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Yang T, Yuan X, Gao W, Hu MJ, Lu MJ, Sun HS. Mendelian randomization did not support the causal effect of diabetes on aortic diseases. Intern Emerg Med 2024:10.1007/s11739-024-03727-z. [PMID: 39210233 DOI: 10.1007/s11739-024-03727-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 12/11/2023] [Indexed: 09/04/2024]
Abstract
Observational studies revealed paradoxically inverse associations between diabetes and aortic diseases (aortic aneurysm or aortic dissection), yet the causality remains to be determined. To investigate the causal associations between diabetes and aortic diseases using Mendelian randomization (MR) analyses. Summary-level data for exposures (type 1 diabetes, type 2 diabetes, fasting glucose, fasting insulin, glycated hemoglobin) and outcomes (aortic dissection and aortic aneurysm) were obtained from public genome-wide association study data. The principal analysis was the inverse-variance weighted (IVW) method. Sensitivity analyses were also carried out, including weighted median, MR-Egger, and multivariable MR methods. According to IVW results, type 1 diabetes (odds ratio [OR]: 0.99; 95% confidence interval [CI] 0.93-1.07; P = 0.87), type 2 diabetes (OR: 0.97; 95% CI 0.77-1.20; P = 0.75), fasting glucose (OR: 1.16; 95% CI 0.48-2.84; P = 0.74), fasting insulin (OR: 2.75; 95% CI 0.53-14.26; P = 0.23), or glycated hemoglobin (OR: 0.33; 95% CI 0.09-1.17; P = 0.09) had no causal effect on aortic dissection. Similarly, type 1 diabetes, type 2 diabetes, fasting glucose, fasting insulin, or glycated hemoglobin had no causal effect on aortic aneurysm. Sensitivity analyses revealed consistent results. MR-Egger method and funnel plot yielded no indication of directional pleiotropy. Diabetes had no causal associations with aortic dissection or aortic aneurysm. The observed inverse associations in previous cohort studies may be explained by confounding factors or reverse causation.
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Affiliation(s)
- Tao Yang
- Department of Cardiovascular Surgery, Cardiovascular Institute and Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, No. 167 North Lishi Road, Xicheng District, Beijing, 100037, China
| | - Xin Yuan
- Department of Cardiovascular Surgery, Cardiovascular Institute and Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, No. 167 North Lishi Road, Xicheng District, Beijing, 100037, China
| | - Wei Gao
- Department of Cardiovascular Surgery, Cardiovascular Institute and Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, No. 167 North Lishi Road, Xicheng District, Beijing, 100037, China
| | - Meng-Jin Hu
- Department of Cardiovascular Surgery, Cardiovascular Institute and Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, No. 167 North Lishi Road, Xicheng District, Beijing, 100037, China
| | - Min-Jie Lu
- Department of Magnetic Resonance Imaging, Cardiovascular Institute and Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, No. 167 North Lishi Road, Xicheng District, Beijing, 100037, China.
| | - Han-Song Sun
- Department of Cardiovascular Surgery, Cardiovascular Institute and Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, No. 167 North Lishi Road, Xicheng District, Beijing, 100037, China.
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Crane A, Shanahan RM, Hudson JS, Nowicki KW, Gersey ZC, Agarwal P, Jacobs RC, Lang MJ, Gross B. Pharmaceutical Modulation of Intracranial Aneurysm Development and Rupture. J Clin Med 2024; 13:3324. [PMID: 38893035 PMCID: PMC11173282 DOI: 10.3390/jcm13113324] [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: 04/17/2024] [Revised: 05/23/2024] [Accepted: 05/31/2024] [Indexed: 06/21/2024] Open
Abstract
Management of intracranial aneurysms (IAs) is determined by patient age, risk of rupture, and comorbid conditions. While endovascular and microsurgical interventions offer solutions to mitigate the risk of rupture, pharmacological management strategies may complement these approaches or serve as alternatives in appropriate cases. The pathophysiology of IAs allows for the targeting of inflammation to prevent the development and rupture of IAs. The aim of this review is to provide an updated summary of different pharmaceutical management strategies for IAs. Acetylsalicylic acid and renin-angiotensin-aldosterone system (RAAS) inhibitor antihypertensives have some evidence supporting their protective effect. Studies of selective cyclooxygenase-2 (COX-2) inhibitors, statins, ADP inhibitors, and other metabolism-affecting drugs have demonstrated inconclusive findings regarding their association with aneurysm growth or rupture. In this manuscript, we highlight the evidence supporting each drug's effectiveness.
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Affiliation(s)
- Alex Crane
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA (Z.C.G.); (M.J.L.)
| | - Regan M. Shanahan
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA (Z.C.G.); (M.J.L.)
| | - Joseph S. Hudson
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA (Z.C.G.); (M.J.L.)
| | - Kamil W. Nowicki
- Department of Neurosurgery, Yale School of Medicine, New Haven, CT 06510, USA;
| | - Zachary C. Gersey
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA (Z.C.G.); (M.J.L.)
| | - Prateek Agarwal
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA (Z.C.G.); (M.J.L.)
| | - Rachel C. Jacobs
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA (Z.C.G.); (M.J.L.)
| | - Michael J. Lang
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA (Z.C.G.); (M.J.L.)
| | - Bradley Gross
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA (Z.C.G.); (M.J.L.)
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Akin MN, Kasap B, Pirincci F, Sezgin B, Ozdemir C, Demirtas Bilgic A, Aftabi Y, Gokdogan Edgunlu T. Changes of miR-139-5p, TGFB1, and COL1A1 in the placental tissue of cases with gestational diabetes mellitus. Gene 2024; 897:148061. [PMID: 38048967 DOI: 10.1016/j.gene.2023.148061] [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: 10/03/2023] [Revised: 11/06/2023] [Accepted: 12/01/2023] [Indexed: 12/06/2023]
Abstract
There are structural changes in the placenta of cases with Gestational Diabetes Mellitus (GDM). TGF-β and collagen pathways have crucial roles in tissue remodeling and TGF-β1 and COL1A1 are important genes in these signalling respectively. Also, lncRNA NEAT1, and miRNA hsa-miR-139-5p and hsa-miR-129-5p have regulatory effects on TGF-β1 and COL1A1. Here we aimed to assess their expressions in the placenta tissue of GDM cases. 30 patients with GDM and 30 healthy pregnant women participated in the study. Placental tissues taken during normal or cesarean delivery were used and total RNA was isolated from the tissues. mRNA levels were determined by qPCR and protein levels were determined by ELISA methods. An in silico analysis was done to elucidate the possible relation of TGF-β1 and COL1A1 gene networks with GDM. We determined that NEAT1 and miR-129-5p expression levels did not differ between GDM and healthy control groups (p = 0.697 and 0.412, respectively). But, miR-139-5p mRNA level, TGFB1 and COL1A1 protein levels significantly differ between the GDM and control groups (p = 0.000, p = 0.000 and p = 0.001, respectively). The in silico analysis revealed that TGFB1 and COL1A1 genes network may have important role in the GDM with their variety of members and regulatory molecules NEAT1, hsa-miR-139-5p, and hsa-miR-129-5p can control their functions. The expression of TGFB1, COL1A1 and miR-139-5p is changed in placenta tissue of GDM cases and many genes in the interacting networks of TGFB1 and COL1A1 could contribute to the pathogenicity of GDM.
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Affiliation(s)
- Melike Nur Akin
- Mugla Sitki Kocman University, Faculty of Medicine, Department of Gynaecology and Obstetrics, Mugla, Turkey
| | - Burcu Kasap
- Mugla Sitki Kocman University, Faculty of Medicine, Department of Gynaecology and Obstetrics, Mugla, Turkey
| | - Fatih Pirincci
- Mugla Sitki Kocman University, Faculty of Medicine, Department of Gynaecology and Obstetrics, Mugla, Turkey
| | - Burak Sezgin
- Mugla Sitki Kocman University, Faculty of Medicine, Department of Gynaecology and Obstetrics, Mugla, Turkey
| | - Cilem Ozdemir
- Muğla Sıtkı Koçman University, Health Sciences Institution, Department of Medical Biology, Mugla, Turkey
| | - Aysegul Demirtas Bilgic
- Muğla Sıtkı Koçman University, Health Sciences Institution, Department of Medical Biology, Mugla, Turkey
| | - Younes Aftabi
- Tabriz University of Medical Sciences, Tuberculosis and Lung Diseases Research Center, Tabriz, Iran
| | - Tuba Gokdogan Edgunlu
- Mugla Sitki Kocman University, Faculty of Medicine, Department of Medical Biology, Mugla, Turkey.
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Hua R, Gao H, He C, Xin S, Wang B, Zhang S, Gao L, Tao Q, Wu W, Sun F, Xu J. An emerging view on vascular fibrosis molecular mediators and relevant disorders: from bench to bed. Front Cardiovasc Med 2023; 10:1273502. [PMID: 38179503 PMCID: PMC10764515 DOI: 10.3389/fcvm.2023.1273502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 11/27/2023] [Indexed: 01/06/2024] Open
Abstract
Vascular fibrosis is a widespread pathologic condition that arises during vascular remodeling in cardiovascular dysfunctions. According to previous studies, vascular fibrosis is characterized by endothelial matrix deposition and vascular wall thickening. The RAAS and TGF-β/Smad signaling pathways have been frequently highlighted. It is, however, far from explicit in terms of understanding the cause and progression of vascular fibrosis. In this review, we collected and categorized a large number of molecules which influence the fibrosing process, in order to acquire a better understanding of vascular fibrosis, particularly of pathologic dysfunction. Furthermore, several mediators that prevent vascular fibrosis are discussed in depth in this review, with the aim that this will contribute to the future prevention and treatment of related conditions.
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Affiliation(s)
- Rongxuan Hua
- Department of Clinical Medicine, School of Basic Medical Sciences, Capital Medical University, Beijing, China
| | - Han Gao
- Department of Clinical Laboratory, Aerospace Center Hospital, Peking University, Beijing, China
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Capital Medical University, Beijing, China
| | - Chengwei He
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Capital Medical University, Beijing, China
| | - Shuzi Xin
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Capital Medical University, Beijing, China
| | - Boya Wang
- State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers, Beijing Key Laboratory of Carcinogenesis and Translational Research, Peking University Cancer Hospital & Institute, Beijing, China
| | - Sitian Zhang
- Department of Clinical Medicine, School of Basic Medical Sciences, Capital Medical University, Beijing, China
| | - Lei Gao
- Department of Biomedical Informatics, School of Biomedical Engineering, Capital Medical University, Beijing, China
| | - Qiang Tao
- Department of Biomedical Informatics, School of Biomedical Engineering, Capital Medical University, Beijing, China
| | - Wenqi Wu
- Experimental Center for Morphological Research Platform, Capital Medical University, Beijing, China
| | - Fangling Sun
- Department of Experimental Animal Laboratory, Xuan-Wu Hospital of Capital Medical University, Beijing, China
| | - Jingdong Xu
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Capital Medical University, Beijing, China
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Picatoste B, Cerro-Pardo I, Blanco-Colio LM, Martín-Ventura JL. Protection of diabetes in aortic abdominal aneurysm: Are antidiabetics the real effectors? Front Cardiovasc Med 2023; 10:1112430. [PMID: 37034348 PMCID: PMC10076877 DOI: 10.3389/fcvm.2023.1112430] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 03/06/2023] [Indexed: 04/11/2023] Open
Abstract
Aortic aneurysms, including abdominal aortic aneurysms (AAAs), is the second most prevalent aortic disease and represents an important cause of death worldwide. AAA is a permanent dilation of the aorta on its infrarenal portion, pathologically associated with oxidative stress, proteolysis, vascular smooth muscle cell loss, immune-inflammation, and extracellular matrix remodeling and degradation. Most epidemiological studies have shown a potential protective role of diabetes mellitus (DM) on the prevalence and incidence of AAA. The effect of DM on AAA might be explained mainly by two factors: hyperglycemia [or other DM-related factors such as insulin resistance (IR)] and/or by the effect of prescribed DM drugs, which may have a direct or indirect effect on the formation and progression of AAAs. However, recent studies further support that the protective role of DM in AAA may be attributable to antidiabetic therapies (i.e.: metformin or SGLT-2 inhibitors). This review summarizes current literature on the relationship between DM and the incidence, progression, and rupture of AAAs, and discusses the potential cellular and molecular pathways that may be involved in its vascular effects. Besides, we provide a summary of current antidiabetic therapies which use could be beneficial for AAA.
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Affiliation(s)
- Belén Picatoste
- Laboratory of Vascular Pathology, IIS-Fundación Jiménez Díaz, Madrid, Spain
- Biomedicine Department, Alfonso X El Sabio University, Madrid, Spain
- Correspondence: Belén Picatoste ,
| | - Isabel Cerro-Pardo
- Laboratory of Vascular Pathology, IIS-Fundación Jiménez Díaz, Madrid, Spain
| | - Luis M. Blanco-Colio
- Laboratory of Vascular Pathology, IIS-Fundación Jiménez Díaz, Madrid, Spain
- CIBERCV, Madrid, Spain
| | - Jose L. Martín-Ventura
- Laboratory of Vascular Pathology, IIS-Fundación Jiménez Díaz, Madrid, Spain
- CIBERCV, Madrid, Spain
- Medicine Department, Autonoma University of Madrid, Madrid, Spain
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Chen L, Wang S, Wang Z, Liu Y, Xu Y, Yang S, Xue G. Construction and analysis of competing endogenous RNA network and patterns of immune infiltration in abdominal aortic aneurysm. Front Cardiovasc Med 2022; 9:955838. [PMID: 35990982 PMCID: PMC9386163 DOI: 10.3389/fcvm.2022.955838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 07/12/2022] [Indexed: 11/29/2022] Open
Abstract
Background Various studies have highlighted the role of circular RNAs (circRNAs) as critical molecular regulators in cardiovascular diseases, but its role in abdominal aortic aneurysm (AAA) is unclear. This study explores the potential molecular mechanisms of AAA based on the circRNA-microRNA (miRNA)-mRNA competing endogenous RNA (ceRNA) network and immune cell infiltration patterns. Methods The expression profiles of circRNAs (GSE144431) and mRNAs (GSE57691 and GSE47472) were obtained from the Gene Expression Omnibus (GEO). Then, the differentially expressed circRNAs (DEcircRNAs) and mRNAs (DEmRNAs) between AAA patients and healthy control samples, and the target miRNAs of these DEmRNAs and DEcircRNAs were identified. Based on the miRNA-DEmRNAs and miRNA-DEcircRNAs pairs, the ceRNA network was constructed. Furthermore, the proportion of the 22 immune cell types in AAA patients was assessed using cell type identification by estimating relative subsets of RNA transcripts (CIBERSORT) algorithm. The expressions of key genes and immune cell infiltration were validated using clinical specimens. Results A total of 214 DEmRNAs were identified in the GSE57691 and GSE47472 datasets, and 517 DEcircRNAs were identified in the GSE144431 dataset. The ceRNA network included 19 circRNAs, 36 mRNAs, and 68 miRNAs. Two key genes, PPARG and FOXO1, were identified among the hub genes of the established protein-protein interaction between mRNAs in the ceRNA network. Moreover, seven types of immune cells were differentially expressed between AAA patients and healthy control samples. Hub genes in ceRNA, such as FOXO1, HSPA8, and RAB5C, positively correlated with resting CD4 memory T cells or M1 macrophages, or both. Conclusion In conclusion, a ceRNA interaction axis was constructed. The composition of infiltrating immune cells was analyzed in the abdominal aorta of AAA patients and healthy control samples. This may help identify potential therapeutic targets for AAA.
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Affiliation(s)
- Liang Chen
- Department of Vascular Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Shuangshuang Wang
- Songyuan Central Hospital, Songyuan Children's Hospital, Songyuan, China
| | - Zheyu Wang
- Department of Vascular Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Yuting Liu
- Department of Vascular Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Yi Xu
- Department of Vascular Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Shuofei Yang
- Department of Vascular Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
- *Correspondence: Shuofei Yang
| | - Guanhua Xue
- Department of Vascular Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
- Guanhua Xue
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Huang Z, Su H, Zhang T, Li Y. Double-edged sword of diabetes mellitus for abdominal aortic aneurysm. Front Endocrinol (Lausanne) 2022; 13:1095608. [PMID: 36589814 PMCID: PMC9800781 DOI: 10.3389/fendo.2022.1095608] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 12/05/2022] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Diabetes mellitus (DM) has been proved to contribute to multiple comorbidities that are risk factors for abdominal aortic aneurysm (AAA). Remarkably, evidences from epidemiologic studies have demonstrated a negative association between the two disease states. On the other hand, hyperglycemic state was linked to post-operative morbidities following AAA repair. This review aims to provide a thorough picture on the double-edged nature of DM and major hypoglycemic medications on prevalence, growth rate and rupture of AAA, as well as DM-associated prognosis post AAA repair. METHODS We performed a comprehensive search in electronic databases to look for literatures demonstrating the association between DM and AAA. The primary focus of the literature search was on the impact of DM on the morbidity, enlargement and rupture rate, as well as post-operative complications of AAA. The role of antidiabetic medications was also explored. RESULTS Retrospective epidemiological studies and large database researches associated the presence of DM with decreased prevalence, slower expansion and limited rupture rate of AAA. Major hypoglycemic drugs exert similar protective effect as DM against AAA by targeting pathological hallmarks involved in AAA formation and progression, which were demonstrated predominantly by animal studies. Nevertheless, presence of DM or postoperative hyperglycemia was linked to poorer short-term and long-term prognosis, primarily due to greater risk of infection, longer duration of hospital stays and death. CONCLUSION While DM is a positive factor in the formation and progression of AAA, it is also associated with higher risk of negative outcomes following AAA repair. Concomitant use of antidiabetic medications may contribute to the protective mechanism of DM in AAA, but further studies are still warranted to explore their role following AAA repair.
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Affiliation(s)
- Zijia Huang
- Department of Pharmacy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Huiling Su
- Department of Pharmacy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Tiejun Zhang
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- *Correspondence: Tiejun Zhang, ; Yuwen Li,
| | - Yuwen Li
- Department of Pharmacy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- *Correspondence: Tiejun Zhang, ; Yuwen Li,
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Arun D, Munir W, Schmitt LV, Vyas R, Ravindran JI, Bashir M, Williams IM, Velayudhan B, Idhrees M. Exploring the Correlation and Protective Role of Diabetes Mellitus in Aortic Aneurysm Disease. Front Cardiovasc Med 2021; 8:769343. [PMID: 34820431 PMCID: PMC8606667 DOI: 10.3389/fcvm.2021.769343] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 10/11/2021] [Indexed: 01/04/2023] Open
Abstract
Introduction: Diabetes mellitus is recognised as a significant risk factor for cardiovascular and peripheral vascular disease, as the abnormal metabolic state increases the risk for atherosclerosis, occlusive arterial disease and vascular dysfunction. There have been reports of potential association across the literature that illustrates a link between diabetes mellitus and aortic aneurysm, with the former having a protective role on the development of the latter. Methods: A thorough literature search was performed through electronic databases, to provide a comprehensive review of the study's reporting on the association of diabetes mellitus and aortic aneurysm, discussing the mechanisms that have been reported; furthemore, we reviewed the reports of the impact of oral hypoglycameic agents on aortic aneurysms. Results: Various proposed mechanisms are involved in this protective process including endothelial dysfunction, chronic hyperglycemia and insulin resistance. The evidence suggests a negative association between these disease process, with prevelance of diabetes mellitus resulting in lower rates of aortic aneurysm, via its protective mechanistic action. The increase in advanced glycation end products, increased arterial stiffness and vascular remodelling seen in diabetes, was found to have a profound impact on aneurysm development, its slow progression and lower rupture rate in these individuals. This review has also highlighted the role of oral hypoglycaemic agents having a protective effect against AA disease. Conclusion: A decrease in development, progression and mortality from aortic aneurysms as well as reduced rates of dissection, have been observed in those with diabetes. This review has provided a comprehensive insight on the effect of diabetes and its physiological processes, and elements of its con-committant treatment, having a protective role against these aortic diseases.
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Affiliation(s)
- Divyatha Arun
- Department of Endocrinology, Columbia Asia Referral Hospital, A Unit of Manipal Hospital, Yeshwanthpur, Bengaluru, India
| | - Wahaj Munir
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Lara Victoria Schmitt
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Rohan Vyas
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Jeuela Iris Ravindran
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Mohamad Bashir
- Institue of Cardiac and Aortic Disorders, SRM Institutes for Medical Science (SIMS Hospitals), Chennai, India
| | | | - Bashi Velayudhan
- Institue of Cardiac and Aortic Disorders, SRM Institutes for Medical Science (SIMS Hospitals), Chennai, India
| | - Mohammed Idhrees
- Institue of Cardiac and Aortic Disorders, SRM Institutes for Medical Science (SIMS Hospitals), Chennai, India
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Deleeuw V, De Clercq A, De Backer J, Sips P. An Overview of Investigational and Experimental Drug Treatment Strategies for Marfan Syndrome. J Exp Pharmacol 2021; 13:755-779. [PMID: 34408505 PMCID: PMC8366784 DOI: 10.2147/jep.s265271] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 07/19/2021] [Indexed: 12/26/2022] Open
Abstract
Marfan syndrome (MFS) is a heritable connective tissue disorder caused by pathogenic variants in the gene coding for the extracellular matrix protein fibrillin-1. While the disease affects multiple organ systems, the most life-threatening manifestations are aortic aneurysms leading to dissection and rupture. Other cardiovascular complications, including mitral valve prolapse, primary cardiomyopathy, and arrhythmia, also occur more frequently in patients with MFS. The standard medical care relies on cardiovascular imaging at regular intervals, along with pharmacological treatment with β-adrenergic receptor blockers aimed at reducing the aortic growth rate. When aortic dilatation reaches a threshold associated with increased risk of dissection, prophylactic surgical aortic replacement is performed. Although current clinical management has significantly improved the life expectancy of patients with MFS, no cure is available and fatal complications still occur, underscoring the need for new treatment options. In recent years, preclinical studies have identified a number of potentially promising therapeutic targets. Nevertheless, the translation of these results into clinical practice has remained challenging. In this review, we present an overview of the currently available knowledge regarding the underlying pathophysiological processes associated with MFS cardiovascular pathology. We then summarize the treatment options that have been developed based on this knowledge and are currently in different stages of preclinical or clinical development, provide a critical review of the limitations of current studies and highlight potential opportunities for future research.
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Affiliation(s)
- Violette Deleeuw
- Center for Medical Genetics, Department of Biomolecular Medicine, Ghent University, Ghent, 9000, Belgium
| | - Adelbert De Clercq
- Center for Medical Genetics, Department of Biomolecular Medicine, Ghent University, Ghent, 9000, Belgium
| | - Julie De Backer
- Center for Medical Genetics, Department of Biomolecular Medicine, Ghent University, Ghent, 9000, Belgium.,Department of Internal Medicine and Pediatrics, Ghent University Hospital, Ghent, 9000, Belgium
| | - Patrick Sips
- Center for Medical Genetics, Department of Biomolecular Medicine, Ghent University, Ghent, 9000, Belgium
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Zhang X, Kang YX, Kong W, Zhang YL, Ju T. Relationship between peroxisome proliferator-activated receptor-γ mRNA expression and intracranial aneurysm rupture. EUR J INFLAMM 2021. [DOI: 10.1177/20587392211028720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
It has been reported that the normal adults can suffer from an intracranial aneurysm (IA) that might present the risk of rupture and cause the subarachnoid hemorrhage. Peroxisome proliferator-activated receptor-γ (PPAR-γ) as a nuclear hormone receptor has been identified to involve in the progress of the formation and rupture of IAs. Quantitative reverse transcription polymerase chain reaction (qRT-PCR) was used to detect PPAR-γmRNA expression in the macrophages of the patients with IAs. The information including fasting blood glucose (FBG), interleukin-6 (IL-6), and systolic blood pressure (SBP) were collected. The aneurysm parameters of all the participants were obtained through the cerebral angiography. Establishing the receiver-operating characteristic curve (ROC curve) evaluated the clinical significances of PPAR-γmRNA for IAs rupture. In this study, we observed that the rupture of IAs was caused by the maximum height of aneurysm ⩾7 mm, the location of aneurysm in posterior communicating artery (PCOM) or anterior communicating artery (ACOM), and the increase of aneurysm size ratio (SR). The levels of SBP and IL-6 in the rupture group were higher than those in the unrupture group, and PPAR-γmRNA expression in the rupture group was also significantly reduced. In addition, heavy drinking was statistically significant between the ruptured and unruptured groups. There was no significant difference in serum FBG level between the two groups. The evidences of this study showed that PPAR-γmRNA was negatively correlated with SBP, SR, and IL-6 levels in rupture group, respectively. The AUC of PPAR-γmRNA in ROC curve was 0.867, indicating that the change of PPAR-γmRNA level had obvious effect on IAs rupture. The aim of this study was to evaluate the potential of PPAR-γ in macrophages to prevent IAs rupture.
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Affiliation(s)
- Xiong Zhang
- Department of Laboratory, The First People’s Hospital of Xianyang, Xianyang, Shaanxi, China
| | - Yan-Xun Kang
- Department of Medical Imaging, The First People’s Hospital of Xianyang, Xianyang, Shaanxi, China
| | - Wei Kong
- Department of Neurology, The First People’s Hospital of Xianyang, Xianyang, Shaanxi, China
| | - Ya-Lan Zhang
- Department of Laboratory, The First People’s Hospital of Xianyang, Xianyang, Shaanxi, China
| | - Tao Ju
- Department of Neurosurgery, Xianyang Hospital of Yan’an University, Xianyang, Shaanxi, China
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Weighted Gene Co-Expression Network Analysis Reveals Key Genes and Potential Drugs in Abdominal Aortic Aneurysm. Biomedicines 2021; 9:biomedicines9050546. [PMID: 34068179 PMCID: PMC8152975 DOI: 10.3390/biomedicines9050546] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 05/06/2021] [Accepted: 05/10/2021] [Indexed: 11/16/2022] Open
Abstract
Abdominal aortic aneurysm (AAA) is a prevalent aortic disease that causes high mortality due to asymptomatic gradual expansion and sudden rupture. The underlying molecular mechanisms and effective pharmaceutical therapy for preventing AAA progression have not been fully identified. In this study, we identified the key modules and hub genes involved in AAA growth from the GSE17901 dataset in the Gene Expression Omnibus (GEO) database through the weighted gene co-expression network analysis (WGCNA). Key genes were further selected and validated in the mouse dataset (GSE12591) and human datasets (GSE7084, GSE47472, and GSE57691). Finally, we predicted drug candidates targeting key genes using the Drug-Gene Interaction database. Overall, we identified key modules enriched in the mitotic cell cycle, GTPase activity, and several metabolic processes. Seven key genes (CCR5, ADCY5, ADCY3, ACACB, LPIN1, ACSL1, UCP3) related to AAA progression were identified. A total of 35 drugs/compounds targeting the key genes were predicted, which may have the potential to prevent AAA progression.
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12
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Que Y, Shu X, Wang L, Wang S, Li S, Hu P, Tong X. Inactivation of SERCA2 Cys 674 accelerates aortic aneurysms by suppressing PPARγ. Br J Pharmacol 2021; 178:2305-2323. [PMID: 33591571 DOI: 10.1111/bph.15411] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 12/24/2020] [Accepted: 02/04/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND AND PURPOSE Inactivation of Cys674 (C674) in the sarcoplasmic/endoplasmic reticulum Ca2+ ATPase 2 (SERCA2) causes intracellular Ca2+ accumulation, which activates calcineurin-mediated nuclear factor of activated T-lymphocytes (NFAT)/NF-κB pathways, and results in the phenotypic modulation of smooth muscle cells (SMCs) to accelerate angiotensin II-induced aortic aneurysms. Our goal was to investigate the mechanism involved. EXPERIMENTAL APPROACH We used heterozygous SERCA2 C674S knock-in (SKI) mice, where half of C674 was substituted by serine, to mimic partial irreversible oxidation of C674. The aortas of SKI mice and their littermate wild-type mice were collected for RNA sequencing, cell culture, protein expression, luciferase activity and aortic aneurysm analysis. KEY RESULTS Inactivation of C674 inhibited the promoter activity and protein expression of PPARγ, which could be reversed by inhibitors of calcineurin or NF-κB. In SKI SMCs, inhibition of NF-κB by pyrrolidinedithiocarbamic acid (PDTC) or overexpression of PPARγ2 reversed the protein expression of SMC phenotypic modulation markers and inhibited cell proliferation, migration, and macrophage adhesion to SMCs. Pioglitazone, a PPARγ agonist, blocked the activation of NFAT/NF-κB, reversed the protein expression of SMC phenotypic modulation markers, and inhibited cell proliferation, migration, and macrophage adhesion to SMCs in SKI SMCs. Furthermore, pioglitazone also ameliorated angiotensin II-induced aortic aneurysms in SKI mice. CONCLUSIONS AND IMPLICATIONS The inactivation of SERCA2 C674 promotes the development of aortic aneurysms by disrupting the balance between PPARγ and NFAT/NF-κB. Our study highlights the importance of C674 redox status in regulating PPARγ to maintain aortic homeostasis.
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Affiliation(s)
- Yumei Que
- Chongqing Key Laboratory of Natural Product Synthesis and Drug Research, School of Pharmaceutical Sciences, Chongqing University, Chongqing, China
| | - Xi Shu
- Chongqing Key Laboratory of Natural Product Synthesis and Drug Research, School of Pharmaceutical Sciences, Chongqing University, Chongqing, China
| | - Langtao Wang
- Chongqing Key Laboratory of Natural Product Synthesis and Drug Research, School of Pharmaceutical Sciences, Chongqing University, Chongqing, China
| | - Sai Wang
- Chongqing Key Laboratory of Natural Product Synthesis and Drug Research, School of Pharmaceutical Sciences, Chongqing University, Chongqing, China
| | - Siqi Li
- Chongqing Key Laboratory of Natural Product Synthesis and Drug Research, School of Pharmaceutical Sciences, Chongqing University, Chongqing, China
| | - Pingping Hu
- Chongqing Key Laboratory of Natural Product Synthesis and Drug Research, School of Pharmaceutical Sciences, Chongqing University, Chongqing, China
| | - Xiaoyong Tong
- Chongqing Key Laboratory of Natural Product Synthesis and Drug Research, School of Pharmaceutical Sciences, Chongqing University, Chongqing, China
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13
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Phie J, Thanigaimani S, Golledge J. Systematic Review and Meta-Analysis of Interventions to Slow Progression of Abdominal Aortic Aneurysm in Mouse Models. Arterioscler Thromb Vasc Biol 2021; 41:1504-1517. [PMID: 33567871 DOI: 10.1161/atvbaha.121.315942] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
[Figure: see text].
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Affiliation(s)
- James Phie
- Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry (J.P., S.T., J.G.), James Cook University, Townsville, Australia
| | - Shivshankar Thanigaimani
- Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry (J.P., S.T., J.G.), James Cook University, Townsville, Australia
| | - Jonathan Golledge
- Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry (J.P., S.T., J.G.), James Cook University, Townsville, Australia.,Australian Institute of Tropical Health and Medicine (J.G.), James Cook University, Townsville, Australia.,Department of Vascular and Endovascular Surgery, Townsville University Hospital, Queensland, Australia (J.G.)
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14
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van Dorst DCH, de Wagenaar NP, van der Pluijm I, Roos-Hesselink JW, Essers J, Danser AHJ. Transforming Growth Factor-β and the Renin-Angiotensin System in Syndromic Thoracic Aortic Aneurysms: Implications for Treatment. Cardiovasc Drugs Ther 2020; 35:1233-1252. [PMID: 33283255 PMCID: PMC8578102 DOI: 10.1007/s10557-020-07116-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/18/2020] [Indexed: 12/12/2022]
Abstract
Thoracic aortic aneurysms (TAAs) are permanent pathological dilatations of the thoracic aorta, which can lead to life-threatening complications, such as aortic dissection and rupture. TAAs frequently occur in a syndromic form in individuals with an underlying genetic predisposition, such as Marfan syndrome (MFS) and Loeys-Dietz syndrome (LDS). Increasing evidence supports an important role for transforming growth factor-β (TGF-β) and the renin-angiotensin system (RAS) in TAA pathology. Eventually, most patients with syndromic TAAs require surgical intervention, as the ability of present medical treatment to attenuate aneurysm growth is limited. Therefore, more effective medical treatment options are urgently needed. Numerous clinical trials investigated the therapeutic potential of angiotensin receptor blockers (ARBs) and β-blockers in patients suffering from syndromic TAAs. This review highlights the contribution of TGF-β signaling, RAS, and impaired mechanosensing abilities of aortic VSMCs in TAA formation. Furthermore, it critically discusses the most recent clinical evidence regarding the possible therapeutic benefit of ARBs and β-blockers in syndromic TAA patients and provides future research perspectives and therapeutic implications.
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Affiliation(s)
- Daan C H van Dorst
- Division of Vascular Medicine and Pharmacology, Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Nathalie P de Wagenaar
- Department of Molecular Genetics, Erasmus University Medical Center, Room Ee702b, Erasmus MC, Wytemaweg 80, 3015 CN, Rotterdam, The Netherlands.,Department of Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Ingrid van der Pluijm
- Department of Molecular Genetics, Erasmus University Medical Center, Room Ee702b, Erasmus MC, Wytemaweg 80, 3015 CN, Rotterdam, The Netherlands.,Department of Vascular Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Jolien W Roos-Hesselink
- Department of Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Jeroen Essers
- Department of Molecular Genetics, Erasmus University Medical Center, Room Ee702b, Erasmus MC, Wytemaweg 80, 3015 CN, Rotterdam, The Netherlands. .,Department of Vascular Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands. .,Department of Radiation Oncology, Erasmus University Medical Center, Rotterdam, The Netherlands.
| | - A H Jan Danser
- Division of Vascular Medicine and Pharmacology, Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
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15
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Golledge J, Pinchbeck J, Tomee SM, Rowbotham SE, Singh TP, Moxon JV, Jenkins JS, Lindeman JH, Dalman RL, McDonnell L, Fitridge R, Morris DR. Efficacy of Telmisartan to Slow Growth of Small Abdominal Aortic Aneurysms: A Randomized Clinical Trial. JAMA Cardiol 2020; 5:1374-1381. [PMID: 32845283 DOI: 10.1001/jamacardio.2020.3524] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Importance Currently there is no drug therapy for abdominal aortic aneurysm (AAA). Objective To test the efficacy of the angiotensin receptor blocker telmisartan in slowing AAA growth in the Telmisartan in the Management of Abdominal Aortic Aneurysm (TEDY) trial. Design, Setting, and Participants A randomized, double-blind, placebo-controlled trial recruited participants between September 6, 2011, and October 5, 2016, to evaluate the efficacy of telmisartan treatment in patients with AAA. Participants with 35- to 49-mm AAAs recruited from Australia, the Netherlands, and the US were randomized 1:1 to receive telmisartan, 40 mg, or identical placebo. Analyses were conducted according to intention-to-treat principles. Final follow-up was conducted on October 11, 2018, and data analysis was performed between June and November 2019. Intervention Telmisartan, 40 mg, or identical placebo. Main Outcomes and Measures The primary outcome of the difference in AAA growth, assessed on core imaging laboratory-read ultrasonographic scanning, was tested with linear mixed-effects models. Other outcomes included effects on blood pressure, computed tomographic (CT)-measured AAA diameter and volume, time to AAA-related events (AAA repair or mortality due to AAA rupture), and health-related quality of life. Results Of 300 intended participants, 210 were enrolled and randomized to receive telmisartan (n = 107) or placebo (n = 103). Of patients included in the intention-to-treat analysis (telmisartan: n = 106, placebo: n = 101), 183 were men (88%); mean (SD) age was 73.5 (7.9) years. At 1 year, participants receiving telmisartan had mean lower systolic (8.9; 95% CI, 4.1-13.8 mm Hg; P < .001) and diastolic (7.0; 4.3-9.8 mm Hg; P < .001) blood pressure levels compared with participants receiving placebo. A total of 188 participants (91%) received at least 2 ultrasonographic scans and 133 participants (64%) had at least 2 CT scans. There was no significant difference in ultrasonographic-assessed AAA growth rates among those assigned telmisartan (1.68 mm/y) or placebo (1.78 mm/y): mean difference, -0.11 mm/y (95% CI, -0.60 to 0.38 mm/y; P = .66). Telmisartan had no significant effects on AAA growth assessed by CT-measured AAA diameter (mean difference, -0.01 mm/y; 95% CI, -0.02 to 0.01 mm/y; P = .23) or volume (mean difference, -0.02 cm3/y; 95% CI, -0.04 to 0.00 cm3/y; P = .11), AAA-related events (relative risk, 1.35; 95% CI, 0.54-3.35; P = .52), or health-related quality of life (mean difference in physical component score at 24 months, 0.4; 95% CI, 0.4-0.4; P = .80). Hypotensive symptoms (eg, syncope) were twice as common among participants receiving telmisartan compared with placebo (28 [26%] vs 13 [13%]; P = .02), but overall adverse event rates were otherwise similar for both groups. Conclusions and Relevance This underpowered study did not show a treatment effect for telmisartan on small AAA growth. Future trials will need to ensure adequate sample size and duration of follow-up. Trial Registrations anzctr.org.au Identifier: ACTRN12611000931976; ClinicalTrials.gov Identifier: NCT01683084.
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Affiliation(s)
- Jonathan Golledge
- Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia.,Department of Surgery, Leiden University Medical Center, Leiden, the Netherlands.,The Department of Vascular and Endovascular Surgery, Townsville University Hospital, Townsville, Queensland, Australia
| | - Jenna Pinchbeck
- Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia
| | - Stephanie M Tomee
- Department of Surgery, Leiden University Medical Center, Leiden, the Netherlands
| | - Sophie E Rowbotham
- Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia
| | - Tejas P Singh
- Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia.,The Department of Vascular and Endovascular Surgery, Townsville University Hospital, Townsville, Queensland, Australia
| | - Joseph V Moxon
- Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia.,The Australian Institute of Tropical Health and Medicine, Townsville, Queensland, Australia
| | - Jason S Jenkins
- Department of Vascular Surgery, The Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Jan H Lindeman
- Department of Surgery, Leiden University Medical Center, Leiden, the Netherlands
| | - Ronald L Dalman
- Department of Surgery, Stanford University School of Medicine, Stanford, California.,Veterans Affairs Palo Alto Health Care System, Palo Alto, California
| | - Lori McDonnell
- Department of Surgery, Stanford University School of Medicine, Stanford, California.,Veterans Affairs Palo Alto Health Care System, Palo Alto, California
| | - Robert Fitridge
- Discipline of Surgery, The University of Adelaide, Adelaide, South Australia, Australia
| | - Dylan R Morris
- Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia.,The Department of Vascular and Endovascular Surgery, Townsville University Hospital, Townsville, Queensland, Australia
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16
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Budbazar E, Rodriguez F, Sanchez JM, Seta F. The Role of Sirtuin-1 in the Vasculature: Focus on Aortic Aneurysm. Front Physiol 2020; 11:1047. [PMID: 32982786 PMCID: PMC7477329 DOI: 10.3389/fphys.2020.01047] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 07/30/2020] [Indexed: 12/19/2022] Open
Abstract
Sirtuin-1 (SirT1) is a nicotinamide adenine dinucleotide-dependent deacetylase and the best characterized member of the sirtuins family in mammalians. Sirtuin-1 shuttles between the cytoplasm and the nucleus, where it deacetylates histones and non-histone proteins involved in a plethora of cellular processes, including survival, growth, metabolism, senescence, and stress resistance. In this brief review, we summarize the current knowledge on the anti-oxidant, anti-inflammatory, anti-apoptotic, and anti-senescence effects of SirT1 with an emphasis on vascular diseases. Specifically, we describe recent research advances on SirT1-mediated molecular mechanisms in aortic aneurysm (AA), and how these processes relate to oxidant stress and the heme-oxygenase (HO) system. HO-1 and HO-2 catalyze the rate-limiting step of cellular heme degradation and, similar to SirT1, HO-1 exerts beneficial effects in the vasculature through the activation of anti-oxidant, anti-inflammatory, anti-apoptotic, and anti-proliferative signaling pathways. SirT1 and HO-1 are part of an integrated system for cellular stress tolerance, and may positively interact to regulate vascular function. We further discuss sex differences in HO-1 and SirT1 activity or expression, and the potential interactions between the two proteins, in relation to the progression and severity of AA, as well as the ongoing efforts for translational applications of SirT1 activation and HO-1 induction in the treatment of cardiovascular diseases including AA.
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Affiliation(s)
- Enkhjargal Budbazar
- Vascular Biology Section, Boston University School of Medicine, Boston, MA, United States
| | - Francisca Rodriguez
- Department of Physiology, University of Murcia and Biomedical Research Institute in Murcia (IMIB), Murcia, Spain
| | - José M Sanchez
- Department of Physiology, University of Murcia and Biomedical Research Institute in Murcia (IMIB), Murcia, Spain
| | - Francesca Seta
- Vascular Biology Section, Boston University School of Medicine, Boston, MA, United States
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17
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Abstract
Abdominal aortic aneurysms (AAA) pose a considerable health burden and at present are only managed surgically since there is no proven pharmacotherapy that will retard their expansion or reduce the incidence of fatal rupture. This pathology shares several pathophysiological mechanisms with atherosclerosis, such as macrophage infiltration, inflammation, and degradation of extracellular matrix. Therefore, therapeutic targets proven effective in the treatment of atherosclerosis could also be considered for treatment of AAA. Different members of the nuclear receptor (NR) superfamily have been extensively studied as potential targets in the treatment of cardiovascular disease (CVD) and therefore might also be suited for AAA treatment. In this context, this review summarizes the role of different NRs in CVD, mostly atherosclerosis, and discusses in detail the current knowledge of their implications in AAA. From this overview it becomes apparent that NRs that were attributed a beneficial or adverse role in CVD have similar roles in AAA. Together, this overview provides compelling evidence to consider several NRs as attractive targets for future treatment of AAA.
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18
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Raffort J, Lareyre F, Clément M, Hassen-Khodja R, Chinetti G, Mallat Z. Diabetes and aortic aneurysm: current state of the art. Cardiovasc Res 2019; 114:1702-1713. [PMID: 30052821 PMCID: PMC6198737 DOI: 10.1093/cvr/cvy174] [Citation(s) in RCA: 95] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 07/19/2018] [Indexed: 12/17/2022] Open
Abstract
Aortic aneurysm is a life-threatening disease due to the risk of aortic rupture. The only curative treatment available relies on surgical approaches; drug-based therapies are lacking, highlighting an unmet need for clinical practice. Abdominal aortic aneurysm (AAA) is frequently associated with atherosclerosis and cardiovascular risk factors including male sex, age, smoking, hypertension, and dyslipidaemia. Thoracic aortic aneurysm (TAA) is more often linked to genetic disorders of the extracellular matrix and the contractile apparatus but also share similar cardiovascular risk factors. Intriguingly, a large body of evidence points to an inverse association between diabetes and both AAA and TAA. A better understanding of the mechanisms underlying the negative association between diabetes and aortic aneurysm could help the development of innovative diagnostic and therapeutic approaches to tackle the disease. Here, we summarize current knowledge on the relationship between glycaemic parameters, diabetes, and the development of aortic aneurysm. Cellular and molecular pathways that underlie the protective effect of diabetes itself and its treatment are reviewed and discussed, along with their potential implications for clinical translation.
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Affiliation(s)
- Juliette Raffort
- Division of Cardiovascular Medicine, Department of Medicine, University of Cambridge, Cambridge, Robinson Way, UK.,Institut National de la Santé et de la Recherche Médicale (Inserm), Unit 970, Paris Cardiovascular Research Center, Team 5, Hôpital Européen Georges Pompidou, 56 rue Leblanc, Paris, France.,Department of Clinical Biochemistry, University Hospital of Nice, 30 avenue de la Voie Romaine, Nice Cedex 1, France.,Université Côte d'Azur, CHU, Inserm U1065, C3M, 151 Route de Ginestière, Nice Cedex 3, France
| | - Fabien Lareyre
- Division of Cardiovascular Medicine, Department of Medicine, University of Cambridge, Cambridge, Robinson Way, UK.,Université Côte d'Azur, CHU, Inserm U1065, C3M, 151 Route de Ginestière, Nice Cedex 3, France.,Department of Vascular Surgery, University Hospital of Nice, 30 avenue de la Voie Romaine, Nice Cedex 1, France
| | - Marc Clément
- Division of Cardiovascular Medicine, Department of Medicine, University of Cambridge, Cambridge, Robinson Way, UK
| | - Réda Hassen-Khodja
- Université Côte d'Azur, CHU, Inserm U1065, C3M, 151 Route de Ginestière, Nice Cedex 3, France.,Department of Vascular Surgery, University Hospital of Nice, 30 avenue de la Voie Romaine, Nice Cedex 1, France
| | - Giulia Chinetti
- Department of Clinical Biochemistry, University Hospital of Nice, 30 avenue de la Voie Romaine, Nice Cedex 1, France.,Université Côte d'Azur, CHU, Inserm U1065, C3M, 151 Route de Ginestière, Nice Cedex 3, France
| | - Ziad Mallat
- Division of Cardiovascular Medicine, Department of Medicine, University of Cambridge, Cambridge, Robinson Way, UK.,Institut National de la Santé et de la Recherche Médicale (Inserm), Unit 970, Paris Cardiovascular Research Center, Team 5, Hôpital Européen Georges Pompidou, 56 rue Leblanc, Paris, France
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19
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Lareyre F, Hassen-Khodja R, Raffort J. Translational applications of glucose metabolism in abdominal aortic aneurysm. J Vasc Surg 2019; 70:2093-2097. [PMID: 31147135 DOI: 10.1016/j.jvs.2019.03.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 03/07/2019] [Indexed: 12/30/2022]
Abstract
Even though diabetes mellitus is a major risk for cardiovascular events and atherosclerosis-related diseases, it is negatively associated with abdominal aortic aneurysm. The understanding of the mechanisms underlying this negative association could bring new insights to identify prognostic and therapeutic targets. Here we summarize current knowledge of the relationship between glycemic parameters and clinical outcomes of patients with abdominal aortic aneurysm. Translational applications of glucose-targeted approaches as well as their potential interest for clinical practice are discussed in this context.
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Affiliation(s)
- Fabien Lareyre
- Department of Vascular Surgery, University Hospital of Nice, Nice, France; Université Côte d'Azur, CHU, Inserm, C3M, Nice, France.
| | - Réda Hassen-Khodja
- Department of Vascular Surgery, University Hospital of Nice, Nice, France; Université Côte d'Azur, CHU, Inserm, C3M, Nice, France
| | - Juliette Raffort
- Université Côte d'Azur, CHU, Inserm, C3M, Nice, France; Clinical Chemistry Laboratory, University Hospital of Nice, Nice, France
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20
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Sima C, Viniegra A, Glogauer M. Macrophage immunomodulation in chronic osteolytic diseases-the case of periodontitis. J Leukoc Biol 2019; 105:473-487. [PMID: 30452781 PMCID: PMC6386606 DOI: 10.1002/jlb.1ru0818-310r] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 10/26/2018] [Accepted: 10/29/2018] [Indexed: 12/12/2022] Open
Abstract
Periodontitis (PD) is a chronic osteolytic disease that shares pathogenic inflammatory features with other conditions associated with nonresolving inflammation. A hallmark of PD is inflammation-mediated alveolar bone loss. Myeloid cells, in particular polymorphonuclear neutrophils (PMN) and macrophages (Mac), are essential players in PD by control of gingival biofilm pathogenicity, activation of adaptive immunity, as well as nonresolving inflammation and collateral tissue damage. Despite mounting evidence of significant innate immune implications to PD progression and healing after therapy, myeloid cell markers and targets for immune modulation have not been validated for clinical use. The remarkable plasticity of monocytes/Mac in response to local activation factors enables these cells to play central roles in inflammation and restoration of tissue homeostasis and provides opportunities for biomarker and therapeutic target discovery for management of chronic inflammatory conditions, including osteolytic diseases such as PD and arthritis. Along a wide spectrum of activation states ranging from proinflammatory to pro-resolving, Macs respond to environmental changes in a site-specific manner in virtually all tissues. This review summarizes the existing evidence on Mac immunomodulation therapies for osteolytic diseases in the broader context of conditions associated with nonresolving inflammation, and discusses osteoimmune implications of Macs in PD.
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Affiliation(s)
- Corneliu Sima
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Ana Viniegra
- Dental Research Institute, Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
| | - Michael Glogauer
- Dental Research Institute, Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
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21
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Aune D, Schlesinger S, Norat T, Riboli E. Diabetes mellitus and the risk of abdominal aortic aneurysm: A systematic review and meta-analysis of prospective studies. J Diabetes Complications 2018; 32:1169-1174. [PMID: 30415876 DOI: 10.1016/j.jdiacomp.2018.09.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 08/17/2018] [Accepted: 09/09/2018] [Indexed: 01/17/2023]
Abstract
BACKGROUND Diabetes mellitus has been associated with reduced risk of abdominal aortic aneurysm in a number of epidemiological studies, however, until recently little data from prospective studies have been available. We therefore conducted a systematic review and meta-analysis of prospective studies to quantify the association. MATERIAL AND METHODS Two investigators searched the PubMed and Embase databases for studies of diabetes and abdominal aortic aneurysm up to May 8th 2018. Prospective studies were included if they reported adjusted relative risk (RR) estimates and 95% confidence intervals (95% CIs) of abdominal aortic aneurysm associated with a diabetes diagnosis. Summary relative risks were estimated by use of a random effects model. RESULTS We identified 16 prospective studies with 16,572 cases among 4,563,415 participants that could be included in the meta-analysis. The summary RR for individuals with diabetes compared to individuals without diabetes was 0.58 (95% CI: 0.51-0.66, I2 = 40.4%, pheterogeneity = 0.06). The results persisted when stratified by sex, duration of follow-up, and in most of the other subgroup analyses. There was no evidence of publication bias with Egger's test, p = 0.64 or by inspection of the funnel plots. CONCLUSIONS These results suggest that individuals with diabetes mellitus are at a reduced risk of abdominal aortic aneurysm, however, whether pharmacological agents for diabetes mellitus explain this observation needs to be clarified in future studies.
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Affiliation(s)
- Dagfinn Aune
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom; Department of Nutrition, Bjørknes University College, Oslo, Norway; Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway.
| | - Sabrina Schlesinger
- Institute for Biometry and Epidemiology, German Diabetes Center, Leibniz Institute for Diabetes Research at the Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Teresa Norat
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
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22
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Patel K, Zafar M, Ziganshin B, Elefteriades J. Diabetes Mellitus: Is It Protective against Aneurysm? A Narrative Review. Cardiology 2018; 141:107-122. [DOI: 10.1159/000490373] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 05/24/2018] [Indexed: 11/19/2022]
Abstract
Objectives: In the course of extensive clinical aortic surgery, we noticed that the aorta was quite thick and fibrotic in diabetic patients. We thought the diabetic aortic aorta might be inimitable to aortic dissection. On this basis, we set out to review information in the literature regarding aortic growth and dissection in diabetic patients. Methods: We used a 2-step search approach to the available literature on diabetes and aneurysm. Firstly, databases including PubMed, Cochrane, Embase and TRIP were searched. Secondly, relevant studies were identified through secondary sources including references of initially selected articles. We address the relationship between diabetes and the incidence, prevalence, growth, mortality and rupture of an aneurysm. Results: Diabetes is thought to exert a protective role in both thoracic aortic aneurysm (TAA) and abdominal aortic aneurysm (AAA). Diabetics were shown to have a slower aneurysm growth rate, lower rupture rate, delayed (> 65 years) age of rupture, decreased rate of mortality from an aneurysm and a decreased length of hospital stay. There was also noted a decreased rate of incidence and prevalence of TAA and AAA in diabetics, smaller aneurysm diameter, reduction in matrix metalloproteinases and an increased aortic wall stress in diabetics. Antidiabetic agents like metformin, thiazolidinediones and dipeptidyl peptidase-4 inhibitors may protect against an aneurysm. Conclusion: Our literature review provides strong (but often circumstantial) evidence that diabetic patients exhibit slower growth of aortic aneurysms and a lower rate of aortic dissection. Furthermore, clinical and experimental studies indicate that common antidiabetic medications on their own inhibit growth of aortic aneurysms. These findings indicate a paradoxically beneficial effect of the otherwise highly detrimental diabetic state.
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Dattani N, Sayers RD, Bown MJ. Diabetes mellitus and abdominal aortic aneurysms: A review of the mechanisms underlying the negative relationship. Diab Vasc Dis Res 2018; 15:367-374. [PMID: 29874945 DOI: 10.1177/1479164118780799] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION Diabetes mellitus appears to be negatively associated with abdominal aortic aneurysm; however, the mechanisms underlying this relationship remain poorly understood. The aim of this article is to provide a comprehensive review of the currently understood biological pathways underlying this relationship. METHODS A review of the literature ('diabetes' OR 'hyperglycaemia' AND 'aneurysm') was performed and relevant studies grouped into biological pathways. RESULTS This review identified a number of biological pathways through which diabetes mellitus may limit the presence, growth and rupture of abdominal aortic aneurysms. These include those influencing extracellular matrix volume, extracellular matrix glycation, the formation of advanced glycation end-products, inflammation, oxidative stress and intraluminal thrombus biology. In addition, there is an increasing evidence to suggest that the medications used to treat diabetes can also limit the development and progression of abdominal aortic aneurysms. CONCLUSION The negative association between diabetes and abdominal aortic aneurysm is robust. Future studies should attempt to target the pathways identified in this review to develop novel therapeutic agents aimed at slowing or even halting aneurysm progression.
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Affiliation(s)
- Nikesh Dattani
- Department of Cardiovascular Sciences, NIHR Leicester Cardiovascular Biomedical Research Unit and British Heart Foundation Cardiovascular Research Centre, University of Leicester, Leicester, UK
| | - Robert D Sayers
- Department of Cardiovascular Sciences, NIHR Leicester Cardiovascular Biomedical Research Unit and British Heart Foundation Cardiovascular Research Centre, University of Leicester, Leicester, UK
| | - Matthew J Bown
- Department of Cardiovascular Sciences, NIHR Leicester Cardiovascular Biomedical Research Unit and British Heart Foundation Cardiovascular Research Centre, University of Leicester, Leicester, UK
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24
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Wang WD, Sun R, Chen YX. PPARγ agonist rosiglitazone alters the temporal and spatial distribution of inflammation during abdominal aortic aneurysm formation. Mol Med Rep 2018; 18:3421-3428. [PMID: 30066924 DOI: 10.3892/mmr.2018.9311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 06/19/2018] [Indexed: 11/06/2022] Open
Abstract
Research into inflammation during abdominal aortic aneurysm (AAA) formation remains inconclusive. The present study aimed to demonstrate the temporal and spatial distribution of inflammatory cytokines, and to confirm the effect of peroxisome proliferator‑activated receptor γ (PPARγ) on the incidence of AAA formation and the distribution of inflammation in the disease process. Male apolipoprotein E‑/‑ mice were randomly divided into eight groups: Angiotensin II (Ang‑II)‑only 7, 14, 21, 28 and 42 days groups, Ang‑II with rosiglitazone (RGZ) 28 and 42 days groups, and the saline control 42 days group. The early stage was defined as between 7 and 21 days, and the late stage as between 28 and 42 days. Incidences of early rupture and late rupture, aneurysm formation and the maximum diameters of the aorta were recorded. Suprarenal abdominal aortic tissues were collected for histological analysis, and western blotting was performed to reveal the distribution of inflammation. Treatment with Ang‑II caused a significant dilation of the aorta in the late stage; however, this was not observed in the early stage. RGZ reduced the maximum diameters in the late stage. With the pathological process alterations, the inflammatory type shifted. Regarding temporal distribution, the tumor necrosis factor (TNF)‑α expression level was increased over time, and the interleukin (IL)‑10 expression level significantly decreased. When considering the spatial distribution, TNF‑α was expressed dominantly in the aneurysmal body and IL‑10 was dominant in the aneurysmal neck in the late stage. The PPARγ agonist RGZ may reduce the expression of TNF‑α in the late stage and increase the expression level of IL‑10, maintaining the TNF‑α or IL‑10 expression levels at the same levels as in the early stage. Aortic inflammation during AAA formation is dynamic. Protective anti‑inflammatory cytokines are upregulated in the early 'compensatory stage'; however, pro‑inflammatory cytokines are dominant in the late 'decompensatory stage'. PPARγ is likely to continue to upregulate the expression of anti‑inflammatory cytokines, extend the 'compensatory stage', and decelerate the process of AAA development and rupture.
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Affiliation(s)
- Wen-Da Wang
- Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, P.R. China
| | - Rui Sun
- Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, P.R. China
| | - Yue-Xin Chen
- Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, P.R. China
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25
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La diabetes mellitus como factor protector del aneurisma de aorta abdominal: posibles mecanismos. CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS 2018; 30:181-187. [DOI: 10.1016/j.arteri.2018.01.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 01/18/2018] [Indexed: 11/22/2022]
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26
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Liu L, Meng L, Zhang P, Lin H, Chi J, Peng F, Guo H. Angiotensin II inhibits the protein expression of ZO‑1 in vascular endothelial cells by downregulating VE‑cadherin. Mol Med Rep 2018; 18:429-434. [PMID: 29749551 DOI: 10.3892/mmr.2018.8991] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 04/03/2018] [Indexed: 11/06/2022] Open
Abstract
Angiotensin II (Ang II) is reported to be involved in the development of various cardiovascular diseases by disrupting microvessel permeability, however, the underlying mechanism remains to be elucidated. The present study aimed to investigate the mechanism by which Ang II disrupts microvascular permeability. Rat endothelial cells were subjected to primary culture and identification. Cells in passages 4‑7 were then used for the following experiments. The cells were divided into control, Ang II, and Ang II + valsartan groups, and reverse transcription‑quantitative polymerase chain reaction and western blot analyses were perform to evaluate the expression of zonula occludens‑1 (ZO‑1) and vascular endothelial (VE)‑cadherin in the cells. The distribution of ZO‑1 protein was also detected using immunofluorescence assays. It was found that, compared with the control group, lower expression levels of ZO‑1 and VE‑cadherin were present in the Ang II group (P<0.01). ZO‑1 was also irregularly distributed at the periphery of the cells. In addition, the overexpression of VE‑cadherin reversed the effect of Ang II on the expression and distribution of ZO‑1 in endothelial cells. Together, these results suggested that Ang II inhibited the protein expression of ZO‑1 in vascular endothelial cells by downregulating VE‑cadherin, thus destroying the tight junctions between endothelial cells, which may also be the mechanism by which Ang II is involved in the development of cardiovascular diseases.
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Affiliation(s)
- Longbin Liu
- Department of Cardiology, Shaoxing Municipal Hospital, Shaoxing, Zhejiang 312000, P.R. China
| | - Liping Meng
- Department of Cardiology, Shaoxing People's Hospital, Shaoxing Hospital of Zhejiang University, Shaoxing, Zhejiang 312000, P.R. China
| | - Peng Zhang
- Department of Cardiology, Shaoxing People's Hospital, Shaoxing Hospital of Zhejiang University, Shaoxing, Zhejiang 312000, P.R. China
| | - Hui Lin
- Department of Cardiology, Shaoxing People's Hospital, Shaoxing Hospital of Zhejiang University, Shaoxing, Zhejiang 312000, P.R. China
| | - Jufang Chi
- Department of Cardiology, Shaoxing People's Hospital, Shaoxing Hospital of Zhejiang University, Shaoxing, Zhejiang 312000, P.R. China
| | - Fang Peng
- Department of Cardiology, Shaoxing People's Hospital, Shaoxing Hospital of Zhejiang University, Shaoxing, Zhejiang 312000, P.R. China
| | - Hangyuan Guo
- Department of Cardiology, Shaoxing Municipal Hospital, Shaoxing, Zhejiang 312000, P.R. China
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27
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MacFarlane EG, Haupt J, Dietz HC, Shore EM. TGF-β Family Signaling in Connective Tissue and Skeletal Diseases. Cold Spring Harb Perspect Biol 2017; 9:cshperspect.a022269. [PMID: 28246187 DOI: 10.1101/cshperspect.a022269] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The transforming growth factor β (TGF-β) family of signaling molecules, which includes TGF-βs, activins, inhibins, and numerous bone morphogenetic proteins (BMPs) and growth and differentiation factors (GDFs), has important functions in all cells and tissues, including soft connective tissues and the skeleton. Specific TGF-β family members play different roles in these tissues, and their activities are often balanced with those of other TGF-β family members and by interactions with other signaling pathways. Perturbations in TGF-β family pathways are associated with numerous human diseases with prominent involvement of the skeletal and cardiovascular systems. This review focuses on the role of this family of signaling molecules in the pathologies of connective tissues that manifest in rare genetic syndromes (e.g., syndromic presentations of thoracic aortic aneurysm), as well as in more common disorders (e.g., osteoarthritis and osteoporosis). Many of these diseases are caused by or result in pathological alterations of the complex relationship between the TGF-β family of signaling mediators and the extracellular matrix in connective tissues.
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Affiliation(s)
- Elena Gallo MacFarlane
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205
| | - Julia Haupt
- Department of Orthopedic Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania 19104.,Center for Research in FOP and Related Disorders, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania 19104
| | - Harry C Dietz
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205.,Howard Hughes Medical Institute, Bethesda, Maryland 21205
| | - Eileen M Shore
- Department of Orthopedic Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania 19104.,Center for Research in FOP and Related Disorders, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania 19104.,Department of Genetics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania 19104
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28
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Meng X, Zhang K, Kong J, Xu L, An G, Qin W, Li J, Zhang Y. Deletion of resistin-like molecule-beta attenuates angiotensin II-induced abdominal aortic aneurysm. Oncotarget 2017; 8:104171-104181. [PMID: 29262630 PMCID: PMC5732796 DOI: 10.18632/oncotarget.22042] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 10/03/2017] [Indexed: 11/25/2022] Open
Abstract
In the present study, we want to test whether deletion of resistin-like molecule-beta (RELMβ) attenuates angiotensin II (Ang II)-induced formation of abdominal aortic aneurysm (AAA). RELMβ gene expression was inhibited by siRNA both in vivo and in vitro. Apolipoprotein E-knockout (ApoE−/−) mice were randomly divided into saline, Ang II, siRNA negative control (si-NC) and siRNA RELMβ (si-RELMβ) groups (n=15 each), and mice in the last three groups underwent Ang II infusion for 4 weeks to induce AAA. RELMβ gene deficiency significantly decreased AAA incidence and severity, which was associated with reduced macrophage accumulation and decreased expression of proinflammatory cytokines (monocyte chemoattractant protein 1 and interleukin 6), matrix metalloproteinase 2 (MMP-2) and MMP-9 in the aortic wall. In cultured macrophages, RELMβ deficiency blunted the response of macrophages to Ang II and downregulated the levels of proinflammatory cytokines, MMP-2 and MMP-9. Recombinant RELMβ promoted the secretion of proinflammatory cytokines, MMP-2 and MMP-9 in macrophages and activated extracellular signal-regulated kinase 1/2 (ERK1/2) and c-Jun N-terminal kinase (JNK) signaling, which was reversed with pretreatment with inhibitors of ERK1/2 and JNK. Deletion of RELMβ attenuated Ang II-induced AAA formation in ApoE−/− mice. The inherent mechanism may involve the reduced expression of proinflammatory cytokines, MMP-2 and MMP-9, which was mediated by ERK1/2 and JNK activation. Therefore, inhibiting RELMβ secretion may be a novel approach for anti-aneurysm treatment.
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Affiliation(s)
- Xiao Meng
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health, Qilu Hospital, Shandong University, Jinan, 250012, China
| | - Kai Zhang
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health, Qilu Hospital, Shandong University, Jinan, 250012, China
| | - Jing Kong
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health, Qilu Hospital, Shandong University, Jinan, 250012, China
| | - Long Xu
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health, Qilu Hospital, Shandong University, Jinan, 250012, China
| | - Guipeng An
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health, Qilu Hospital, Shandong University, Jinan, 250012, China
| | - Weidong Qin
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health, Qilu Hospital, Shandong University, Jinan, 250012, China
| | - Jifu Li
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health, Qilu Hospital, Shandong University, Jinan, 250012, China
| | - Yun Zhang
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health, Qilu Hospital, Shandong University, Jinan, 250012, China
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29
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Hinchliffe RJ. Metformin and Abdominal Aortic Aneurysm. Eur J Vasc Endovasc Surg 2017; 54:679-680. [PMID: 28988609 DOI: 10.1016/j.ejvs.2017.08.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 08/17/2017] [Indexed: 11/24/2022]
Affiliation(s)
- Robert J Hinchliffe
- Bristol Centre for Surgical Research, Bristol NIHR Biomedical Research Centre, University of Bristol, Bristol, UK.
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30
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Doderer SA, Gäbel G, Kokje VBC, Northoff BH, Holdt LM, Hamming JF, Lindeman JHN. Adventitial adipogenic degeneration is an unidentified contributor to aortic wall weakening in the abdominal aortic aneurysm. J Vasc Surg 2017; 67:1891-1900.e4. [PMID: 28912007 DOI: 10.1016/j.jvs.2017.05.088] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 05/01/2017] [Indexed: 02/09/2023]
Abstract
OBJECTIVE The processes driving human abdominal aortic aneurysm (AAA) progression are not fully understood. Although antiinflammatory and proteolytic strategies effectively quench aneurysm progression in preclinical models, so far all clinical interventions failed. These observations hint at an incomplete understanding of the processes involved in AAA progression and rupture. Interestingly, strong clinical and molecular associations exist between popliteal artery aneurysms (PAAs) and AAAs; however, PAAs have an extremely low propensity to rupture. We thus reasoned that differences between these aneurysms may provide clues toward (auxiliary) processes involved in AAA-related wall debilitation. A better understanding of the pathophysiologic processes driving AAA growth can contribute to pharmaceutical treatments in the future. METHODS Aneurysmal wall samples were collected during open elective and emergency repair. Control perirenal aorta was obtained during kidney transplantation, and reference popliteal tissue obtained from the anatomy department. This study incorporates various techniques including (immuno)histochemistry, Western Blot, quantitative polymerase chain reaction, microarray, and cell culture. RESULTS Histologic evaluation of AAAs, PAAs, and control aorta shows extensive medial (PAA) and transmural fibrosis (AAA), and reveals abundant adventitial adipocytes aggregates as an exclusive phenomenon of AAAs (P < .001). Quantitative polymerase chain reaction, immunohistochemistry, Western blotting, and microarray analysis showed enrichment of adipogenic mediators (C/EBP family P = .027; KLF5 P < .000; and peroxisome proliferator activated receptor-γ, P = .032) in AAA tissue. In vitro differentiation tests indicated a sharply increased adipogenic potential of AAA adventitial mesenchymal cells (P < .0001). Observed enrichment of adipocyte-related genes and pathways in ruptured AAA (P < .0003) supports an association between the extent of fatty degeneration and rupture. CONCLUSIONS This translational study identifies extensive adventitial fatty degeneration as an ignored and distinctive feature of AAA disease. Enrichment of adipocyte genesis and adipocyte-related genes in ruptured AAA point to an association between the extent of fatty degeneration and rupture. This observation may (partly) explain the failure of medical therapy and could provide a lead for pharmaceutical alleviation of AAA progression.
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Affiliation(s)
- Stefan A Doderer
- Department of Vascular Surgery, Leiden University Medical Center (LUMC), Leiden, The Netherlands
| | - Gabor Gäbel
- Department of Vascular and Endovascular Surgery, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Vivianne B C Kokje
- Department of Vascular Surgery, Leiden University Medical Center (LUMC), Leiden, The Netherlands
| | - Bernd H Northoff
- Institute of Laboratory Medicine, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Lesca M Holdt
- Institute of Laboratory Medicine, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Jaap F Hamming
- Department of Vascular Surgery, Leiden University Medical Center (LUMC), Leiden, The Netherlands
| | - Jan H N Lindeman
- Department of Vascular Surgery, Leiden University Medical Center (LUMC), Leiden, The Netherlands.
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31
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Golledge J, Moxon J, Pinchbeck J, Anderson G, Rowbotham S, Jenkins J, Bourke M, Bourke B, Dear A, Buckenham T, Jones R, Norman PE. Association between metformin prescription and growth rates of abdominal aortic aneurysms. Br J Surg 2017. [DOI: 10.1002/bjs.10587] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Abstract
Background
It has been suggested that diabetes medications, such as metformin, may have effects that inhibit abdominal aortic aneurysm (AAA) growth. The aim of this study was to examine the association of diabetes treatments with AAA growth in three patient cohorts.
Methods
AAA growth was studied using ultrasound surveillance in cohort 1, repeated CT in cohort 2 and more detailed repeat CT in cohort 3. Growth was estimated by the mean annual increase in maximum AAA diameter.
Results
A total of 1697 patients with an AAA were studied, of whom 118, 39 and 16 patients were prescribed metformin for the treatment of diabetes in cohorts 1, 2 and 3 respectively. Prescription of metformin was associated with a reduced likelihood of median or greater AAA growth in all three cohorts (cohort 1: adjusted odds ratio (OR) 0·59, 95 per cent c.i. 0·39 to 0·87, P = 0·008; cohort 2: adjusted OR 0·38, 0·18 to 0·80, P = 0·011; cohort 3: adjusted OR 0·13, 0·03 to 0·61, P = 0·010). No other diabetes treatment was significantly associated with AAA growth in any cohort.
Conclusion
These findings suggest a potential role for metformin in limiting AAA growth.
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Affiliation(s)
- J Golledge
- Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia
- Department of Vascular and Endovascular Surgery, Townsville Hospital, Townsville, Queensland, Australia
| | - J Moxon
- Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia
| | - J Pinchbeck
- Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia
| | - G Anderson
- Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia
| | - S Rowbotham
- Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia
- School of Medicine, University of Queensland, Brisbane, Queensland, Australia
- Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - J Jenkins
- Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - M Bourke
- Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia
- Gosford Vascular Clinic, Gosford, New South Wales, Australia
| | - B Bourke
- Gosford Vascular Clinic, Gosford, New South Wales, Australia
| | - A Dear
- Eastern Health Clinical School, Monash University and Department of Medicine, Box Hill Hospital, Melbourne, Victoria, Australia
| | - T Buckenham
- Christchurch School of Medicine and Health Sciences, Otago University, Christchurch, New Zealand
| | - R Jones
- Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia
| | - P E Norman
- School of Surgery, University of Western Australia, Fremantle Hospital, Fremantle, Western Australia, Australia
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32
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Xuan H, Xu B, Wang W, Tanaka H, Fujimura N, Miyata M, Michie SA, Dalman RL. Inhibition or deletion of angiotensin II type 1 receptor suppresses elastase-induced experimental abdominal aortic aneurysms. J Vasc Surg 2017; 67:573-584.e2. [PMID: 28434702 DOI: 10.1016/j.jvs.2016.12.110] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Accepted: 12/15/2016] [Indexed: 01/30/2023]
Abstract
OBJECTIVE Angiotensin (Ang) II type 1 receptor (AT1) activation is essential for the development of exogenous Ang II-induced abdominal aortic aneurysms (AAAs) in hyperlipidemic animals. Experimental data derived from this modeling system, however, provide limited insight into the role of endogenous Ang II in aneurysm pathogenesis. Consequently, the potential translational value of AT1 inhibition in clinical AAA disease management remains incompletely understood on the basis of the existing literature. METHODS AAAs were created in wild-type (WT) and AT1a knockout (KO) mice by intra-aortic infusion of porcine pancreatic elastase (PPE). WT mice were treated with the AT1 receptor antagonist telmisartan, 10 mg/kg/d in chow, or the peroxisome proliferator-activated receptor γ (PPARγ) antagonist GW9662, 3 mg/kg/d through oral gavage, beginning 1 week before or 3 days after PPE infusion. Influences on aneurysm progression as well as mechanistic insights into AT1-mediated pathogenic processes were determined using noninvasive ultrasound imaging, histopathology, aortic gene expression profiling, and flow cytometric analysis. RESULTS After PPE infusion, aortic enlargement was almost completely abrogated in AT1a KO mice compared with WT mice. As defined by a ≥50% increase in aortic diameter, no PPE-infused, AT1a KO mouse actually developed an AAA. On histologic evaluation, medial smooth muscle cellularity and elastic lamellae were preserved in AT1a KO mice compared with WT mice, with marked attenuation of mural angiogenesis and leukocyte infiltration. In WT mice, telmisartan administration effectively suppressed aneurysm pathogenesis after PPE infusion as well, regardless of whether treatment was initiated before or after aneurysm creation or continued for a limited or extended time. Telmisartan treatment was associated with reduced messenger RNA levels for CCL5 and matrix metalloproteinases 2 and 9 in aneurysmal aortae, with no apparent effect on PPARγ-regulated gene expression. Administration of the PPARγ antagonist GW9662 failed to "rescue" the aneurysm phenotype in telmisartan-treated, PPE-infused WT mice. Neither effector T-cell differentiation nor regulatory T-cell cellularity was affected by telmisartan treatment status. CONCLUSIONS Telmisartan effectively suppresses the progression of elastase-induced AAAs without apparent effect on PPARγ activation or T-cell differentiation. These findings reinforce the critical importance of endogenous AT1 activation in experimental AAA pathogenesis and reinforce the translational potential of AT1 inhibition in medical aneurysm disease management.
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Affiliation(s)
- Haojun Xuan
- Department of Surgery, Stanford University School of Medicine, Stanford, Calif; Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou, China
| | - Baohui Xu
- Department of Surgery, Stanford University School of Medicine, Stanford, Calif
| | - Wei Wang
- Department of Surgery, Stanford University School of Medicine, Stanford, Calif
| | - Hiroki Tanaka
- Department of Surgery, Stanford University School of Medicine, Stanford, Calif
| | - Naoki Fujimura
- Department of Surgery, Stanford University School of Medicine, Stanford, Calif
| | - Masaaki Miyata
- Department of Cardiovascular Medicine and Hypertension, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Sara A Michie
- Department of Pathology, Stanford University School of Medicine, Stanford, Calif
| | - Ronald L Dalman
- Department of Surgery, Stanford University School of Medicine, Stanford, Calif.
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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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34
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Hsu CY, Su YW, Chen YT, Tsai SH, Chang CC, Li SY, Huang PH, Chen JW, Lin SJ. Association between use of oral-antidiabetic drugs and the risk of aortic aneurysm: a nested case-control analysis. Cardiovasc Diabetol 2016; 15:125. [PMID: 27585542 PMCID: PMC5009543 DOI: 10.1186/s12933-016-0447-9] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Accepted: 08/23/2016] [Indexed: 11/17/2022] Open
Abstract
Background Pleiotropic effects on cardiovascular protection have been suggested in several oral antidiabetic drugs (OAD). The impacts of OADs on aortic aneurysm (AA) growth have been found in animal studies, but the evidence of their beneficial effects for AA protection in human are lacking. We investigated the relationship between OAD therapy and the risk of developing AA. Methods We conducted a nested case–control analysis using the database extracted from Taiwan’s National Health Insurance Research Database. The database consists of 1.2 million diabetic patients representing the majority of the type 2 diabetes population in Taiwan from 2000 to 2013. Cases were identified as those with either inpatient or outpatient diagnosis code of AA. One control was selected for each case matching on duration of follow-up, age, sex, urbanization, monthly income, severity of diabetes, and risk factor for AA. We identified variable classes of OADs, including metformin, sulfonylureas, thiazolidinedione (TZD), alpha-glucosidase inhibitors, meglitinide, dipeptidyl peptidase-4 (DPP-4) inhibitors prior to the development of AA. Results A total of 4468 cases diagnosed with AA and 4468 matched controls were identified. Metformin use, sulfonylurea use, and TZD were associated with lower risk of developing AA, odds ratio [OR] 0.72 (95 % confidence interval [CI] 0.64–0.80), 0.82 (95 % CI 0.74–0.92), and 0.82 (95 % CI 0.69–0.98), respectively. The effects of metformin and sulfonylurea on AA were dose responsive. Neither alpha-glucosidase inhibitors (OR 0.95; 95 % CI 0.81–1.11) nor DPP-4 inhibitors (OR 0.85; 95 % CI 0.68–1.07) was significantly associated with AA events. Conclusions Metformin, sulfonylurea, and TZD treated patients were associated with lower risks of AA development, but not DPP-4 inhibitors or alpha-glucosidase inhibitor. The protective effects of hypoglycemic agents are further confirmed by the dose responsive relations in metformin and sulfonylurea groups.
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Affiliation(s)
- Chien-Yi Hsu
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.,Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan.,Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Division of Cardiology and Cardiovascular Research Center, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan
| | - Yu-Wen Su
- Division of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Yung-Tai Chen
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Medicine, Taipei City Hospital, Heping Fuyou Branch, Taipei, Taiwan
| | - Shih-Hung Tsai
- Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, No.325, Sec.2, Cheng-Kung Road, Taipei, Taiwan.
| | - Chun-Chin Chang
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.,Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan.,Taipei Veterans General Hospital, Taoyuan Branch, Taoyuan, Taiwan
| | - Szu-Yuan Li
- Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Po-Hsun Huang
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.,Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Jaw-Wen Chen
- Department of Medical Research, Taipei Veterans General Hospital, 112, No. 201, Sec. 2, Shih-Pai Road, Taipei, Taiwan.,Institute of Pharmacology, National Yang-Ming University, Taipei, Taiwan.,Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Shing-Jong Lin
- Department of Medical Research, Taipei Veterans General Hospital, 112, No. 201, Sec. 2, Shih-Pai Road, Taipei, Taiwan. .,Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan. .,Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan. .,Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
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Xiong J, Wu Z, Chen C, Wei Y, Guo W. Association between diabetes and prevalence and growth rate of abdominal aortic aneurysms: A meta-analysis. Int J Cardiol 2016; 221:484-95. [PMID: 27414727 DOI: 10.1016/j.ijcard.2016.07.016] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 06/28/2016] [Accepted: 07/04/2016] [Indexed: 01/11/2023]
Abstract
BACKGROUND Although the prevalence of abdominal aortic aneurysm (AAA) was lower in diabetes, the relationship between diabetes and AAA prevalence remains unclear. In this meta-analysis, we sought to clarify the effect of diabetes on prevalence and growth rate (GR) of AAA. METHODS We searched PubMed, Web of Science, Scopus and Cochrane databases. Articles reporting the AAA prevalence in diabetic patients and diabetic effects in GR of AAA were included. RESULTS Forty-nine studies on AAA prevalence in diabetics and thirteen studies on effect of diabetes in GR of AAA were included for meta-analysis. A strongly negative association was found between diabetes and AAA prevalence in population based screening (odds ratio [OR]adjusted: 0.66; 95% confidence interval [CI]: 0.58-0.75) and prospective studies (ORadjusted: 0.52; 95% CI: 0.43-0.63), but not in case-control studies (ORadjusted: 0.48; 95% CI: 0.20-1.15). Similar association was found in North American (ORadjusted: 0.62; 95% CI 0.54-0.71) and European (ORadjusted: 0.45; 95% CI 0.33-0.62) studies. The strongly negative association remained consistent after stratification by time of data collection (up to -1995 [ORadjusted: 0.65; 95% CI: 0.53-0.80], 1996-2005 [ORadjusted: 0.61; 95% CI: 0.47-0.78], 2006 and beyond- [ORadjusted: 0.67; 95% CI: 0.53-0.85], and data collection time >10years [ORadjusted: OR: 0.44; 95% CI 0.34-0.58]). The annual mean diabetic effect on AAA GR was -0.60mm/y (95% CI: -0.76 - -0.43). CONCLUSION Diabetes was strongly and negatively associated with AAA prevalence regardless of study type, geography and time of data collection, as well as negative impact of diabetes on GR of AAA.
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Affiliation(s)
- Jiang Xiong
- Department of Vascular and Endovascular Surgery, Chinese PLA General Hospital, Beijing, PR China.
| | - Zhongyin Wu
- Department of Vascular and Endovascular Surgery, Chinese PLA General Hospital, Beijing, PR China
| | - Chen Chen
- Department of Health Policy and Management, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Yingqi Wei
- Beijing Center for Diseases Prevention and Control, Beijing, PR China
| | - Wei Guo
- Department of Vascular and Endovascular Surgery, Chinese PLA General Hospital, Beijing, PR China
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Takagi H. Association of diabetes mellitus with presence, expansion, and rupture of abdominal aortic aneurysm: "Curiouser and curiouser!" cried ALICE. Semin Vasc Surg 2016; 29:18-26. [PMID: 27823585 DOI: 10.1053/j.semvascsurg.2016.06.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Both coronary artery and peripheral artery disease are representative atherosclerotic diseases that are positively associated with presence of abdominal aortic aneurysm (AAA). Diabetes mellitus, which is one of major risk factors of coronary artery and peripheral artery diseases, however, has been curiously suggested to be negatively associated with AAA, despite the positive associations of coronary artery and peripheral artery diseases with presence of AAA. In the present article, we overviewed epidemiologic evidence (meta-analyses) regarding the associations of diabetes mellitus with presence, expansion, and rupture of AAA through a systematic literature search. Our exhaustive search identified seven meta-analyses. Main results of almost all meta-analyses (except for the two earliest ones) apparently found that diabetes mellitus is negatively associated with presence, expansion, and rupture of AAA.
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Affiliation(s)
- Hisato Takagi
- Department of Cardiovascular Surgery, Shizuoka Medical Center, 762-1 Nagasawa, Shimizu-cho, Sunto-gun, Shizuoka 411-8611, Japan.
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- Department of Cardiovascular Surgery, Shizuoka Medical Center, 762-1 Nagasawa, Shimizu-cho, Sunto-gun, Shizuoka 411-8611, Japan
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Tai HC, Tsai PJ, Chen JY, Lai CH, Wang KC, Teng SH, Lin SC, Chang AYW, Jiang MJ, Li YH, Wu HL, Maeda N, Tsai YS. Peroxisome Proliferator-Activated Receptor γ Level Contributes to Structural Integrity and Component Production of Elastic Fibers in the Aorta. Hypertension 2016; 67:1298-308. [PMID: 27045031 DOI: 10.1161/hypertensionaha.116.07367] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2016] [Accepted: 03/09/2016] [Indexed: 01/24/2023]
Abstract
Loss of integrity and massive disruption of elastic fibers are key features of abdominal aortic aneurysm (AAA). Peroxisome proliferator-activated receptor γ (PPARγ) has been shown to attenuate AAA through inhibition of inflammation and proteolytic degradation. However, its involvement in elastogenesis during AAA remains unclear. PPARγ was highly expressed in human AAA within all vascular cells, including inflammatory cells and fibroblasts. In the aortas of transgenic mice expressing PPARγ at 25% normal levels (Pparg(C) (/-) mice), we observed the fragmentation of elastic fibers and reduced expression of vital elastic fiber components of elastin and fibulin-5. These were not observed in mice with 50% normal PPARγ expression (Pparg(+/-) mice). Infusion of a moderate dose of angiotensin II (500 ng/kg per minute) did not induce AAA but Pparg(+/-) aorta developed flattened elastic lamellae, whereas Pparg(C/-) aorta showed severe destruction of elastic fibers. After infusion of angiotensin II at 1000 ng/kg per minute, 73% of Pparg(C/-) mice developed atypical suprarenal aortic aneurysms: superior mesenteric arteries were dilated with extensive collagen deposition in adventitia and infiltrations of inflammatory cells. Although matrix metalloproteinase inhibition by doxycycline somewhat attenuated the dilation of aneurysm, it did not reduce the incidence nor elastic lamella deterioration in angiotensin II-infused Pparg(C/-) mice. Furthermore, PPARγ antagonism downregulated elastin and fibulin-5 in fibroblasts, but not in vascular smooth muscle cells. Chromatin immunoprecipitation assay demonstrated PPARγ binding in the genomic sequence of fibulin-5 in fibroblasts. Our results underscore the importance of PPARγ in AAA development though orchestrating proper elastogenesis and preserving elastic fiber integrity.
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Affiliation(s)
- Haw-Chih Tai
- From the Institute of Clinical Medicine (H.-C.T., J.-Y.C., C.-H.L., Y.-S.T.), Cardiovascular Research Center (H.-C.T., J.-Y.C., C.-H.L., K.-C.W., M.-J.J., Y.-H.L., H.-L.W., Y.-S.T.), Departments of Medical Laboratory Science and Biotechnology (P.-J.T.), Biochemistry and Molecular Biology (K.-C.W., H.-L.W.), Physiology (S.-C.L., A.Y.W.C.), Cell Biology and Anatomy (M.-J.J.), National Cheng Kung University, Tainan, Taiwan, Republic of China; Departments of Internal Medicine (J.-Y.C., Y.-H.L.), Surgery (C.-H.L.), and Research Center of Clinical Medicine (Y.-S.T.), National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China; Graduate Institute of Biomedical Sciences, Chang Gung University, Taoyuan, Taiwan, Republic of China (S.-H.T.); and Department of Pathology and Laboratory Medicine, University of North Carolina at Chapel Hill (N.M.)
| | - Pei-Jane Tsai
- From the Institute of Clinical Medicine (H.-C.T., J.-Y.C., C.-H.L., Y.-S.T.), Cardiovascular Research Center (H.-C.T., J.-Y.C., C.-H.L., K.-C.W., M.-J.J., Y.-H.L., H.-L.W., Y.-S.T.), Departments of Medical Laboratory Science and Biotechnology (P.-J.T.), Biochemistry and Molecular Biology (K.-C.W., H.-L.W.), Physiology (S.-C.L., A.Y.W.C.), Cell Biology and Anatomy (M.-J.J.), National Cheng Kung University, Tainan, Taiwan, Republic of China; Departments of Internal Medicine (J.-Y.C., Y.-H.L.), Surgery (C.-H.L.), and Research Center of Clinical Medicine (Y.-S.T.), National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China; Graduate Institute of Biomedical Sciences, Chang Gung University, Taoyuan, Taiwan, Republic of China (S.-H.T.); and Department of Pathology and Laboratory Medicine, University of North Carolina at Chapel Hill (N.M.)
| | - Ju-Yi Chen
- From the Institute of Clinical Medicine (H.-C.T., J.-Y.C., C.-H.L., Y.-S.T.), Cardiovascular Research Center (H.-C.T., J.-Y.C., C.-H.L., K.-C.W., M.-J.J., Y.-H.L., H.-L.W., Y.-S.T.), Departments of Medical Laboratory Science and Biotechnology (P.-J.T.), Biochemistry and Molecular Biology (K.-C.W., H.-L.W.), Physiology (S.-C.L., A.Y.W.C.), Cell Biology and Anatomy (M.-J.J.), National Cheng Kung University, Tainan, Taiwan, Republic of China; Departments of Internal Medicine (J.-Y.C., Y.-H.L.), Surgery (C.-H.L.), and Research Center of Clinical Medicine (Y.-S.T.), National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China; Graduate Institute of Biomedical Sciences, Chang Gung University, Taoyuan, Taiwan, Republic of China (S.-H.T.); and Department of Pathology and Laboratory Medicine, University of North Carolina at Chapel Hill (N.M.)
| | - Chao-Han Lai
- From the Institute of Clinical Medicine (H.-C.T., J.-Y.C., C.-H.L., Y.-S.T.), Cardiovascular Research Center (H.-C.T., J.-Y.C., C.-H.L., K.-C.W., M.-J.J., Y.-H.L., H.-L.W., Y.-S.T.), Departments of Medical Laboratory Science and Biotechnology (P.-J.T.), Biochemistry and Molecular Biology (K.-C.W., H.-L.W.), Physiology (S.-C.L., A.Y.W.C.), Cell Biology and Anatomy (M.-J.J.), National Cheng Kung University, Tainan, Taiwan, Republic of China; Departments of Internal Medicine (J.-Y.C., Y.-H.L.), Surgery (C.-H.L.), and Research Center of Clinical Medicine (Y.-S.T.), National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China; Graduate Institute of Biomedical Sciences, Chang Gung University, Taoyuan, Taiwan, Republic of China (S.-H.T.); and Department of Pathology and Laboratory Medicine, University of North Carolina at Chapel Hill (N.M.)
| | - Kuan-Chieh Wang
- From the Institute of Clinical Medicine (H.-C.T., J.-Y.C., C.-H.L., Y.-S.T.), Cardiovascular Research Center (H.-C.T., J.-Y.C., C.-H.L., K.-C.W., M.-J.J., Y.-H.L., H.-L.W., Y.-S.T.), Departments of Medical Laboratory Science and Biotechnology (P.-J.T.), Biochemistry and Molecular Biology (K.-C.W., H.-L.W.), Physiology (S.-C.L., A.Y.W.C.), Cell Biology and Anatomy (M.-J.J.), National Cheng Kung University, Tainan, Taiwan, Republic of China; Departments of Internal Medicine (J.-Y.C., Y.-H.L.), Surgery (C.-H.L.), and Research Center of Clinical Medicine (Y.-S.T.), National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China; Graduate Institute of Biomedical Sciences, Chang Gung University, Taoyuan, Taiwan, Republic of China (S.-H.T.); and Department of Pathology and Laboratory Medicine, University of North Carolina at Chapel Hill (N.M.)
| | - Shih-Hua Teng
- From the Institute of Clinical Medicine (H.-C.T., J.-Y.C., C.-H.L., Y.-S.T.), Cardiovascular Research Center (H.-C.T., J.-Y.C., C.-H.L., K.-C.W., M.-J.J., Y.-H.L., H.-L.W., Y.-S.T.), Departments of Medical Laboratory Science and Biotechnology (P.-J.T.), Biochemistry and Molecular Biology (K.-C.W., H.-L.W.), Physiology (S.-C.L., A.Y.W.C.), Cell Biology and Anatomy (M.-J.J.), National Cheng Kung University, Tainan, Taiwan, Republic of China; Departments of Internal Medicine (J.-Y.C., Y.-H.L.), Surgery (C.-H.L.), and Research Center of Clinical Medicine (Y.-S.T.), National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China; Graduate Institute of Biomedical Sciences, Chang Gung University, Taoyuan, Taiwan, Republic of China (S.-H.T.); and Department of Pathology and Laboratory Medicine, University of North Carolina at Chapel Hill (N.M.)
| | - Shih-Chieh Lin
- From the Institute of Clinical Medicine (H.-C.T., J.-Y.C., C.-H.L., Y.-S.T.), Cardiovascular Research Center (H.-C.T., J.-Y.C., C.-H.L., K.-C.W., M.-J.J., Y.-H.L., H.-L.W., Y.-S.T.), Departments of Medical Laboratory Science and Biotechnology (P.-J.T.), Biochemistry and Molecular Biology (K.-C.W., H.-L.W.), Physiology (S.-C.L., A.Y.W.C.), Cell Biology and Anatomy (M.-J.J.), National Cheng Kung University, Tainan, Taiwan, Republic of China; Departments of Internal Medicine (J.-Y.C., Y.-H.L.), Surgery (C.-H.L.), and Research Center of Clinical Medicine (Y.-S.T.), National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China; Graduate Institute of Biomedical Sciences, Chang Gung University, Taoyuan, Taiwan, Republic of China (S.-H.T.); and Department of Pathology and Laboratory Medicine, University of North Carolina at Chapel Hill (N.M.)
| | - Alice Y W Chang
- From the Institute of Clinical Medicine (H.-C.T., J.-Y.C., C.-H.L., Y.-S.T.), Cardiovascular Research Center (H.-C.T., J.-Y.C., C.-H.L., K.-C.W., M.-J.J., Y.-H.L., H.-L.W., Y.-S.T.), Departments of Medical Laboratory Science and Biotechnology (P.-J.T.), Biochemistry and Molecular Biology (K.-C.W., H.-L.W.), Physiology (S.-C.L., A.Y.W.C.), Cell Biology and Anatomy (M.-J.J.), National Cheng Kung University, Tainan, Taiwan, Republic of China; Departments of Internal Medicine (J.-Y.C., Y.-H.L.), Surgery (C.-H.L.), and Research Center of Clinical Medicine (Y.-S.T.), National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China; Graduate Institute of Biomedical Sciences, Chang Gung University, Taoyuan, Taiwan, Republic of China (S.-H.T.); and Department of Pathology and Laboratory Medicine, University of North Carolina at Chapel Hill (N.M.)
| | - Meei-Jyh Jiang
- From the Institute of Clinical Medicine (H.-C.T., J.-Y.C., C.-H.L., Y.-S.T.), Cardiovascular Research Center (H.-C.T., J.-Y.C., C.-H.L., K.-C.W., M.-J.J., Y.-H.L., H.-L.W., Y.-S.T.), Departments of Medical Laboratory Science and Biotechnology (P.-J.T.), Biochemistry and Molecular Biology (K.-C.W., H.-L.W.), Physiology (S.-C.L., A.Y.W.C.), Cell Biology and Anatomy (M.-J.J.), National Cheng Kung University, Tainan, Taiwan, Republic of China; Departments of Internal Medicine (J.-Y.C., Y.-H.L.), Surgery (C.-H.L.), and Research Center of Clinical Medicine (Y.-S.T.), National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China; Graduate Institute of Biomedical Sciences, Chang Gung University, Taoyuan, Taiwan, Republic of China (S.-H.T.); and Department of Pathology and Laboratory Medicine, University of North Carolina at Chapel Hill (N.M.)
| | - Yi-Heng Li
- From the Institute of Clinical Medicine (H.-C.T., J.-Y.C., C.-H.L., Y.-S.T.), Cardiovascular Research Center (H.-C.T., J.-Y.C., C.-H.L., K.-C.W., M.-J.J., Y.-H.L., H.-L.W., Y.-S.T.), Departments of Medical Laboratory Science and Biotechnology (P.-J.T.), Biochemistry and Molecular Biology (K.-C.W., H.-L.W.), Physiology (S.-C.L., A.Y.W.C.), Cell Biology and Anatomy (M.-J.J.), National Cheng Kung University, Tainan, Taiwan, Republic of China; Departments of Internal Medicine (J.-Y.C., Y.-H.L.), Surgery (C.-H.L.), and Research Center of Clinical Medicine (Y.-S.T.), National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China; Graduate Institute of Biomedical Sciences, Chang Gung University, Taoyuan, Taiwan, Republic of China (S.-H.T.); and Department of Pathology and Laboratory Medicine, University of North Carolina at Chapel Hill (N.M.)
| | - Hua-Lin Wu
- From the Institute of Clinical Medicine (H.-C.T., J.-Y.C., C.-H.L., Y.-S.T.), Cardiovascular Research Center (H.-C.T., J.-Y.C., C.-H.L., K.-C.W., M.-J.J., Y.-H.L., H.-L.W., Y.-S.T.), Departments of Medical Laboratory Science and Biotechnology (P.-J.T.), Biochemistry and Molecular Biology (K.-C.W., H.-L.W.), Physiology (S.-C.L., A.Y.W.C.), Cell Biology and Anatomy (M.-J.J.), National Cheng Kung University, Tainan, Taiwan, Republic of China; Departments of Internal Medicine (J.-Y.C., Y.-H.L.), Surgery (C.-H.L.), and Research Center of Clinical Medicine (Y.-S.T.), National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China; Graduate Institute of Biomedical Sciences, Chang Gung University, Taoyuan, Taiwan, Republic of China (S.-H.T.); and Department of Pathology and Laboratory Medicine, University of North Carolina at Chapel Hill (N.M.)
| | - Nobuyo Maeda
- From the Institute of Clinical Medicine (H.-C.T., J.-Y.C., C.-H.L., Y.-S.T.), Cardiovascular Research Center (H.-C.T., J.-Y.C., C.-H.L., K.-C.W., M.-J.J., Y.-H.L., H.-L.W., Y.-S.T.), Departments of Medical Laboratory Science and Biotechnology (P.-J.T.), Biochemistry and Molecular Biology (K.-C.W., H.-L.W.), Physiology (S.-C.L., A.Y.W.C.), Cell Biology and Anatomy (M.-J.J.), National Cheng Kung University, Tainan, Taiwan, Republic of China; Departments of Internal Medicine (J.-Y.C., Y.-H.L.), Surgery (C.-H.L.), and Research Center of Clinical Medicine (Y.-S.T.), National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China; Graduate Institute of Biomedical Sciences, Chang Gung University, Taoyuan, Taiwan, Republic of China (S.-H.T.); and Department of Pathology and Laboratory Medicine, University of North Carolina at Chapel Hill (N.M.)
| | - Yau-Sheng Tsai
- From the Institute of Clinical Medicine (H.-C.T., J.-Y.C., C.-H.L., Y.-S.T.), Cardiovascular Research Center (H.-C.T., J.-Y.C., C.-H.L., K.-C.W., M.-J.J., Y.-H.L., H.-L.W., Y.-S.T.), Departments of Medical Laboratory Science and Biotechnology (P.-J.T.), Biochemistry and Molecular Biology (K.-C.W., H.-L.W.), Physiology (S.-C.L., A.Y.W.C.), Cell Biology and Anatomy (M.-J.J.), National Cheng Kung University, Tainan, Taiwan, Republic of China; Departments of Internal Medicine (J.-Y.C., Y.-H.L.), Surgery (C.-H.L.), and Research Center of Clinical Medicine (Y.-S.T.), National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China; Graduate Institute of Biomedical Sciences, Chang Gung University, Taoyuan, Taiwan, Republic of China (S.-H.T.); and Department of Pathology and Laboratory Medicine, University of North Carolina at Chapel Hill (N.M.).
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A novel small molecule TLR4 antagonist (IAXO-102) negatively regulates non-hematopoietic toll like receptor 4 signalling and inhibits aortic aneurysms development. Atherosclerosis 2015; 242:563-70. [DOI: 10.1016/j.atherosclerosis.2015.08.010] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Revised: 07/17/2015] [Accepted: 08/06/2015] [Indexed: 12/21/2022]
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Zhou M, Xu H, Liu W, Liu H. Rosiglitazone modulates collagen deposition and metabolism in atherosclerotic plaques of fat-fed ApoE-knockout mice. Exp Ther Med 2015; 10:1265-1270. [PMID: 26622476 PMCID: PMC4578073 DOI: 10.3892/etm.2015.2711] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2014] [Accepted: 06/16/2015] [Indexed: 01/16/2023] Open
Abstract
Abnormal collagen deposition, as well as collagen metabolism, plays a crucial role in the formation and progression of vulnerable atherosclerotic plaques (VAPs), which are susceptible to rupture. According to our previous findings, rosiglitazone, a thiazolidinedione, can promote the stability of atherosclerotic plaques in fat-fed ApoE-knockout mice; however, it is unknown whether it can modulate collagen deposition and metabolism in VAPs. The present study was designed to determine the effect of rosiglitazone on collagen deposition and metabolism in the plaques of fat-fed ApoE-knockout mice. Following 13 weeks of the high-fat diet, the mice were randomized into three groups (10 mice/group) and intragastrically administered rosiglitazone, simvastatin and distilled water, respectively, for a further 13 weeks. The category of the collagen present in the plaques was evaluated using the picro-Sirius red polarization method. Additionally, the protein expression of matrix metalloproteinase 9 (MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1) in the plaques was determined using immunohistochemistry. The results showed that rosiglitazone reduced the lipid to collagen and type III to type I collagen ratios in the plaques, and these reductions were correlated with the reduction in the plaque MMP-9 to TIMP-1 ratio. These results suggest that rosiglitazone can modulate collagen deposition and metabolism and promote the stabilization of VAPs.
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Affiliation(s)
- Mingxue Zhou
- Beijing Institute of Traditional Chinese Medicine, Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University, Beijing 100010, P.R. China
| | - Hao Xu
- Department of Cardiovascular Medicine, Xiyuan Hospital, Academy of Chinese Medical Sciences, Beijing 100091, P.R. China
| | - Weihong Liu
- Beijing Institute of Traditional Chinese Medicine, Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University, Beijing 100010, P.R. China
| | - Hongxu Liu
- Department of Cardiovascular Medicine, Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University, Beijing 100010, P.R. China
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Nasr H, Torsney E, Poston RN, Hayes L, Gaze DC, Basser R, Thompson MM, Loftus IM, Cockerill GW. Investigating the Effect of a Single Infusion of Reconstituted High-Density Lipoprotein in Patients with Symptomatic Carotid Plaques. Ann Vasc Surg 2015; 29:1380-91. [PMID: 26140943 PMCID: PMC6419536 DOI: 10.1016/j.avsg.2015.04.084] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Revised: 04/25/2015] [Accepted: 04/28/2015] [Indexed: 11/28/2022]
Abstract
Background Elevation of plasma high-density lipoprotein (HDL) cholesterol concentration reduces cardiovascular mortality and morbidity. HDLs have been shown to possess acute anti-inflammatory, antioxidant, and antithrombotic properties. We hypothesize that HDL therapy can acutely alter local and systemic manifestations of plaque instability. Methods Forty patients with early symptomatic carotid disease were randomized to either receive reconstituted HDL (rHDL) 40 mg/kg (n = 20) or placebo (n = 20). Carotid endarterectomies were performed 24 hr later. Plaques were obtained intraoperatively and used for measurement of thrombomodulatory genes expression. Plasma samples were collected before the infusion, 24 and 48 hr later to measure changes in systemic markers of plaque instability. Results No significant differences were noted in thrombomodulatory genes expression between the 2 groups. Systemic levels of tissue factor, matrix metalloproteinase 9 (MMP-9), and monocyte chemotactic factor-1 (MCP-1) were significantly reduced in the rHDL group. However, the effects on MMP-9 and MCP-1 were abolished in the immediate postoperative period. Although rHDL did not affect plasma interleukin-6 levels 24 hr following the infusion, it prevented the significant postoperative elevation seen in the placebo group. Conclusions A single infusion of rHDL can acutely alter plasma biomarkers associated with plaque instability and cardiovascular morbidity.
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Affiliation(s)
- Hosaam Nasr
- Centre for Cardiovascular Sciences, Division of Clinical Sciences, St George's University of London, London, UK.
| | - Evelyn Torsney
- Centre for Cardiovascular Sciences, Division of Clinical Sciences, St George's University of London, London, UK
| | | | - Lawrence Hayes
- Centre for Cardiovascular Sciences, Division of Clinical Sciences, St George's University of London, London, UK
| | - David C Gaze
- Centre for Cardiovascular Sciences, Division of Clinical Sciences, St George's University of London, London, UK
| | | | - Matthew M Thompson
- Centre for Cardiovascular Sciences, Division of Clinical Sciences, St George's University of London, London, UK
| | - Ian M Loftus
- Centre for Cardiovascular Sciences, Division of Clinical Sciences, St George's University of London, London, UK
| | - Gillian W Cockerill
- Centre for Cardiovascular Sciences, Division of Clinical Sciences, St George's University of London, London, UK
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Charolidi N, Pirianov G, Torsney E, Pearce S, Laing K, Nohturfft A, Cockerill GW. Pioglitazone Identifies a New Target for Aneurysm Treatment: Role of Egr1 in an Experimental Murine Model of Aortic Aneurysm. J Vasc Res 2015; 52:81-93. [PMID: 26113112 DOI: 10.1159/000430986] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Accepted: 04/26/2015] [Indexed: 11/19/2022] Open
Abstract
Peroxisome proliferator-activated receptor x03B3; agonists have been shown to inhibit angiotensin II (AngII)-induced experimental abdominal aortic aneurysms. Macrophage infiltration to the vascular wall is an early event in this pathology, and therefore we explored the effects of the peroxisome proliferator-activated receptor x03B3; agonist pioglitazone on AngII-treated macrophages. Using microarray-based expression profiling of phorbol ester-stimulated THP-1 cells, we found that a number of aneurysm-related gene changes effected by AngII were modulated following the addition of pioglitazone. Among those genes, polycystic kidney disease 1 (PKD1) was significantly up-regulated (multiple testing corrected p < 0.05). The analysis of the PKD1 proximal promoter revealed a putative early growth response 1 (EGR1) binding site, which was confirmed by chromatin immunoprecipitation (ChIP) and quantitative PCR. Further analysis of publicly available ChIP-sequencing data revealed that this putative binding site overlapped with a conserved EGR1 binding peak present in 5 other cell lines. Quantitative real-time PCR showed that EGR1 suppressed PKD1, while AngII significantly up-regulated PKD1, an effect counteracted by pioglitazone. Conversely, in EGR1 short hairpin RNA lentivirally transduced THP-1 cells, reduced EGR1 led to a significant up-regulation of PKD1, especially after treatment with pioglitazone. In vivo, deficiency of Egr1 in the haematopoietic compartment of mice completely abolished the incidence of CaCl2-induced aneurysm formation.
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Affiliation(s)
- Nicoletta Charolidi
- Institute of Cardiovascular and Cell Sciences, St. George's, University of London, London, UK
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Morris DR, Cunningham MA, Ahimastos AA, Kingwell BA, Pappas E, Bourke M, Reid CM, Stijnen T, Dalman RL, Aalami OO, Lindeman JH, Norman PE, Walker PJ, Fitridge R, Bourke B, Dear AE, Pinchbeck J, Jaeggi R, Golledge J. TElmisartan in the management of abDominal aortic aneurYsm (TEDY): The study protocol for a randomized controlled trial. Trials 2015; 16:274. [PMID: 26081587 PMCID: PMC4482315 DOI: 10.1186/s13063-015-0793-z] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 06/02/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Experimental studies suggest that angiotensin II plays a central role in the pathogenesis of abdominal aortic aneurysm. This trial aims to evaluate the efficacy of the angiotensin receptor blocker telmisartan in limiting the progression of abdominal aortic aneurysm. METHODS/DESIGN Telmisartan in the management of abdominal aortic aneurysm (TEDY) is a multicentre, parallel-design, randomised, double-blind, placebo-controlled trial with an intention-to-treat analysis. We aim to randomly assign 300 participants with small abdominal aortic aneurysm to either 40 mg of telmisartan or identical placebo and follow patients over 2 years. The primary endpoint will be abdominal aortic aneurysm growth as measured by 1) maximum infra-renal aortic volume on computed tomographic angiography, 2) maximum orthogonal diameter on computed tomographic angiography, and 3) maximum diameter on ultrasound. Secondary endpoints include change in resting brachial blood pressure, abdominal aortic aneurysm biomarker profile and health-related quality of life. TEDY is an international collaboration conducted from major vascular centres in Australia, the United States and the Netherlands. DISCUSSION Currently, no medication has been convincingly demonstrated to limit abdominal aortic aneurysm progression. TEDY will examine the potential of a promising treatment strategy for patients with small abdominal aortic aneurysms. TRIAL REGISTRATION Australian and Leiden study centres: Australian New Zealand Clinical Trials Registry ACTRN12611000931976 , registered on 30 August 2011; Stanford study centre: clinicaltrials.gov NCT01683084 , registered on 5 September 2012.
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Affiliation(s)
- Dylan R Morris
- Queensland Research Centre for Peripheral Vascular Disease, School of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia.
| | | | - Anna A Ahimastos
- Baker IDI Heart and Diabetes Institute and The Department of Cardiovascular Medicine, Alfred Hospital Melbourne, Melbourne, Australia.
| | - Bronwyn A Kingwell
- Baker IDI Heart and Diabetes Institute and The Department of Cardiovascular Medicine, Alfred Hospital Melbourne, Melbourne, Australia.
| | - Elise Pappas
- Queensland Research Centre for Peripheral Vascular Disease, School of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia.
| | - Michael Bourke
- Gosford Vascular Services, Gosford, New South Wales, Australia.
| | - Christopher M Reid
- Centre of Cardiovascular Research and Education in Therapeutics, Department of Epidemiology and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, Australia.
| | - Theo Stijnen
- Leiden University Medical Center, Leiden, The Netherlands.
| | - Ronald L Dalman
- Division of Vascular Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA.
| | - Oliver O Aalami
- Division of Vascular Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA.
| | - Jan H Lindeman
- Leiden University Medical Center, Leiden, The Netherlands.
| | - Paul E Norman
- School of Surgery, University of Western Australia, Perth, WA, Australia.
| | - Philip J Walker
- University of Queensland School of Medicine, Discipline of Surgery and Centre for Clinical Research, and Department of Vascular Surgery, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
| | - Robert Fitridge
- Department of Surgery, University of Adelaide, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia.
| | - Bernie Bourke
- Gosford Vascular Services, Gosford, New South Wales, Australia.
| | - Anthony E Dear
- Eastern Health Clinical School, Department of Medicine, Monash University, Melbourne, Australia.
| | - Jenna Pinchbeck
- Queensland Research Centre for Peripheral Vascular Disease, School of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia.
| | - Rene Jaeggi
- Queensland Research Centre for Peripheral Vascular Disease, School of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia.
| | - Jonathan Golledge
- Queensland Research Centre for Peripheral Vascular Disease, School of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia.
- The Department of Vascular and Endovascular Surgery, The Townsville Hospital, Townsville, QLD, Australia.
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Shimada K, Furukawa H, Wada K, Korai M, Wei Y, Tada Y, Kuwabara A, Shikata F, Kitazato KT, Nagahiro S, Lawton MT, Hashimoto T. Protective Role of Peroxisome Proliferator-Activated Receptor-γ in the Development of Intracranial Aneurysm Rupture. Stroke 2015; 46:1664-72. [PMID: 25931465 DOI: 10.1161/strokeaha.114.007722] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Accepted: 04/02/2015] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND PURPOSE Inflammation is emerging as a key component of the pathophysiology of intracranial aneurysms. Peroxisome proliferator-activated receptor-γ (PPARγ) is a nuclear hormone receptor of which activation modulates various aspects of inflammation. METHODS Using a mouse model of intracranial aneurysm, we examined the potential roles of PPARγ in the development of rupture of intracranial aneurysm. RESULTS A PPARγ agonist, pioglitazone, significantly reduced the incidence of ruptured aneurysms and the rupture rate without affecting the total incidence aneurysm (unruptured aneurysms and ruptured aneurysms). PPARγ antagonist (GW9662) abolished the protective effect of pioglitazone. The protective effect of pioglitazone was absent in mice lacking macrophage PPARγ. Pioglitazone treatment reduced the mRNA levels of inflammatory cytokines (monocyte chemoattractant factor-1, interleukin-1, and interleukin-6) that are primarily produced by macrophages in the cerebral arteries. Pioglitazone treatment reduced the infiltration of M1 macrophage into the cerebral arteries and the macrophage M1/M2 ratio. Depletion of macrophages significantly reduced the rupture rate. CONCLUSIONS Our data showed that the activation of macrophage PPARγ protects against the development of aneurysmal rupture. PPARγ in inflammatory cells may be a potential therapeutic target for the prevention of aneurysmal rupture.
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Affiliation(s)
- Kenji Shimada
- From the Departments of Anesthesia and Perioperative Care (K.S., H.F., K.W., M.K., Y.W., A.K., F.S., T.H.) and Neurological Surgery (M.T.L.), University of California, San Francisco; and Department of Neurosurgery (K.S., M.K., Y.T., K.T.K., S.N.), School of Medicine, The University of Tokushima, Tokushima City, Japan
| | - Hajime Furukawa
- From the Departments of Anesthesia and Perioperative Care (K.S., H.F., K.W., M.K., Y.W., A.K., F.S., T.H.) and Neurological Surgery (M.T.L.), University of California, San Francisco; and Department of Neurosurgery (K.S., M.K., Y.T., K.T.K., S.N.), School of Medicine, The University of Tokushima, Tokushima City, Japan
| | - Kosuke Wada
- From the Departments of Anesthesia and Perioperative Care (K.S., H.F., K.W., M.K., Y.W., A.K., F.S., T.H.) and Neurological Surgery (M.T.L.), University of California, San Francisco; and Department of Neurosurgery (K.S., M.K., Y.T., K.T.K., S.N.), School of Medicine, The University of Tokushima, Tokushima City, Japan
| | - Masaaki Korai
- From the Departments of Anesthesia and Perioperative Care (K.S., H.F., K.W., M.K., Y.W., A.K., F.S., T.H.) and Neurological Surgery (M.T.L.), University of California, San Francisco; and Department of Neurosurgery (K.S., M.K., Y.T., K.T.K., S.N.), School of Medicine, The University of Tokushima, Tokushima City, Japan
| | - Yuan Wei
- From the Departments of Anesthesia and Perioperative Care (K.S., H.F., K.W., M.K., Y.W., A.K., F.S., T.H.) and Neurological Surgery (M.T.L.), University of California, San Francisco; and Department of Neurosurgery (K.S., M.K., Y.T., K.T.K., S.N.), School of Medicine, The University of Tokushima, Tokushima City, Japan
| | - Yoshiteru Tada
- From the Departments of Anesthesia and Perioperative Care (K.S., H.F., K.W., M.K., Y.W., A.K., F.S., T.H.) and Neurological Surgery (M.T.L.), University of California, San Francisco; and Department of Neurosurgery (K.S., M.K., Y.T., K.T.K., S.N.), School of Medicine, The University of Tokushima, Tokushima City, Japan
| | - Atsushi Kuwabara
- From the Departments of Anesthesia and Perioperative Care (K.S., H.F., K.W., M.K., Y.W., A.K., F.S., T.H.) and Neurological Surgery (M.T.L.), University of California, San Francisco; and Department of Neurosurgery (K.S., M.K., Y.T., K.T.K., S.N.), School of Medicine, The University of Tokushima, Tokushima City, Japan
| | - Fumiaki Shikata
- From the Departments of Anesthesia and Perioperative Care (K.S., H.F., K.W., M.K., Y.W., A.K., F.S., T.H.) and Neurological Surgery (M.T.L.), University of California, San Francisco; and Department of Neurosurgery (K.S., M.K., Y.T., K.T.K., S.N.), School of Medicine, The University of Tokushima, Tokushima City, Japan
| | - Keiko T Kitazato
- From the Departments of Anesthesia and Perioperative Care (K.S., H.F., K.W., M.K., Y.W., A.K., F.S., T.H.) and Neurological Surgery (M.T.L.), University of California, San Francisco; and Department of Neurosurgery (K.S., M.K., Y.T., K.T.K., S.N.), School of Medicine, The University of Tokushima, Tokushima City, Japan
| | - Shinji Nagahiro
- From the Departments of Anesthesia and Perioperative Care (K.S., H.F., K.W., M.K., Y.W., A.K., F.S., T.H.) and Neurological Surgery (M.T.L.), University of California, San Francisco; and Department of Neurosurgery (K.S., M.K., Y.T., K.T.K., S.N.), School of Medicine, The University of Tokushima, Tokushima City, Japan
| | - Michael T Lawton
- From the Departments of Anesthesia and Perioperative Care (K.S., H.F., K.W., M.K., Y.W., A.K., F.S., T.H.) and Neurological Surgery (M.T.L.), University of California, San Francisco; and Department of Neurosurgery (K.S., M.K., Y.T., K.T.K., S.N.), School of Medicine, The University of Tokushima, Tokushima City, Japan
| | - Tomoki Hashimoto
- From the Departments of Anesthesia and Perioperative Care (K.S., H.F., K.W., M.K., Y.W., A.K., F.S., T.H.) and Neurological Surgery (M.T.L.), University of California, San Francisco; and Department of Neurosurgery (K.S., M.K., Y.T., K.T.K., S.N.), School of Medicine, The University of Tokushima, Tokushima City, Japan.
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Hasan DM, Starke RM, Gu H, Wilson K, Chu Y, Chalouhi N, Heistad DD, Faraci FM, Sigmund CD. Smooth Muscle Peroxisome Proliferator-Activated Receptor γ Plays a Critical Role in Formation and Rupture of Cerebral Aneurysms in Mice In Vivo. Hypertension 2015; 66:211-20. [PMID: 25916724 DOI: 10.1161/hypertensionaha.115.05332] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 04/07/2015] [Indexed: 12/17/2022]
Abstract
Vascular inflammation plays a critical role in the pathogenesis of cerebral aneurysms. Peroxisome proliferator-activated receptor γ (PPARγ) protects against vascular inflammation and atherosclerosis, whereas dominant-negative mutations in PPARγ promote atherosclerosis and vascular dysfunction. We tested the role of PPARγ in aneurysm formation and rupture. Aneurysms were induced with a combination of systemic infusion of angiotensin-II and local injection of elastase in (1) mice that received the PPARγ antagonist GW9662 or the PPARγ agonist pioglitazone, (2) mice carrying dominant-negative PPARγ mutations in endothelial or smooth muscle cells, and (3) mice that received the Cullin inhibitor MLN4924. Incidence of aneurysm formation, rupture, and mortality was quantified. Cerebral arteries were analyzed for expression of Cullin3, Kelch-like ECH-associated protein 1, nuclear factor (erythroid-derived 2)-like 2, NAD(P)H dehydrogenase (quinone)1 (NQO1), and inflammatory marker mRNAs. Neither pioglitazone nor GW9662 altered the incidence of aneurysm formation. GW9662 significantly increased the incidence of aneurysm rupture, whereas pioglitazone tended to decrease the incidence of rupture. Dominant-negative endothelial-specific PPARγ did not alter the incidence of aneurysm formation or rupture. In contrast, dominant-negative smooth muscle-specific PPARγ resulted in an increase in aneurysm formation (P<0.05) and rupture (P=0.05). Dominant-negative smooth muscle-specific PPARγ, but not dominant-negative endothelial-specific PPARγ, resulted in significant decreases in expression of genes encoding Cullin3, Kelch-like ECH-associated protein 1, and nuclear factor (erythroid-derived 2)-like 2, along with significant increases in tumor necrosis factor-α, monocyte chemoattractant protein-1, chemokine (C-X-C motif) ligand 1, CD68, matrix metalloproteinase-3, -9, and -13. MLN4924 did not alter incidence of aneurysm formation, but increased the incidence of rupture (P<0.05). In summary, endogenous PPARγ, specifically smooth muscle PPARγ, plays an important role in protecting from formation and rupture of experimental cerebral aneurysms in mice.
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Affiliation(s)
- David M Hasan
- From the Department of Neurological Surgery (D.M.H., H.G., K.W., Y.C.) and Departments of Pharmacology and Internal Medicine, Carver College of Medicine (Y.C., D.D.H., F.M.F., C.D.S.), University of Department of Internal Medicine, Iowa; Department of Neurological Surgery, University of Virginia, Charlottesville (R.M.S.); Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, PA (N.C.); and Department of Internal Medicine, Iowa City Veterans Affairs Healthcare System (F.M.F.)
| | - Robert M Starke
- From the Department of Neurological Surgery (D.M.H., H.G., K.W., Y.C.) and Departments of Pharmacology and Internal Medicine, Carver College of Medicine (Y.C., D.D.H., F.M.F., C.D.S.), University of Department of Internal Medicine, Iowa; Department of Neurological Surgery, University of Virginia, Charlottesville (R.M.S.); Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, PA (N.C.); and Department of Internal Medicine, Iowa City Veterans Affairs Healthcare System (F.M.F.)
| | - He Gu
- From the Department of Neurological Surgery (D.M.H., H.G., K.W., Y.C.) and Departments of Pharmacology and Internal Medicine, Carver College of Medicine (Y.C., D.D.H., F.M.F., C.D.S.), University of Department of Internal Medicine, Iowa; Department of Neurological Surgery, University of Virginia, Charlottesville (R.M.S.); Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, PA (N.C.); and Department of Internal Medicine, Iowa City Veterans Affairs Healthcare System (F.M.F.)
| | - Katina Wilson
- From the Department of Neurological Surgery (D.M.H., H.G., K.W., Y.C.) and Departments of Pharmacology and Internal Medicine, Carver College of Medicine (Y.C., D.D.H., F.M.F., C.D.S.), University of Department of Internal Medicine, Iowa; Department of Neurological Surgery, University of Virginia, Charlottesville (R.M.S.); Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, PA (N.C.); and Department of Internal Medicine, Iowa City Veterans Affairs Healthcare System (F.M.F.)
| | - Yi Chu
- From the Department of Neurological Surgery (D.M.H., H.G., K.W., Y.C.) and Departments of Pharmacology and Internal Medicine, Carver College of Medicine (Y.C., D.D.H., F.M.F., C.D.S.), University of Department of Internal Medicine, Iowa; Department of Neurological Surgery, University of Virginia, Charlottesville (R.M.S.); Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, PA (N.C.); and Department of Internal Medicine, Iowa City Veterans Affairs Healthcare System (F.M.F.)
| | - Nohra Chalouhi
- From the Department of Neurological Surgery (D.M.H., H.G., K.W., Y.C.) and Departments of Pharmacology and Internal Medicine, Carver College of Medicine (Y.C., D.D.H., F.M.F., C.D.S.), University of Department of Internal Medicine, Iowa; Department of Neurological Surgery, University of Virginia, Charlottesville (R.M.S.); Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, PA (N.C.); and Department of Internal Medicine, Iowa City Veterans Affairs Healthcare System (F.M.F.)
| | - Donald D Heistad
- From the Department of Neurological Surgery (D.M.H., H.G., K.W., Y.C.) and Departments of Pharmacology and Internal Medicine, Carver College of Medicine (Y.C., D.D.H., F.M.F., C.D.S.), University of Department of Internal Medicine, Iowa; Department of Neurological Surgery, University of Virginia, Charlottesville (R.M.S.); Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, PA (N.C.); and Department of Internal Medicine, Iowa City Veterans Affairs Healthcare System (F.M.F.)
| | - Frank M Faraci
- From the Department of Neurological Surgery (D.M.H., H.G., K.W., Y.C.) and Departments of Pharmacology and Internal Medicine, Carver College of Medicine (Y.C., D.D.H., F.M.F., C.D.S.), University of Department of Internal Medicine, Iowa; Department of Neurological Surgery, University of Virginia, Charlottesville (R.M.S.); Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, PA (N.C.); and Department of Internal Medicine, Iowa City Veterans Affairs Healthcare System (F.M.F.)
| | - Curt D Sigmund
- From the Department of Neurological Surgery (D.M.H., H.G., K.W., Y.C.) and Departments of Pharmacology and Internal Medicine, Carver College of Medicine (Y.C., D.D.H., F.M.F., C.D.S.), University of Department of Internal Medicine, Iowa; Department of Neurological Surgery, University of Virginia, Charlottesville (R.M.S.); Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, PA (N.C.); and Department of Internal Medicine, Iowa City Veterans Affairs Healthcare System (F.M.F.).
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Yoo YS, Park HS, Choi GH, Lee T. Recent Advances in the Development of Experimental Animal Models Mimicking Human Aortic Aneurysms. Vasc Specialist Int 2015. [PMID: 26217637 PMCID: PMC4480291 DOI: 10.5758/vsi.2015.31.1.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Aortic aneurysm is a common and life-threatening disease that can cause death from rupture. Current therapeutic options are limited to surgical or endovascular procedures because no pharmacological approaches have been proven to decrease the chance of expansion or rupture. The best approach to the management of aortic aneurysm would be the understanding and prevention of the processes involved in disease occurrence, progression, and rupture. There is a need for animal models that can reproduce the pathophysiological features of human aortic aneurysm, and several such models have been studied. This review will emphasize recent advances in animal models used in the determination of mechanisms and treatments of aortic aneurysms.
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Affiliation(s)
- Young Sun Yoo
- Department of Surgery, Chosun University Hospital, Chosun University College of Medicine, Gwangju
| | - Hyung Sub Park
- Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam
| | - Geum Hee Choi
- Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam
| | - Taeseung Lee
- Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam ; Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
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47
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Liu M, Chen Y, Yang X, Zhang L, Zhao T, Zhao B, Jia L, Zhu Y, Gao X, Zhang B, Li X, Xiang R, Han J, Duan Y. DanHong Injection inhibits the development of primary abdominal aortic aneurysms in apoE knockout mice. CHINESE SCIENCE BULLETIN-CHINESE 2014. [DOI: 10.1007/s11434-014-0175-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Diabetes and abdominal aortic aneurysms. Eur J Vasc Endovasc Surg 2014; 47:243-61. [PMID: 24447529 DOI: 10.1016/j.ejvs.2013.12.007] [Citation(s) in RCA: 163] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2013] [Accepted: 12/01/2013] [Indexed: 11/24/2022]
Abstract
Epidemiologic evidence suggests that patients with diabetes may have a lower incidence of abdominal aortic aneurysm (AAA); however, the link between diabetes and AAA development and expansion is unclear. The aim of this review is to analyze updated evidence to better understand the impact of diabetes on prevalence, incidence, clinical outcome, and expansion rate of AAA. A systematic review of literature published in the last 20 years using the PubMed and Cochrane databases was undertaken. Studies reporting appropriate data were identified and a meta-analysis performed using the generic inverse variance method. Sixty-four studies were identified. Methodological quality was "fair" in 16 and "good" in 44 studies according to a formal assessment checklist (Newcastle-Ottawa). In 17 large population prevalence studies there was a significant inverse association between diabetes and AAA: pooled odds ratio (OR) 0.80; 95% confidence intervals (CI) 0.70-0.90 (p = .0009). An inverse association was also confirmed by pooled analysis of data from smaller prevalence studies on selected populations (OR 0.59; 95% CI 0.35-0.99; p = .05), while no significant results were provided by case-control studies. A significant lower pooled incidence of new AAA in diabetics was found over six prospective studies: OR 0.54; 95% CI 0.31-0.91; p = .03. Diabetic patients showed increased operative (30-day/in-hospital) mortality after AAA repair: pooled OR 1.26; 95% CI 1.10-1.44; p = .0008. The increased operative risk was more evident in studies with 30-day assessment. In the long-term, diabetics showed lower survival rates at 2-5 years, while there was general evidence of lower growth rates of small AAA in patients with diabetes compared to non-diabetics. There is currently evidence to support an inverse relationship between diabetes and AAA development and enlargement, even though fair methodological quality or unclear risk of bias in many available studies decreases the strength of the finding. At the same time, operative and long-term survival is lower in diabetic patients, suggesting increased cardiovascular burden. The higher mortality in diabetics raises the question as to whether AAA repair should be individualized in selected diabetic populations at higher AAA rupture risk.
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Recombinant human thrombomodulin suppresses experimental abdominal aortic aneurysms induced by calcium chloride in mice. Ann Surg 2014; 258:1103-10. [PMID: 23295319 DOI: 10.1097/sla.0b013e31827df7cb] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To investigate whether recombinant thrombomodulin containing all the extracellular domains (rTMD123) has therapeutic potential against aneurysm development. SUMMARY BACKGROUND DATA The pathogenesis of abdominal aortic aneurysm (AAA) is characterized by chronic inflammation and proteolytic degradation of extracellular matrix. Thrombomodulin, a transmembrane glycoprotein, exerts anti-inflammatory activities such as inhibition of cytokine production and sequestration of proinflammatory high-mobility group box 1 (HMGB1) to prevent it from engaging the receptor for advanced glycation end product (RAGE) that may sustain inflammation and tissue damage. METHODS The in vivo effects of treatment and posttreatment with rTMD123 on aortic dilatation were measured using the CaCl2-induced AAA model in mice. RESULTS Characterization of the CaCl2-induced model revealed that HMGB1 and RAGE, both localized mainly to macrophages, were persistently upregulated during a 28-day period of AAA development. In vitro, rTMD123-HMGB1 interaction prevented HMGB1 binding to macrophages, thereby prohibiting activation of HMGB1-RAGE signaling in macrophages. In vivo, short-term treatment with rTMD123 upon AAA induction suppressed the levels of proinflammatory cytokines, HMGB1, and RAGE in the aortic tissue; reduced the infiltrating macrophage number; and finally attenuated matrix metalloproteinase production, extracellular matrix destruction, and AAA formation without disturbing vascular calcification. Consistently, posttreatment with rTMD123 seven days after AAA induction alleviated vascular inflammation and retarded AAA progression. CONCLUSIONS These data suggest that rTMD123 confers protection against AAA development. The mechanism of action may be associated with reduction of proinflammatory mediators, blockade of macrophage recruitment, and suppression of HMGB1-RAGE signaling involved in aneurysm formation and downstream macrophage activation.
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Sang-qi Granula Reduces Blood Pressure and Myocardial Fibrosis by Suppressing Inflammatory Responses Associated with the Peroxisome Proliferator-Activated Receptors and Nuclear Factor κ B Protein in Spontaneously Hypertensive Rats. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2013; 2013:721729. [PMID: 24171042 PMCID: PMC3793543 DOI: 10.1155/2013/721729] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2013] [Revised: 08/08/2013] [Accepted: 08/18/2013] [Indexed: 12/22/2022]
Abstract
Aim. Sang-qi Granula (SQ) is a compound prepared from Chinese herbs and is currently used for treatment of hypertension in China. Given its protective effects on cardial function in decreasing blood pressure, we investigated the mechanism of protective effects of SQ on myocardium. Methods. 16 male normal Wistar-Kyoto rats and 16 spontaneous hypertension rats (SHR) were employed without medical treatment. 16 SHR were employed with SQ treatment. Rats in each group were sacrificed at two time points (8-week treatment and 16-week treatment). Blood pressure (BP), and heart weight/body weight (HW/BW) were measured. The expression of myeloperoxidase (MCP-1), ICAM-1, TNF- α , and CD68-positive cells was assessed. The interstitial collagen volume fraction (CVF), perivascular collagen volume area (PVCA), and the expression of TGF- β , Smad-3, PPAR α , γ , and NF- κ B (P65 and P50) were observed. Results. SQ significantly inhibited the elevation of the blood pressure and HW/BW of SHR. Next, SQ prevented myocardial fibrosis. Finally, a proinflammatory mediator associated with NF- κ B (TNF- α , ICAM-1, MCP-1, CD68), TGF- β , and Smad-3 related to collagen deposition, which is upregulated in SHR group, was significantly suppressed by SQ. Expression of NF- κ B was decreased in SHQ+SQ group compared to PPAR α , and γ expression was increased by SQ. Conclusion. Treatment with SQ ameliorates cardial fibrosis induced by hypertension by attenuating the upregulation of ICAM-1, TNF- α , MCP-1, TGF- β , Smad-3, P65, and P50 expression and improving PPAR α and PPAR γ expression level. The results suggest that SQ may be an option for preventing cardial fibrosis through PPAR signalling pathway.
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