V.D., J.J.B.) and Medical Statistics Department (B.M.), Leiden University Medical Center, The Netherlands; Department of Cardiology, National University Heart Centre, National University Health System, Singapore (W.K.F.K., K.K.P., T.C.Y., J.W.Y.); Department of Cardiology, Princess Alexandra Hospital, The University of Queensland, St Lucia, Australia (A.C.T.N., L.M.C., L.M.); Division of Cardiology, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (M.S., S.P.); University of Medicine and Pharmacy "Carol Davila", Department of Cardiology-Euroecolab, Institute of Cardiovascular Diseases "Prof. Dr. C. C. Iliescu", Bucharest, Romania (R.E., B.A.P.); and Department of Cardiology, AHEPA University Hospital, Thessaloniki, Greece (V.K.)
| | - Sarah Parent
- From the Department of Cardiology (W.K.F.K., M.V.R., V.K., E.T.v.d.V., N.A.M., V.D., J.J.B.) and Medical Statistics Department (B.M.), Leiden University Medical Center, The Netherlands; Department of Cardiology, National University Heart Centre, National University Health System, Singapore (W.K.F.K., K.K.P., T.C.Y., J.W.Y.); Department of Cardiology, Princess Alexandra Hospital, The University of Queensland, St Lucia, Australia (A.C.T.N., L.M.C., L.M.); Division of Cardiology, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (M.S., S.P.); University of Medicine and Pharmacy "Carol Davila", Department of Cardiology-Euroecolab, Institute of Cardiovascular Diseases "Prof. Dr. C. C. Iliescu", Bucharest, Romania (R.E., B.A.P.); and Department of Cardiology, AHEPA University Hospital, Thessaloniki, Greece (V.K.)
| | - Roxana Enache
- From the Department of Cardiology (W.K.F.K., M.V.R., V.K., E.T.v.d.V., N.A.M., V.D., J.J.B.) and Medical Statistics Department (B.M.), Leiden University Medical Center, The Netherlands; Department of Cardiology, National University Heart Centre, National University Health System, Singapore (W.K.F.K., K.K.P., T.C.Y., J.W.Y.); Department of Cardiology, Princess Alexandra Hospital, The University of Queensland, St Lucia, Australia (A.C.T.N., L.M.C., L.M.); Division of Cardiology, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (M.S., S.P.); University of Medicine and Pharmacy "Carol Davila", Department of Cardiology-Euroecolab, Institute of Cardiovascular Diseases "Prof. Dr. C. C. Iliescu", Bucharest, Romania (R.E., B.A.P.); and Department of Cardiology, AHEPA University Hospital, Thessaloniki, Greece (V.K.)
| | - Bogdan A Popescu
- From the Department of Cardiology (W.K.F.K., M.V.R., V.K., E.T.v.d.V., N.A.M., V.D., J.J.B.) and Medical Statistics Department (B.M.), Leiden University Medical Center, The Netherlands; Department of Cardiology, National University Heart Centre, National University Health System, Singapore (W.K.F.K., K.K.P., T.C.Y., J.W.Y.); Department of Cardiology, Princess Alexandra Hospital, The University of Queensland, St Lucia, Australia (A.C.T.N., L.M.C., L.M.); Division of Cardiology, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (M.S., S.P.); University of Medicine and Pharmacy "Carol Davila", Department of Cardiology-Euroecolab, Institute of Cardiovascular Diseases "Prof. Dr. C. C. Iliescu", Bucharest, Romania (R.E., B.A.P.); and Department of Cardiology, AHEPA University Hospital, Thessaloniki, Greece (V.K.)
| | - James W Yip
- From the Department of Cardiology (W.K.F.K., M.V.R., V.K., E.T.v.d.V., N.A.M., V.D., J.J.B.) and Medical Statistics Department (B.M.), Leiden University Medical Center, The Netherlands; Department of Cardiology, National University Heart Centre, National University Health System, Singapore (W.K.F.K., K.K.P., T.C.Y., J.W.Y.); Department of Cardiology, Princess Alexandra Hospital, The University of Queensland, St Lucia, Australia (A.C.T.N., L.M.C., L.M.); Division of Cardiology, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (M.S., S.P.); University of Medicine and Pharmacy "Carol Davila", Department of Cardiology-Euroecolab, Institute of Cardiovascular Diseases "Prof. Dr. C. C. Iliescu", Bucharest, Romania (R.E., B.A.P.); and Department of Cardiology, AHEPA University Hospital, Thessaloniki, Greece (V.K.)
| | - Lawrence Ma
- From the Department of Cardiology (W.K.F.K., M.V.R., V.K., E.T.v.d.V., N.A.M., V.D., J.J.B.) and Medical Statistics Department (B.M.), Leiden University Medical Center, The Netherlands; Department of Cardiology, National University Heart Centre, National University Health System, Singapore (W.K.F.K., K.K.P., T.C.Y., J.W.Y.); Department of Cardiology, Princess Alexandra Hospital, The University of Queensland, St Lucia, Australia (A.C.T.N., L.M.C., L.M.); Division of Cardiology, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (M.S., S.P.); University of Medicine and Pharmacy "Carol Davila", Department of Cardiology-Euroecolab, Institute of Cardiovascular Diseases "Prof. Dr. C. C. Iliescu", Bucharest, Romania (R.E., B.A.P.); and Department of Cardiology, AHEPA University Hospital, Thessaloniki, Greece (V.K.)
| | - Vasileios Kamperidis
- From the Department of Cardiology (W.K.F.K., M.V.R., V.K., E.T.v.d.V., N.A.M., V.D., J.J.B.) and Medical Statistics Department (B.M.), Leiden University Medical Center, The Netherlands; Department of Cardiology, National University Heart Centre, National University Health System, Singapore (W.K.F.K., K.K.P., T.C.Y., J.W.Y.); Department of Cardiology, Princess Alexandra Hospital, The University of Queensland, St Lucia, Australia (A.C.T.N., L.M.C., L.M.); Division of Cardiology, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (M.S., S.P.); University of Medicine and Pharmacy "Carol Davila", Department of Cardiology-Euroecolab, Institute of Cardiovascular Diseases "Prof. Dr. C. C. Iliescu", Bucharest, Romania (R.E., B.A.P.); and Department of Cardiology, AHEPA University Hospital, Thessaloniki, Greece (V.K.)
| | - Enno T van der Velde
- From the Department of Cardiology (W.K.F.K., M.V.R., V.K., E.T.v.d.V., N.A.M., V.D., J.J.B.) and Medical Statistics Department (B.M.), Leiden University Medical Center, The Netherlands; Department of Cardiology, National University Heart Centre, National University Health System, Singapore (W.K.F.K., K.K.P., T.C.Y., J.W.Y.); Department of Cardiology, Princess Alexandra Hospital, The University of Queensland, St Lucia, Australia (A.C.T.N., L.M.C., L.M.); Division of Cardiology, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (M.S., S.P.); University of Medicine and Pharmacy "Carol Davila", Department of Cardiology-Euroecolab, Institute of Cardiovascular Diseases "Prof. Dr. C. C. Iliescu", Bucharest, Romania (R.E., B.A.P.); and Department of Cardiology, AHEPA University Hospital, Thessaloniki, Greece (V.K.)
| | - Bart Mertens
- From the Department of Cardiology (W.K.F.K., M.V.R., V.K., E.T.v.d.V., N.A.M., V.D., J.J.B.) and Medical Statistics Department (B.M.), Leiden University Medical Center, The Netherlands; Department of Cardiology, National University Heart Centre, National University Health System, Singapore (W.K.F.K., K.K.P., T.C.Y., J.W.Y.); Department of Cardiology, Princess Alexandra Hospital, The University of Queensland, St Lucia, Australia (A.C.T.N., L.M.C., L.M.); Division of Cardiology, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (M.S., S.P.); University of Medicine and Pharmacy "Carol Davila", Department of Cardiology-Euroecolab, Institute of Cardiovascular Diseases "Prof. Dr. C. C. Iliescu", Bucharest, Romania (R.E., B.A.P.); and Department of Cardiology, AHEPA University Hospital, Thessaloniki, Greece (V.K.)
| | - Nina Ajmone Marsan
- From the Department of Cardiology (W.K.F.K., M.V.R., V.K., E.T.v.d.V., N.A.M., V.D., J.J.B.) and Medical Statistics Department (B.M.), Leiden University Medical Center, The Netherlands; Department of Cardiology, National University Heart Centre, National University Health System, Singapore (W.K.F.K., K.K.P., T.C.Y., J.W.Y.); Department of Cardiology, Princess Alexandra Hospital, The University of Queensland, St Lucia, Australia (A.C.T.N., L.M.C., L.M.); Division of Cardiology, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (M.S., S.P.); University of Medicine and Pharmacy "Carol Davila", Department of Cardiology-Euroecolab, Institute of Cardiovascular Diseases "Prof. Dr. C. C. Iliescu", Bucharest, Romania (R.E., B.A.P.); and Department of Cardiology, AHEPA University Hospital, Thessaloniki, Greece (V.K.)
| | - Victoria Delgado
- From the Department of Cardiology (W.K.F.K., M.V.R., V.K., E.T.v.d.V., N.A.M., V.D., J.J.B.) and Medical Statistics Department (B.M.), Leiden University Medical Center, The Netherlands; Department of Cardiology, National University Heart Centre, National University Health System, Singapore (W.K.F.K., K.K.P., T.C.Y., J.W.Y.); Department of Cardiology, Princess Alexandra Hospital, The University of Queensland, St Lucia, Australia (A.C.T.N., L.M.C., L.M.); Division of Cardiology, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (M.S., S.P.); University of Medicine and Pharmacy "Carol Davila", Department of Cardiology-Euroecolab, Institute of Cardiovascular Diseases "Prof. Dr. C. C. Iliescu", Bucharest, Romania (R.E., B.A.P.); and Department of Cardiology, AHEPA University Hospital, Thessaloniki, Greece (V.K.)
| | - Jeroen J Bax
- From the Department of Cardiology (W.K.F.K., M.V.R., V.K., E.T.v.d.V., N.A.M., V.D., J.J.B.) and Medical Statistics Department (B.M.), Leiden University Medical Center, The Netherlands; Department of Cardiology, National University Heart Centre, National University Health System, Singapore (W.K.F.K., K.K.P., T.C.Y., J.W.Y.); Department of Cardiology, Princess Alexandra Hospital, The University of Queensland, St Lucia, Australia (A.C.T.N., L.M.C., L.M.); Division of Cardiology, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (M.S., S.P.); University of Medicine and Pharmacy "Carol Davila", Department of Cardiology-Euroecolab, Institute of Cardiovascular Diseases "Prof. Dr. C. C. Iliescu", Bucharest, Romania (R.E., B.A.P.); and Department of Cardiology, AHEPA University Hospital, Thessaloniki, Greece (V.K.).
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Arnold AP, Cassis LA, Eghbali M, Reue K, Sandberg K. Sex Hormones and Sex Chromosomes Cause Sex Differences in the Development of Cardiovascular Diseases. Arterioscler Thromb Vasc Biol 2017; 37:746-756. [PMID: 28279969 DOI: 10.1161/atvbaha.116.307301] [Citation(s) in RCA: 209] [Impact Index Per Article: 29.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Accepted: 02/15/2017] [Indexed: 12/25/2022]
Abstract
This review summarizes recent evidence concerning hormonal and sex chromosome effects in obesity, atherosclerosis, aneurysms, ischemia/reperfusion injury, and hypertension. Cardiovascular diseases occur and progress differently in the 2 sexes, because biological factors differing between the sexes have sex-specific protective and harmful effects. By comparing the 2 sexes directly, and breaking down sex into its component parts, one can discover sex-biasing protective mechanisms that might be targeted in the clinic. Gonadal hormones, especially estrogens and androgens, have long been found to account for some sex differences in cardiovascular diseases, and molecular mechanisms mediating these effects have recently been elucidated. More recently, the inherent sexual inequalities in effects of sex chromosome genes have also been implicated as contributors in animal models of cardiovascular diseases, especially a deleterious effect of the second X chromosome found in females but not in males. Hormonal and sex chromosome mechanisms interact in the sex-specific control of certain diseases, sometimes by opposing the action of the other.
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Affiliation(s)
- Arthur P Arnold
- From the Department of Integrative Biology and Physiology, University of California, Los Angeles (A.P.A.); Department of Pharmacology and Nutritional Sciences, University of Kentucky College of Medicine, Lexington (L.A.C.); Department of Anesthesiology (M.E.) and Department of Human Genetics (K.R.), David Geffen School of Medicine at UCLA, Los Angeles, CA; and Department of Medicine, Georgetown University Medical Center, Washington, DC (K.S.).
| | - Lisa A Cassis
- From the Department of Integrative Biology and Physiology, University of California, Los Angeles (A.P.A.); Department of Pharmacology and Nutritional Sciences, University of Kentucky College of Medicine, Lexington (L.A.C.); Department of Anesthesiology (M.E.) and Department of Human Genetics (K.R.), David Geffen School of Medicine at UCLA, Los Angeles, CA; and Department of Medicine, Georgetown University Medical Center, Washington, DC (K.S.)
| | - Mansoureh Eghbali
- From the Department of Integrative Biology and Physiology, University of California, Los Angeles (A.P.A.); Department of Pharmacology and Nutritional Sciences, University of Kentucky College of Medicine, Lexington (L.A.C.); Department of Anesthesiology (M.E.) and Department of Human Genetics (K.R.), David Geffen School of Medicine at UCLA, Los Angeles, CA; and Department of Medicine, Georgetown University Medical Center, Washington, DC (K.S.)
| | - Karen Reue
- From the Department of Integrative Biology and Physiology, University of California, Los Angeles (A.P.A.); Department of Pharmacology and Nutritional Sciences, University of Kentucky College of Medicine, Lexington (L.A.C.); Department of Anesthesiology (M.E.) and Department of Human Genetics (K.R.), David Geffen School of Medicine at UCLA, Los Angeles, CA; and Department of Medicine, Georgetown University Medical Center, Washington, DC (K.S.)
| | - Kathryn Sandberg
- From the Department of Integrative Biology and Physiology, University of California, Los Angeles (A.P.A.); Department of Pharmacology and Nutritional Sciences, University of Kentucky College of Medicine, Lexington (L.A.C.); Department of Anesthesiology (M.E.) and Department of Human Genetics (K.R.), David Geffen School of Medicine at UCLA, Los Angeles, CA; and Department of Medicine, Georgetown University Medical Center, Washington, DC (K.S.)
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Shen YH, LeMaire SA. Molecular pathogenesis of genetic and sporadic aortic aneurysms and dissections. Curr Probl Surg 2017; 54:95-155. [PMID: 28521856 DOI: 10.1067/j.cpsurg.2017.01.001] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 01/16/2017] [Indexed: 12/20/2022]
Affiliation(s)
- Ying H Shen
- Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX; Department of Cardiovascular Surgery, Texas Heart Institute, Houston, TX; Cardiovascular Research Institute, Baylor College of Medicine, Houston, TX.
| | - Scott A LeMaire
- Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX; Department of Cardiovascular Surgery, Texas Heart Institute, Houston, TX; Cardiovascular Research Institute, Baylor College of Medicine, Houston, TX; Department of Molecular Physiology and Biophysics, Baylor College of Medicine, Houston, TX.
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29
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A New Mouse Model for Introduction of Aortic Aneurysm by Implantation of Deoxycorticosterone Acetate Pellets or Aldosterone Infusion in the Presence of High Salt. Methods Mol Biol 2017; 1614:155-163. [PMID: 28500602 DOI: 10.1007/978-1-4939-7030-8_12] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Dysfunction of the renin-angiotensin-aldosterone system (RAAS) has been implicated in the etiologies of many cardiovascular diseases, including aortic aneurysm. In particular, the infusion of angiotensin II (Ang II) in the apolipoprotein E-deficient mice (apoE-/-) and low density lipoprotein receptor knockout mice (LDLR-/-) to induce aortic aneurysm has been extensively used in the field. In contrast, whether aldosterone (Aldo), an essential component of RAAS and a downstream effector of Ang II, is involved in aortic aneurysm is largely unknown. Here, we describe a new animal model for induction of aortic aneurysm in mice in which administration of deoxycorticosterone acetate (DOCA) and high salt or aldosterone and high salt, but not DOCA or high salt alone, to C57BL/6 male mice can potently induce aortic aneurysm formation and rupture in an age-dependent manner. This new aortic aneurysm mouse model is different from Ang II infusion mouse model and exhibits several unique features that mimic human aortic aneurysm.
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Alsiraj Y, Thatcher SE, Charnigo R, Chen K, Blalock E, Daugherty A, Cassis LA. Female Mice With an XY Sex Chromosome Complement Develop Severe Angiotensin II-Induced Abdominal Aortic Aneurysms. Circulation 2016; 135:379-391. [PMID: 27815372 DOI: 10.1161/circulationaha.116.023789] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 10/19/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND Abdominal aortic aneurysms (AAAs) are a deadly pathology with strong sexual dimorphism. Similar to humans, female mice exhibit far lower incidences of angiotensin II-induced AAAs than males. In addition to sex hormones, the X and Y sex chromosomes, and their unique complements of genes, may contribute to sexually dimorphic AAA pathology. Here, we defined the effect of female (XX) versus male (XY) sex chromosome complement on angiotensin II-induced AAA formation and rupture in phenotypically female mice. METHODS Female low-density lipoprotein receptor (Ldlr) deficient mice with an XX or XY sex chromosome complement were infused with angiotensin II for 28 days to induce AAAs. Abdominal aortic lumen diameters were quantified by ultrasound, whereas AAA diameters were quantified at study end point. DNA microarrays were performed on abdominal aortas. To mimic males, female mice were administered a single dose of testosterone as neonates or as adults before angiotensin II infusions. RESULTS Female Ldlr-/- deficient mice with an XX and XY sex chromosome complement had similar sex organ weights and low serum testosterone concentrations. Abdominal aortas from female XY mice selectively expressed Y chromosome genes, whereas genes known to escape X inactivation were higher in XX females. The majority of aortic gene differences in XY versus XX females fell within inflammatory pathways. AAA incidences doubled and aneurysms ruptured in XY females. AAAs from XY females exhibited inflammation, and plasma interleukin-1β concentrations were increased in XY females. Moreover, aortas from XY females had augmented matrix metalloproteinase activity and increased oxidative stress. Last, testosterone exposure applied chronically, or as a single bolus at postnatal day 1, markedly worsened AAA outcomes in XY in comparison with XX adult females. CONCLUSIONS An XY sex chromosome complement in phenotypic females profoundly influenced aortic gene expression profiles and promoted AAA severity. When XY females were exposed to testosterone, aneurysm rupture rates were striking. Mechanisms for augmented AAA severity in XY females include increased inflammation, augmented matrix metalloproteineases, and oxidative stress. Our results demonstrate that genes on the sex chromosomes regulate aortic vascular biology and contribute to sexual dimorphism of AAAs. Sex chromosome genes may serve as novel targets for sex-specific AAA therapeutics.
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Affiliation(s)
- Yasir Alsiraj
- From Department of Pharmacology and Nutritional Sciences (Y.A., S.E.T., K.C., E.B., L.A.C.), Department of Biostatistics (R.C.), Department of Physiology and Saha Cardiovascular Research Center (A.D.), University of Kentucky, Lexington, KY
| | - Sean E Thatcher
- From Department of Pharmacology and Nutritional Sciences (Y.A., S.E.T., K.C., E.B., L.A.C.), Department of Biostatistics (R.C.), Department of Physiology and Saha Cardiovascular Research Center (A.D.), University of Kentucky, Lexington, KY
| | - Richard Charnigo
- From Department of Pharmacology and Nutritional Sciences (Y.A., S.E.T., K.C., E.B., L.A.C.), Department of Biostatistics (R.C.), Department of Physiology and Saha Cardiovascular Research Center (A.D.), University of Kentucky, Lexington, KY
| | - Kuey Chen
- From Department of Pharmacology and Nutritional Sciences (Y.A., S.E.T., K.C., E.B., L.A.C.), Department of Biostatistics (R.C.), Department of Physiology and Saha Cardiovascular Research Center (A.D.), University of Kentucky, Lexington, KY
| | - Eric Blalock
- From Department of Pharmacology and Nutritional Sciences (Y.A., S.E.T., K.C., E.B., L.A.C.), Department of Biostatistics (R.C.), Department of Physiology and Saha Cardiovascular Research Center (A.D.), University of Kentucky, Lexington, KY
| | - Alan Daugherty
- From Department of Pharmacology and Nutritional Sciences (Y.A., S.E.T., K.C., E.B., L.A.C.), Department of Biostatistics (R.C.), Department of Physiology and Saha Cardiovascular Research Center (A.D.), University of Kentucky, Lexington, KY
| | - Lisa A Cassis
- From Department of Pharmacology and Nutritional Sciences (Y.A., S.E.T., K.C., E.B., L.A.C.), Department of Biostatistics (R.C.), Department of Physiology and Saha Cardiovascular Research Center (A.D.), University of Kentucky, Lexington, KY.
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31
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Animal Models Used to Explore Abdominal Aortic Aneurysms: A Systematic Review. Eur J Vasc Endovasc Surg 2016; 52:487-499. [DOI: 10.1016/j.ejvs.2016.07.004] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Accepted: 07/01/2016] [Indexed: 01/09/2023]
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Finch CE, Shams S. Apolipoprotein E and Sex Bias in Cerebrovascular Aging of Men and Mice. Trends Neurosci 2016; 39:625-637. [PMID: 27546867 PMCID: PMC5040339 DOI: 10.1016/j.tins.2016.07.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 06/30/2016] [Accepted: 07/01/2016] [Indexed: 11/18/2022]
Abstract
Alzheimer disease (AD) research has mainly focused on neurodegenerative processes associated with the classic neuropathologic markers of senile plaques and neurofibrillary tangles. Additionally, cerebrovascular contributions to dementia are increasingly recognized, particularly from cerebral small vessel disease (SVD). Remarkably, in AD brains, the apolipoprotein E (ApoE) ɛ4 allele shows male excess for cerebral microbleeds (CMBs), a marker of SVD, which is opposite to the female excess of plaques and tangles. Mouse transgenic models add further complexities to sex-ApoE ɛ4 allele interactions, with female excess of both CMBs and brain amyloid. We conclude that brain aging and AD pathogenesis cannot be understood in humans without addressing major gaps in the extent of sex differences in cerebrovascular pathology.
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Affiliation(s)
- Caleb E Finch
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA; Department of Biological Sciences, Dornsife College, University of Southern California, Los Angeles, CA, USA.
| | - Sara Shams
- Department of Clinical Science, Intervention, and Technology, Division of Medical Imaging and Technology, Karolinska Institutet, Stockholm, Sweden; Department of Radiology, Karolinska University Hospital, Stockholm, Sweden.
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Trachet B, Piersigilli A, Fraga-Silva RA, Aslanidou L, Sordet-Dessimoz J, Astolfo A, Stampanoni MFM, Segers P, Stergiopulos N. Ascending Aortic Aneurysm in Angiotensin II-Infused Mice: Formation, Progression, and the Role of Focal Dissections. Arterioscler Thromb Vasc Biol 2016; 36:673-81. [PMID: 26891740 DOI: 10.1161/atvbaha.116.307211] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Accepted: 02/05/2016] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To understand the anatomy and physiology of ascending aortic aneurysms in angiotensin II-infused ApoE(-/-) mice. APPROACH AND RESULTS We combined an extensive in vivo imaging protocol (high-frequency ultrasound and contrast-enhanced microcomputed tomography at baseline and after 3, 10, 18, and 28 days of angiotensin II infusion) with synchrotron-based ultrahigh resolution ex vivo imaging (phase contrast X-ray tomographic microscopy) in n=47 angiotensin II-infused mice and 6 controls. Aortic regurgitation increased significantly over time, as did the luminal volume of the ascending aorta. In the samples that were scanned ex vivo, we observed one or several focal dissections, with the largest located in the outer convex aspect of the ascending aorta. The volume of the dissections moderately correlated to the volume of the aneurysm as measured in vivo (r(2)=0.46). After 3 days of angiotensin II infusion, we found an interlaminar hematoma in 7/12 animals, which could be linked to an intimal tear. There was also a significant increase in single laminar ruptures, which may have facilitated a progressive enlargement of the focal dissections over time. At later time points, the hematoma was resorbed and the medial and adventitial thickness increased. Fatal transmural dissection occurred in 8/47 mice at an early stage of the disease, before adventita remodeling. CONCLUSIONS We visualized and quantified the dissections that lead to ascending aortic aneurysms in angiotensin II-infused mice and provided unique insight into the temporal evolution of these lesions.
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Affiliation(s)
- Bram Trachet
- From the Institute of Bioengineering, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland (B.T., R.A.F.-S., L.A., N.S.); IBiTech-bioMMeda, Ghent University-iMinds Medical IT, Ghent, Belgium (B.T., P.S.); School of Life Sciences, PTEC GE, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland (A.P.); Institute of Animal Pathology, Vetsuisse Faculty, University of Bern, Bern, Switzerland (A.P.); Histology Core Facility, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland (J.S.-D.); Swiss Light Source, Paul Scherrer Institut, Villigen, Switzerland (A.A., M.F.M.S.); and Institute for Biomedical Engineering, University and ETH Zürich, Zürich, Switzerland (M.F.M.S.).
| | - Alessandra Piersigilli
- From the Institute of Bioengineering, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland (B.T., R.A.F.-S., L.A., N.S.); IBiTech-bioMMeda, Ghent University-iMinds Medical IT, Ghent, Belgium (B.T., P.S.); School of Life Sciences, PTEC GE, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland (A.P.); Institute of Animal Pathology, Vetsuisse Faculty, University of Bern, Bern, Switzerland (A.P.); Histology Core Facility, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland (J.S.-D.); Swiss Light Source, Paul Scherrer Institut, Villigen, Switzerland (A.A., M.F.M.S.); and Institute for Biomedical Engineering, University and ETH Zürich, Zürich, Switzerland (M.F.M.S.)
| | - Rodrigo A Fraga-Silva
- From the Institute of Bioengineering, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland (B.T., R.A.F.-S., L.A., N.S.); IBiTech-bioMMeda, Ghent University-iMinds Medical IT, Ghent, Belgium (B.T., P.S.); School of Life Sciences, PTEC GE, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland (A.P.); Institute of Animal Pathology, Vetsuisse Faculty, University of Bern, Bern, Switzerland (A.P.); Histology Core Facility, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland (J.S.-D.); Swiss Light Source, Paul Scherrer Institut, Villigen, Switzerland (A.A., M.F.M.S.); and Institute for Biomedical Engineering, University and ETH Zürich, Zürich, Switzerland (M.F.M.S.)
| | - Lydia Aslanidou
- From the Institute of Bioengineering, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland (B.T., R.A.F.-S., L.A., N.S.); IBiTech-bioMMeda, Ghent University-iMinds Medical IT, Ghent, Belgium (B.T., P.S.); School of Life Sciences, PTEC GE, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland (A.P.); Institute of Animal Pathology, Vetsuisse Faculty, University of Bern, Bern, Switzerland (A.P.); Histology Core Facility, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland (J.S.-D.); Swiss Light Source, Paul Scherrer Institut, Villigen, Switzerland (A.A., M.F.M.S.); and Institute for Biomedical Engineering, University and ETH Zürich, Zürich, Switzerland (M.F.M.S.)
| | - Jessica Sordet-Dessimoz
- From the Institute of Bioengineering, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland (B.T., R.A.F.-S., L.A., N.S.); IBiTech-bioMMeda, Ghent University-iMinds Medical IT, Ghent, Belgium (B.T., P.S.); School of Life Sciences, PTEC GE, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland (A.P.); Institute of Animal Pathology, Vetsuisse Faculty, University of Bern, Bern, Switzerland (A.P.); Histology Core Facility, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland (J.S.-D.); Swiss Light Source, Paul Scherrer Institut, Villigen, Switzerland (A.A., M.F.M.S.); and Institute for Biomedical Engineering, University and ETH Zürich, Zürich, Switzerland (M.F.M.S.)
| | - Alberto Astolfo
- From the Institute of Bioengineering, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland (B.T., R.A.F.-S., L.A., N.S.); IBiTech-bioMMeda, Ghent University-iMinds Medical IT, Ghent, Belgium (B.T., P.S.); School of Life Sciences, PTEC GE, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland (A.P.); Institute of Animal Pathology, Vetsuisse Faculty, University of Bern, Bern, Switzerland (A.P.); Histology Core Facility, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland (J.S.-D.); Swiss Light Source, Paul Scherrer Institut, Villigen, Switzerland (A.A., M.F.M.S.); and Institute for Biomedical Engineering, University and ETH Zürich, Zürich, Switzerland (M.F.M.S.)
| | - Marco F M Stampanoni
- From the Institute of Bioengineering, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland (B.T., R.A.F.-S., L.A., N.S.); IBiTech-bioMMeda, Ghent University-iMinds Medical IT, Ghent, Belgium (B.T., P.S.); School of Life Sciences, PTEC GE, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland (A.P.); Institute of Animal Pathology, Vetsuisse Faculty, University of Bern, Bern, Switzerland (A.P.); Histology Core Facility, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland (J.S.-D.); Swiss Light Source, Paul Scherrer Institut, Villigen, Switzerland (A.A., M.F.M.S.); and Institute for Biomedical Engineering, University and ETH Zürich, Zürich, Switzerland (M.F.M.S.)
| | - Patrick Segers
- From the Institute of Bioengineering, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland (B.T., R.A.F.-S., L.A., N.S.); IBiTech-bioMMeda, Ghent University-iMinds Medical IT, Ghent, Belgium (B.T., P.S.); School of Life Sciences, PTEC GE, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland (A.P.); Institute of Animal Pathology, Vetsuisse Faculty, University of Bern, Bern, Switzerland (A.P.); Histology Core Facility, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland (J.S.-D.); Swiss Light Source, Paul Scherrer Institut, Villigen, Switzerland (A.A., M.F.M.S.); and Institute for Biomedical Engineering, University and ETH Zürich, Zürich, Switzerland (M.F.M.S.)
| | - Nikolaos Stergiopulos
- From the Institute of Bioengineering, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland (B.T., R.A.F.-S., L.A., N.S.); IBiTech-bioMMeda, Ghent University-iMinds Medical IT, Ghent, Belgium (B.T., P.S.); School of Life Sciences, PTEC GE, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland (A.P.); Institute of Animal Pathology, Vetsuisse Faculty, University of Bern, Bern, Switzerland (A.P.); Histology Core Facility, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland (J.S.-D.); Swiss Light Source, Paul Scherrer Institut, Villigen, Switzerland (A.A., M.F.M.S.); and Institute for Biomedical Engineering, University and ETH Zürich, Zürich, Switzerland (M.F.M.S.)
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Pharmacologic blockade and genetic deletion of androgen receptor attenuates aortic aneurysm formation. J Vasc Surg 2016; 63:1602-1612.e2. [PMID: 26817611 DOI: 10.1016/j.jvs.2015.11.038] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Accepted: 11/05/2015] [Indexed: 11/22/2022]
Abstract
BACKGROUND Testosterone is theorized to play a major role in the pathophysiology of abdominal aortic aneurysms (AAAs) because this disease occurs primarily in men. The role of the androgen receptor (AR) in the formation of AAAs has not been well elucidated, and therefore, it is hypothesized that androgen blockade will attenuate experimental aortic aneurysm formation. METHODS Aortas of 8- to 12-week-old male C57Bl/6 wild-type (WT) mice or male AR knockout (AR(-/-)) mice were perfused with purified porcine pancreatic elastase (0.35 U/mL) to induce AAA formation. Two groups of WT male mice were treated with the AR blockers flutamide (50 mg/kg) or ketoconazole (150 mg/kg) twice daily by intraperitoneal injection. Aortas were harvested on day 14 after video micrometry was used to measure AAA diameter. Cytokine arrays and histologic analysis were performed on aortic tissue. Groups were compared using an analysis of variance and a Tukey post hoc test. RESULTS Flutamide and ketoconazole treatment (mean ± standard error of the mean) attenuated AAA formation in WT mice (84.2% ± 22.8% [P = .009] and 91.5% ± 18.2% [P = .037]) compared with WT elastase (121% ± 5.23%). In addition, AR(-/-) mice showed attenuation of AAA growth (64.4% ± 22.7%; P < .0001) compared with WT elastase. Cytokine arrays of aortic tissue revealed decreased levels of proinflammatory cytokines interleukin (IL)-α, IL-6, and IL-17 in flutamide-treated and AR(-/-) groups compared with controls. CONCLUSIONS Pharmacologic and genetic AR blockade cause attenuation of AAA formation. Therapies for AR blockade used in prostate cancer may provide medical treatment to halt progression of AAAs in humans.
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Cacciottolo M, Christensen A, Moser A, Liu J, Pike CJ, Smith C, LaDu MJ, Sullivan PM, Morgan TE, Dolzhenko E, Charidimou A, Wahlund LO, Wiberg MK, Shams S, Chiang GCY, Finch CE. The APOE4 allele shows opposite sex bias in microbleeds and Alzheimer's disease of humans and mice. Neurobiol Aging 2016; 37:47-57. [PMID: 26686669 PMCID: PMC4687024 DOI: 10.1016/j.neurobiolaging.2015.10.010] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Revised: 10/06/2015] [Accepted: 10/11/2015] [Indexed: 12/21/2022]
Abstract
The apolipoprotein APOE4 allele confers greater risk of Alzheimer's disease (AD) for women than men, in conjunction with greater clinical deficits per unit of AD neuropathology (plaques, tangles). Cerebral microbleeds, which contribute to cognitive dysfunctions during AD, also show APOE4 excess, but sex-APOE allele interactions are not described. We report that elderly men diagnosed for mild cognitive impairment and AD showed a higher risk of cerebral cortex microbleeds with APOE4 allele dose effect in 2 clinical cohorts (ADNI and KIDS). Sex-APOE interactions were further analyzed in EFAD mice carrying human APOE alleles and familial AD genes (5XFAD (+/-) /human APOE(+/+)). At 7 months, E4FAD mice had cerebral cortex microbleeds with female excess, in contrast to humans. Cerebral amyloid angiopathy, plaques, and soluble Aβ also showed female excess. Both the cerebral microbleeds and cerebral amyloid angiopathy increased in proportion to individual Aβ load. In humans, the opposite sex bias of APOE4 allele for microbleeds versus the plaques and tangles is the first example of organ-specific, sex-linked APOE allele effects, and further shows AD as a uniquely human condition.
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Affiliation(s)
- Mafalda Cacciottolo
- Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Amy Christensen
- Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Alexandra Moser
- Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Jiahui Liu
- Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Christian J Pike
- Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Conor Smith
- Department of Anatomy and Cell Biology, University of Illinois at Chicago, Chicago, IL, USA
| | - Mary Jo LaDu
- Department of Anatomy and Cell Biology, University of Illinois at Chicago, Chicago, IL, USA
| | - Patrick M Sullivan
- Department of Medicine, Duke University, Durham VA Medical Center and GRECC, Durham, NC, USA
| | - Todd E Morgan
- Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Egor Dolzhenko
- Department of Molecular and Computational Biology, University of Southern California, Los Angeles, CA, USA
| | - Andreas Charidimou
- Hemorrhagic Stroke Research Program, Department of Neurology, Massachusetts General Hospital Stroke Research Center, Harvard Medical School, Boston, MA, USA
| | - Lars-Olof Wahlund
- Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Division of Clinical Geriatrics, Karolinska University Hospital, Stockholm, Sweden
| | - Maria Kristofferson Wiberg
- Division of Medical Imaging and Technology, Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, Stockholm, Sweden; Department of Radiology, Karolinska University Hospital, Stockholm, Sweden
| | - Sara Shams
- Division of Medical Imaging and Technology, Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, Stockholm, Sweden; Department of Radiology, Karolinska University Hospital, Stockholm, Sweden
| | | | - Caleb E Finch
- Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA; Department of Molecular and Computational Biology, University of Southern California, Los Angeles, CA, USA; Department of Biological Sciences, Dornsife College, University of Southern California, Los Angeles, CA, USA.
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Thatcher SE, Zhang X, Woody S, Wang Y, Alsiraj Y, Charnigo R, Daugherty A, Cassis LA. Exogenous 17-β estradiol administration blunts progression of established angiotensin II-induced abdominal aortic aneurysms in female ovariectomized mice. Biol Sex Differ 2015; 6:12. [PMID: 26131353 PMCID: PMC4485333 DOI: 10.1186/s13293-015-0030-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Accepted: 06/15/2015] [Indexed: 11/24/2022] Open
Abstract
Background Abdominal aortic aneurysms (AAAs) occur predominately in males. However, AAAs in females have rapid growth rates and rupture at smaller sizes. Mechanisms contributing to AAA progression in females are undefined. We defined effects of ovariectomy, with and without 17-β estradiol (E2), on progression of established angiotensin II (AngII)-induced AAAs in female mice. Methods We used neonatal testosterone exposures at 1 day of age to promote susceptibility to AngII-induced AAAs in adult female Ldlr−/− mice. Females were infused with AngII for 28 days to induce AAAs, and then stratified into groups that were sham, ovariectomized (Ovx, vehicle), or Ovx with E2 administration for 2 months of continued AngII infusions. Aortic lumen diameters were quantified by ultrasound and analyzed by linear mixed model, and maximal AAA diameters were analyzed by one-way ANOVA. Atherosclerosis was quantified en face in the aortic arch. AAA tissue sections were analyzed for cellular composition. We quantified effects of E2 on abdominal aortic smooth muscle cell (SMC) growth, α-actin and transforming growth factor-beta (TGF-β) production, and wound healing. Results Serum E2 concentrations were increased significantly by E2. Aortic lumen diameters increased over time in sham-operated and Ovx (vehicle) females, but not in Ovx females administered E2. At day 70, E2 administration decreased significantly aortic lumen diameters compared to Ovx vehicle and sham-operated females. Compared to Ovx females (vehicle), maximal AAA diameters were reduced significantly by E2. AAA tissue sections from Ovx females administered E2 exhibited significant increases in α-actin and decreases in neutrophils compared to Ovx females administered vehicle. In abdominal aortic SMCs, E2 resulted in a concentration-dependent increase in α-actin, elevated TGF-β, and more rapid wound healing. E2 administration to Ovx females also significantly reduced atherosclerotic lesions compared to sham-operated females. This effect was accompanied by significant reductions in serum cholesterol concentrations. Conclusions E2 administration to Ovx females abolished progressive growth and decreased severity of AngII-induced AAAs. These effects were accompanied by increased SMC α-actin, elevated TGF-β, and reduced neutrophils. Similarly, E2 administration reduced AngII-induced atherosclerosis. These results suggest that loss of E2 in post-menopausal females may contribute to progressive growth of AAAs. Electronic supplementary material The online version of this article (doi:10.1186/s13293-015-0030-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sean E Thatcher
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Room 521b, Charles T. Wethington Bldg, Lexington, KY 40536-0200 USA
| | - Xuan Zhang
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Room 521b, Charles T. Wethington Bldg, Lexington, KY 40536-0200 USA
| | - Shannon Woody
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Room 521b, Charles T. Wethington Bldg, Lexington, KY 40536-0200 USA
| | - Yu Wang
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Room 521b, Charles T. Wethington Bldg, Lexington, KY 40536-0200 USA
| | - Yasir Alsiraj
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Room 521b, Charles T. Wethington Bldg, Lexington, KY 40536-0200 USA
| | - Richard Charnigo
- Department of Statistics, University of Kentucky, Lexington, KY 40536 USA
| | - Alan Daugherty
- Saha Cardiovascular Center, University of Kentucky, Lexington, KY 40536 USA ; Department of Physiology, University of Kentucky, Lexington, KY 40536 USA
| | - Lisa A Cassis
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Room 521b, Charles T. Wethington Bldg, Lexington, KY 40536-0200 USA
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Liu J, Lu H, Howatt DA, Balakrishnan A, Moorleghen JJ, Sorci-Thomas M, Cassis LA, Daugherty A. Associations of ApoAI and ApoB-containing lipoproteins with AngII-induced abdominal aortic aneurysms in mice. Arterioscler Thromb Vasc Biol 2015; 35:1826-34. [PMID: 26044581 DOI: 10.1161/atvbaha.115.305482] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2015] [Accepted: 05/20/2015] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Dyslipidemia is implicated in abdominal aortic aneurysms (AAAs) in humans and angiotensin (Ang) II-infused mice. This study determined effects of major lipoprotein classes on AngII-induced AAAs using multiple mouse strains with dietary and pharmacological manipulations. APPROACH AND RESULTS Western diet had minor effects on plasma cholesterol concentrations and the low incidence of AngII-induced AAAs in C57BL/6J mice. Low incidence of AAAs in this strain was not attributed to protection from high-density lipoprotein, because apolipoprotein (apo) AI deficiency did not increase AngII-induced AAAs. ApoAI deletion also failed to alter AAA occurrence in hypercholesterolemic mice. Low-density lipoprotein receptor-/- mice fed normal diet had low incidence of AngII-induced AAAs. Western diet feeding of this strain provoked pronounced hypercholesterolemia because of increased apoB-containing lipoproteins with attendant increases of atherosclerosis in both sexes, but AAAs only in male mice. ApoE-deficient mice fed normal diet were modestly hypercholesterolemic, whereas this strain fed Western diet was severely hypercholesterolemic because of increased apoB-containing lipoprotein concentrations. The latter augmented atherosclerosis, but did not change the high incidence of AAAs in this strain. To determine whether reductions in apoB-containing lipoproteins influenced AngII-induced AAAs, ezetimibe was administered at a dose that partially reduced plasma cholesterol concentrations to ApoE-deficient mice fed Western diet. This decreased atherosclerosis, but not AAAs. This ezetimibe dose in ApoE-deficient mice fed normal diet significantly decreased plasma apoB-containing lipoprotein concentrations and reduced AngII-induced AAAs. CONCLUSIONS ApoB-containing lipoproteins contribute to augmentation of AngII-induced AAA in male mice. However, unlike atherosclerosis, AAA occurrence was not correlated with increases in plasma apoB-containing lipoprotein concentrations.
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Affiliation(s)
- Jing Liu
- From the Saha Cardiovascular Research Center (J.L., H.L., D.A.H., A.B., J.J.M., A.D.) and Department of Pharmacology and Nutritional Sciences (J.L., L.A.C., A.D.), University of Kentucky, Lexington; and Department of Medicine, Medical College of Wisconsin, Milwaukee (M.S.-T.)
| | - Hong Lu
- From the Saha Cardiovascular Research Center (J.L., H.L., D.A.H., A.B., J.J.M., A.D.) and Department of Pharmacology and Nutritional Sciences (J.L., L.A.C., A.D.), University of Kentucky, Lexington; and Department of Medicine, Medical College of Wisconsin, Milwaukee (M.S.-T.)
| | - Deborah A Howatt
- From the Saha Cardiovascular Research Center (J.L., H.L., D.A.H., A.B., J.J.M., A.D.) and Department of Pharmacology and Nutritional Sciences (J.L., L.A.C., A.D.), University of Kentucky, Lexington; and Department of Medicine, Medical College of Wisconsin, Milwaukee (M.S.-T.)
| | - Anju Balakrishnan
- From the Saha Cardiovascular Research Center (J.L., H.L., D.A.H., A.B., J.J.M., A.D.) and Department of Pharmacology and Nutritional Sciences (J.L., L.A.C., A.D.), University of Kentucky, Lexington; and Department of Medicine, Medical College of Wisconsin, Milwaukee (M.S.-T.)
| | - Jessica J Moorleghen
- From the Saha Cardiovascular Research Center (J.L., H.L., D.A.H., A.B., J.J.M., A.D.) and Department of Pharmacology and Nutritional Sciences (J.L., L.A.C., A.D.), University of Kentucky, Lexington; and Department of Medicine, Medical College of Wisconsin, Milwaukee (M.S.-T.)
| | - Mary Sorci-Thomas
- From the Saha Cardiovascular Research Center (J.L., H.L., D.A.H., A.B., J.J.M., A.D.) and Department of Pharmacology and Nutritional Sciences (J.L., L.A.C., A.D.), University of Kentucky, Lexington; and Department of Medicine, Medical College of Wisconsin, Milwaukee (M.S.-T.)
| | - Lisa A Cassis
- From the Saha Cardiovascular Research Center (J.L., H.L., D.A.H., A.B., J.J.M., A.D.) and Department of Pharmacology and Nutritional Sciences (J.L., L.A.C., A.D.), University of Kentucky, Lexington; and Department of Medicine, Medical College of Wisconsin, Milwaukee (M.S.-T.)
| | - Alan Daugherty
- From the Saha Cardiovascular Research Center (J.L., H.L., D.A.H., A.B., J.J.M., A.D.) and Department of Pharmacology and Nutritional Sciences (J.L., L.A.C., A.D.), University of Kentucky, Lexington; and Department of Medicine, Medical College of Wisconsin, Milwaukee (M.S.-T.).
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Davis JP, Salmon M, Pope NH, Lu G, Su G, Sharma AK, Ailawadi G, Upchurch GR. Attenuation of aortic aneurysms with stem cells from different genders. J Surg Res 2015; 199:249-58. [PMID: 25958166 DOI: 10.1016/j.jss.2015.04.025] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Revised: 03/31/2015] [Accepted: 04/08/2015] [Indexed: 01/09/2023]
Abstract
BACKGROUND No medical therapies are yet available to slow abdominal aortic aneurysm (AAA) growth. This study sought to investigate the effect of different genders of bone marrow-derived mesenchymal stem cells (MSC) on AAA growth in a murine AAA model. Given the decreased rate of AAA in women, it is hypothesized that female MSC would attenuate AAA growth more so than male MSC. MATERIALS AND METHODS Aortas of 8-10-wk-old male C57Bl/6 mice were perfused with purified porcine pancreatic elastase to induce AAA formation. Bone marrow-derived MSC from male and female mice were dosed via tail vein injection (3 million cells per dose, 500 μL of volume per injection) on postaortic perfusion days 1, 3, and 5. Aortas were harvested after 14 d. RESULTS Mean aortic dilation in the elastase group was 121 ± 5.2% (mean ± standard error of the mean), while male MSC inhibited AAA growth (87.8 ± 6.9%, P = 0.008) compared with that of elastase. Female MSC showed the most marked attenuation of AAA growth (75.2 ± 8.3% P = 0.0004). Proinflammatory cytokines tumor necrosis factor α, interleukin 1β, and monocyte chemotactic protein-1 (MCP-1) were only decreased in tissues treated with female MSC (P = 0.017, P = 0.001, and P < 0.0001, respectively, when compared with elastase). CONCLUSIONS These data exhibit that female MSC more strongly attenuate AAA growth in the murine model. Furthermore, female MSC and male MSC inhibit proinflammatory cytokines at varying levels. The effects of MSC on aortic tissue offer a promising insight into biologic therapies for future medical treatment of AAAs in humans.
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Affiliation(s)
- John P Davis
- Division of Vascular and Endovascular Surgery and Cardiothoracic Surgery, Department of Surgery, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Morgan Salmon
- Division of Vascular and Endovascular Surgery and Cardiothoracic Surgery, Department of Surgery, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Nicolas H Pope
- Division of Vascular and Endovascular Surgery and Cardiothoracic Surgery, Department of Surgery, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Guanyi Lu
- Division of Vascular and Endovascular Surgery and Cardiothoracic Surgery, Department of Surgery, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Gang Su
- Division of Vascular and Endovascular Surgery and Cardiothoracic Surgery, Department of Surgery, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Ashish K Sharma
- Division of Vascular and Endovascular Surgery and Cardiothoracic Surgery, Department of Surgery, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Gorav Ailawadi
- Division of Vascular and Endovascular Surgery and Cardiothoracic Surgery, Department of Surgery, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Gilbert R Upchurch
- Division of Vascular and Endovascular Surgery and Cardiothoracic Surgery, Department of Surgery, University of Virginia School of Medicine, Charlottesville, Virginia.
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Schmit BM, Yang P, Fu C, DeSart K, Berceli SA, Jiang Z. Hypertension overrides the protective effect of female hormones on the development of aortic aneurysm secondary to Alk5 deficiency via ERK activation. Am J Physiol Heart Circ Physiol 2014; 308:H115-25. [PMID: 25398982 DOI: 10.1152/ajpheart.00521.2014] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The prevalence of aortic aneurysm is five times higher in men than women among the general population. Similar sexual dimorphism also exists in syndromic aortic aneurysms triggered by TGF-β signaling disorders. To understand the responsible mechanisms, we developed an animal model where inducible deletion of the type I TGF-β receptor, Alk5, specifically in smooth muscle cells (Alk5iko) causes spontaneous aortic aneurysm formation. This model recapitulated an extreme scenario of the dimorphism in aortic aneurysm development between genders. In a comparative experiment, all Alk5iko males (n=42) developed aortic aneurysms and 26% of them died prematurely from aortic rupture. In contrast, the Alk5iko females (n=14) presented only a subclinical phenotype characteristic of scarcely scattered elastin breaks. Removal of male hormones via orchiectomy (n=7) resulted in only minimal influence on aortic pathology. However, reduction of female hormones via ovariectomy (n=15) increased the phenotypic penetrance from zero to 53%. Finally, an elevation of systolic blood pressure by 30 points unmasked the subclinical phenotype of Alk5iko females (n=17) to 59%. This exaggerated phenotypic penetrance was coupled with an early intensification of ERK signaling, a molecular signature that correlated to 100% phenotypic penetrance in normotensive Alk5iko males. In conclusion, aortic aneurysm induced by Alk5iko exhibits dimorphic incidence between genders with females less susceptible to aortic disease. This sexual dimorphism is partially the result from the protective effects of female hormones. Hypertension, a known risk factor for aortic aneurysm, is able to break the female sex protective effects through mechanisms associated with enhanced ERK activity.
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Affiliation(s)
- Bradley M Schmit
- Division of Vascular Surgery and Endovascular Therapy, University of Florida College of Medicine, Gainesville, Florida; and
| | - Pu Yang
- Division of Vascular Surgery and Endovascular Therapy, University of Florida College of Medicine, Gainesville, Florida; and
| | - Chunhua Fu
- Division of Vascular Surgery and Endovascular Therapy, University of Florida College of Medicine, Gainesville, Florida; and
| | - Kenneth DeSart
- Division of Vascular Surgery and Endovascular Therapy, University of Florida College of Medicine, Gainesville, Florida; and
| | - Scott A Berceli
- Division of Vascular Surgery and Endovascular Therapy, University of Florida College of Medicine, Gainesville, Florida; and The Malcom Randall VA Medical Center, Gainesville, Florida
| | - Zhihua Jiang
- Division of Vascular Surgery and Endovascular Therapy, University of Florida College of Medicine, Gainesville, Florida; and
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Makrygiannis G, Courtois A, Drion P, Defraigne JO, Kuivaniemi H, Sakalihasan N. Sex Differences in Abdominal Aortic Aneurysm: The Role of Sex Hormones. Ann Vasc Surg 2014; 28:1946-58. [DOI: 10.1016/j.avsg.2014.07.008] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Revised: 06/21/2014] [Accepted: 07/27/2014] [Indexed: 01/16/2023]
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Lee J, Shen M, Parajuli N, Oudit GY, McMurtry MS, Kassiri Z. Gender-dependent aortic remodelling in patients with bicuspid aortic valve-associated thoracic aortic aneurysm. J Mol Med (Berl) 2014; 92:939-49. [DOI: 10.1007/s00109-014-1178-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Revised: 05/01/2014] [Accepted: 05/23/2014] [Indexed: 12/19/2022]
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Abstract
Two recent studies identify how sex-specific pheromonal factors in flies and worms alter lifespan through metabolic pathways that are shared with mammals. Sex differences in human lifespans imply nonautonomous effects modulated by sex-specific gene-environment interactions that could still include pheromonal mechanisms.
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Affiliation(s)
- Caleb E Finch
- Davis School of Gerontology and Department of Biological Sciences, University of Southern California, Los Angeles, CA 90089, USA.
| | - John Tower
- Davis School of Gerontology and Department of Biological Sciences, University of Southern California, Los Angeles, CA 90089, USA.
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Zhang X, Thatcher S, Wu C, Daugherty A, Cassis LA. Castration of male mice prevents the progression of established angiotensin II-induced abdominal aortic aneurysms. J Vasc Surg 2014; 61:767-76. [PMID: 24439319 DOI: 10.1016/j.jvs.2013.11.004] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Revised: 10/31/2013] [Accepted: 11/01/2013] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Male sex is a nonmodifiable risk factor for abdominal aortic aneurysm (AAA) development. Similar to humans, male mice are more susceptible to angiotensin II (AngII)-induced AAAs than female mice. Previous studies demonstrated that castration of males markedly reduced the formation of AngII-induced AAAs. Progression of AAA size is associated with increased risk of aneurysm rupture. In this study, we hypothesized that castration of male mice would reduce the progression of established AngII-induced AAAs. METHODS Male apolipoprotein E-deficient mice were infused with AngII for 1 month to induce AAA formation. Aortic diameters were measured by ultrasound imaging, and mice were stratified into two groups that underwent a sham operation or castration. AngII infusions were continued for a further 2 months. Ultrasound imaging was used to quantify lumen diameters, and excised aortas were processed for quantification of AAA size, volume, and tissue characteristics. RESULTS Sham-operated mice exhibited progressive dilation of suprarenal aortic lumen diameters during the continued AngII infusion. Aortic lumen diameters were significantly decreased in castrated mice (n = 17) compared with sham-operated mice (n = 15) at study end point (1.63 ± 0.04 vs 1.88 ± 0.05 mm; P < .05). However, maximal external AAA diameters were not significantly different between sham-operated and castrated mice. The vascular volume/lumen volume ratio of excised AAAs imaged by ultrasound was significantly increased by castration (9.5% ± 2.0%) vs sham operation (4.8% ± 0.9%; n = 11 per group; P < .05). Moreover, compared with the thin-walled AAAs of sham-operated mice, aneurysm sections from castrated mice exhibited increased smooth muscle α-actin and collagen. CONCLUSIONS Removal of endogenous male hormones by castration selectively reduces aortic lumen expansion while not altering the external AAA dimensions. CLINICAL RELEVANCE There are no therapeutics that slow the progression of abdominal aortic aneurysms (AAAs), and as the size of an AAA increases, so does the risk of rupture and death. Male sex is a nonmodifiable risk factor for AAA development, but whether male sex hormones have a similar effect on AAA progression is unclear. Removal of male sex hormones in an established mouse model of angiotensin II-induced AAAs resulted in reduced progressive lumen dilation while not altering external AAA dimensions. Therapies that limit androgen action may provide benefit against AAA progression. Alternatively, supplemental testosterone may be contraindicated in men diagnosed with an AAA.
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Affiliation(s)
- Xuan Zhang
- Graduate Center for Toxicology, University of Kentucky, Lexington, Ky
| | - Sean Thatcher
- Graduate Center for Nutritional Sciences, University of Kentucky, Lexington, Ky
| | - Congqing Wu
- Graduate Center for Nutritional Sciences, University of Kentucky, Lexington, Ky
| | - Alan Daugherty
- Saha Cardiovascular Research Center, University of Kentucky, Lexington, Ky
| | - Lisa A Cassis
- Department of Molecular and Biomedical Pharmacology, University of Kentucky, Lexington, Ky.
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Liu S, Xie Z, Daugherty A, Cassis LA, Pearson KJ, Gong MC, Guo Z. Mineralocorticoid receptor agonists induce mouse aortic aneurysm formation and rupture in the presence of high salt. Arterioscler Thromb Vasc Biol 2013; 33:1568-79. [PMID: 23661677 PMCID: PMC3707291 DOI: 10.1161/atvbaha.112.300820] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2012] [Accepted: 04/24/2013] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Elevated plasma aldosterone concentrations in patients have been linked to a spectrum of cardiovascular diseases. Mineralocorticoid receptor antagonists provide additional benefits in patients with heart failure. However, whether aldosterone and the mineralocorticoid receptor are involved in aortic aneurysm is unknown. APPROACH AND RESULTS We report that administration of deoxycorticosterone acetate (DOCA) and salt or aldosterone and salt, but not DOCA or salt alone, to C57BL/6 male mice induced abdominal and thoracic aortic aneurysm formation and rupture in an age-dependent manner. DOCA and salt- or aldosterone and salt-induced aortic aneurysm mimicked human aortic aneurysm with respect to elastin degradation, inflammatory cell infiltration, smooth muscle cell degeneration and apoptosis, and oxidative stress. Aortic aneurysm formation did not correlate with the increase in blood pressure induced by DOCA and salt. Systemic administration of the angiotensin-converting enzyme inhibitor, enalapril, or angiotensin type 1 receptor antagonist, losartan, did not affect DOCA and salt-induced aortic aneurysm. In contrast, the mineralocorticoid receptor antagonists, spironolactone or eplerenone, significantly attenuated DOCA and salt- or aldosterone and salt-induced aortic aneurysm. CONCLUSIONS The current study describes a novel aortic aneurysm animal model induced by mineralocorticoid receptor agonist and high salt, and reveals a previously unrecognized but potentially significant role of aldosterone in the pathogenesis of aortic aneurysm. These findings imply that mineralocorticoid receptor antagonists may be effective in the treatment of some aortic aneurysms.
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MESH Headings
- Aldosterone/blood
- Angiotensin II Type 1 Receptor Blockers/administration & dosage
- Angiotensin-Converting Enzyme Inhibitors/administration & dosage
- Animals
- Aorta/drug effects
- Aorta/metabolism
- Aorta/pathology
- Aortic Aneurysm, Abdominal/chemically induced
- Aortic Aneurysm, Abdominal/drug therapy
- Aortic Aneurysm, Abdominal/etiology
- Aortic Aneurysm, Abdominal/metabolism
- Aortic Aneurysm, Abdominal/pathology
- Aortic Aneurysm, Abdominal/physiopathology
- Aortic Aneurysm, Thoracic/chemically induced
- Aortic Aneurysm, Thoracic/drug therapy
- Aortic Aneurysm, Thoracic/etiology
- Aortic Aneurysm, Thoracic/metabolism
- Aortic Aneurysm, Thoracic/pathology
- Aortic Aneurysm, Thoracic/physiopathology
- Aortic Rupture/chemically induced
- Aortic Rupture/drug therapy
- Aortic Rupture/etiology
- Aortic Rupture/metabolism
- Aortic Rupture/pathology
- Aortic Rupture/physiopathology
- Apoptosis
- Blood Pressure
- Desoxycorticosterone
- Disease Models, Animal
- Elastin/metabolism
- Enalapril/administration & dosage
- Eplerenone
- Losartan/administration & dosage
- Male
- Mice
- Mice, Inbred C57BL
- Mineralocorticoid Receptor Antagonists/administration & dosage
- Muscle, Smooth, Vascular/metabolism
- Muscle, Smooth, Vascular/pathology
- Oxidative Stress
- Receptors, Mineralocorticoid/agonists
- Receptors, Mineralocorticoid/metabolism
- Sodium Chloride, Dietary
- Spironolactone/administration & dosage
- Spironolactone/analogs & derivatives
- Time Factors
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Affiliation(s)
- Shu Liu
- Department of Internal Medicine, University of Kentucky, Lexington, KY 40536
| | - Zhongwen Xie
- Department of Physiology, University of Kentucky, Lexington, KY 40536
| | - Alan Daugherty
- Department of Internal Medicine, University of Kentucky, Lexington, KY 40536
- The Graduate Center for Nutritional Sciences, University of Kentucky, Lexington, KY 40536
- Saha Cardiovascular Research Center, University of Kentucky, Lexington, KY 40536
| | - Lisa A. Cassis
- The Graduate Center for Nutritional Sciences, University of Kentucky, Lexington, KY 40536
- Department of Molecular and Biomedical Pharmacology, University of Kentucky, Lexington, KY 40536
| | - Kevin J. Pearson
- The Graduate Center for Nutritional Sciences, University of Kentucky, Lexington, KY 40536
| | - Ming C. Gong
- Department of Physiology, University of Kentucky, Lexington, KY 40536
- The Graduate Center for Nutritional Sciences, University of Kentucky, Lexington, KY 40536
| | - Zhenheng Guo
- Department of Internal Medicine, University of Kentucky, Lexington, KY 40536
- The Graduate Center for Nutritional Sciences, University of Kentucky, Lexington, KY 40536
- Saha Cardiovascular Research Center, University of Kentucky, Lexington, KY 40536
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Circulation Research
Thematic Synopsis. Circ Res 2013. [DOI: 10.1161/circresaha.113.301487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Holmes KW, Maslen CL, Kindem M, Kroner BL, Song HK, Ravekes W, Dietz HC, Weinsaft JW, Roman MJ, Devereux RB, Pyeritz RE, Bavaria J, Milewski K, Milewicz D, LeMaire SA, Hendershot T, Eagle KA, Tolunay HE, Desvigne-Nickens P, Silberbach M. GenTAC registry report: gender differences among individuals with genetically triggered thoracic aortic aneurysm and dissection. Am J Med Genet A 2013; 161A:779-86. [PMID: 23444191 PMCID: PMC3606679 DOI: 10.1002/ajmg.a.35836] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2012] [Accepted: 12/06/2012] [Indexed: 01/15/2023]
Abstract
Previous data suggest women are at increased risk of death from aortic dissection. Therefore, we analyzed data from the GenTAC registry, the NIH-sponsored program that collects information about individuals with genetically triggered thoracic aortic aneurysms and cardiovascular conditions. We performed cross-sectional analyses in adults with Marfan syndrome (MFS), familial thoracic aortic aneurysm or dissection (FTAAD), bicuspid aortic valve (BAV) with thoracic aortic aneurysm or dissection, and subjects under 50 years of age with thoracic aortic aneurysm or dissection (TAAD <50 years). Women comprised 32% of 1,449 subjects and were 21% of subjects with BAV, 34% with FTAAD, 22% with TAAD <50 years, and 47% with MFS. Thoracic aortic dissections occurred with equal gender frequency yet women with BAV had more extensive dissections. Aortic size was smaller in women but was similar after controlling for BSA. Age at operation for aortic valve dysfunction, aneurysm or dissection did not differ by gender. Multivariate analysis (adjusting for age, BSA, hypertension, study site, diabetes, and subgroup diagnoses) showed that women had fewer total aortic surgeries (OR = 0.65, P < 0.01) and were less likely to receive angiotensin converting enzyme inhibitors (ACEi; OR = 0.68, P < 0.05). As in BAV, other genetically triggered aortic diseases such as FTAAD and TAAD <50 are more common in males. In women, decreased prevalence of aortic operations and less treatment with ACEi may be due to their smaller absolute aortic diameters. Longitudinal studies are needed to determine if women are at higher risk for adverse events.
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Lu H, Rateri DL, Bruemmer D, Cassis LA, Daugherty A. Novel mechanisms of abdominal aortic aneurysms. Curr Atheroscler Rep 2013; 14:402-12. [PMID: 22833280 DOI: 10.1007/s11883-012-0271-y] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Abdominal aortic aneurysms (AAAs) are a common but asymptomatic disease that has high susceptibility to rupture. Current therapeutic options are limited to surgical procedures because no pharmacological approaches have been proven to decrease either expansion or rupture of human AAAs. The current dearth of effective medical treatment is attributed to insufficient understanding of the mechanisms underlying the initiation, propagation and rupture of AAAs. This review will emphasize recent advances in mechanistic studies that may provide insights into potential pharmacological treatments for this disease. While we primarily focus on recent salient findings, we also discuss mechanisms that continue to be controversial depending on models under study. Despite the progress on exploring mechanisms of experimental AAAs, ultimate validation of mechanisms will require completion of prospective double-blinded clinical trials. In addition, we advocate increased emphasis of collaborative studies using animal models and human tissues for determination of mechanisms that explore expansion and rupture of existing AAAs.
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Affiliation(s)
- Hong Lu
- Saha Cardiovascular Research Center, Biomedical Biological Sciences Research Building, B243, University of Kentucky, Lexington, KY 40536-0509, USA.
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Rateri DL, Moorleghen JJ, Knight V, Balakrishnan A, Howatt DA, Cassis LA, Daugherty A. Depletion of endothelial or smooth muscle cell-specific angiotensin II type 1a receptors does not influence aortic aneurysms or atherosclerosis in LDL receptor deficient mice. PLoS One 2012; 7:e51483. [PMID: 23236507 PMCID: PMC3517567 DOI: 10.1371/journal.pone.0051483] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2012] [Accepted: 11/06/2012] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Whole body genetic deletion of AT1a receptors in mice uniformly reduces hypercholesterolemia and angiotensin II-(AngII) induced atherosclerosis and abdominal aortic aneurysms (AAAs). However, the role of AT1a receptor stimulation of principal cell types resident in the arterial wall remains undefined. Therefore, the aim of this study was to determine whether deletion of AT1a receptors in either endothelial cells or smooth muscle cells influences the development of atherosclerosis and AAAs. METHODOLOGY/PRINCIPAL FINDINGS AT1a receptor floxed mice were developed in an LDL receptor -/- background. To generate endothelial or smooth muscle cell specific deficiency, AT1a receptor floxed mice were bred with mice expressing Cre under the control of either Tie2 or SM22, respectively. Groups of males and females were fed a saturated fat-enriched diet for 3 months to determine effects on atherosclerosis. Deletion of AT1a receptors in either endothelial or smooth muscle cells had no discernible effect on the size of atherosclerotic lesions. We also determined the effect of cell-specific AT1a receptor deficiency on atherosclerosis and AAAs using male mice fed a saturated fat-enriched diet and infused with AngII (1,000 ng/kg/min). Again, deletion of AT1a receptors in either endothelial or smooth muscle cells had no discernible effects on either AngII-induced atherosclerotic lesions or AAAs. CONCLUSIONS Although previous studies have demonstrated whole body AT1a receptor deficiency diminishes atherosclerosis and AAAs, depletion of AT1a receptors in either endothelial or smooth muscle cells did not affect either of these vascular pathologies.
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MESH Headings
- Animals
- Aortic Aneurysm, Abdominal/etiology
- Aortic Aneurysm, Abdominal/pathology
- Atherosclerosis/etiology
- Atherosclerosis/pathology
- Blood Pressure
- Chromatography, Gel
- Crosses, Genetic
- Diet, High-Fat
- Endothelial Cells/metabolism
- Female
- Genotype
- Image Processing, Computer-Assisted
- Male
- Mice
- Mice, Knockout
- Muscle, Smooth/metabolism
- Receptor, Angiotensin, Type 1/deficiency
- Receptors, LDL/genetics
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Affiliation(s)
- Debra L. Rateri
- Saha Cardiovascular Research Center, University of Kentucky, Lexington, Kentucky, United States of America
| | - Jessica J. Moorleghen
- Saha Cardiovascular Research Center, University of Kentucky, Lexington, Kentucky, United States of America
| | - Victoria Knight
- Saha Cardiovascular Research Center, University of Kentucky, Lexington, Kentucky, United States of America
| | - Anju Balakrishnan
- Saha Cardiovascular Research Center, University of Kentucky, Lexington, Kentucky, United States of America
| | - Deborah A. Howatt
- Saha Cardiovascular Research Center, University of Kentucky, Lexington, Kentucky, United States of America
| | - Lisa A. Cassis
- Department of Molecular and Biomedical Pharmacology, University of Kentucky, Lexington, Kentucky, United States of America
| | - Alan Daugherty
- Saha Cardiovascular Research Center, University of Kentucky, Lexington, Kentucky, United States of America
- Department of Molecular and Biomedical Pharmacology, University of Kentucky, Lexington, Kentucky, United States of America
- * E-mail:
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50
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Basu R, Fan D, Kandalam V, Lee J, Das SK, Wang X, Baldwin TA, Oudit GY, Kassiri Z. Loss of Timp3 gene leads to abdominal aortic aneurysm formation in response to angiotensin II. J Biol Chem 2012; 287:44083-96. [PMID: 23144462 DOI: 10.1074/jbc.m112.425652] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Aortic aneurysm is dilation of the aorta primarily due to degradation of the aortic wall extracellular matrix (ECM). Tissue inhibitors of metalloproteinases (TIMPs) inhibit matrix metalloproteinases (MMPs), the proteases that degrade the ECM. Timp3 is the only ECM-bound Timp, and its levels are altered in the aorta from patients with abdominal aortic aneurysm (AAA). We investigated the causal role of Timp3 in AAA formation. Infusion of angiotensin II (Ang II) using micro-osmotic (Alzet) pumps in Timp3(-/-) male mice, but not in wild type control mice, led to adverse remodeling of the abdominal aorta, reduced collagen and elastin proteins but not mRNA, and elevated proteolytic activities, suggesting excess protein degradation within 2 weeks that led to formation of AAA by 4 weeks. Intriguingly, despite early up-regulation of MMP2 in Timp3(-/-)Ang II aortas, additional deletion of Mmp2 in these mice (Timp3(-/-)/Mmp2(-/-)) resulted in exacerbated AAA, compromised survival due to aortic rupture, and inflammation in the abdominal aorta. Reconstitution of WT bone marrow in Timp3(-/-)/Mmp2(-/-) mice reduced inflammation and prevented AAA in these animals following Ang II infusion. Treatment with a broad spectrum MMP inhibitor (PD166793) prevented the Ang II-induced AAA in Timp3(-/-) and Timp3(-/-)/Mmp2(-/-) mice. Our study demonstrates that the regulatory function of TIMP3 is critical in preventing adverse vascular remodeling and AAA. Hence, replenishing TIMP3, a physiological inhibitor of a number of metalloproteinases, could serve as a therapeutic approach in limiting AAA development or expansion.
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Affiliation(s)
- Ratnadeep Basu
- Department of Physiology, Division of Cardiology, University of Alberta, Edmonton, Alberta T6G 2S2, Canada
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