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Li Y, Zheng X, Guo J, Samura M, Ge Y, Zhao S, Li G, Chen X, Shoji T, Ikezoe T, Miyata M, Xu B, Dalman RL. Treatment With Small Molecule Inhibitors of Advanced Glycation End-Products Formation and Advanced Glycation End-Products-Mediated Collagen Cross-Linking Promotes Experimental Aortic Aneurysm Progression in Diabetic Mice. J Am Heart Assoc 2023; 12:e028081. [PMID: 37158066 PMCID: PMC10227285 DOI: 10.1161/jaha.122.028081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 04/14/2023] [Indexed: 05/10/2023]
Abstract
Background Although diabetes attenuates abdominal aortic aneurysms (AAAs), the mechanisms by which diabetes suppresses AAAs remain incompletely understood. Accumulation of advanced glycation end- (AGEs) reduces extracellular matrix (ECM) degradation in diabetes. Because ECM degradation is critical for AAA pathogenesis, we investigated whether AGEs mediate experimental AAA suppression in diabetes by blocking AGE formation or disrupting AGE-ECM cross-linking using small molecule inhibitors. Methods and Results Male C57BL/6J mice were treated with streptozotocin and intra-aortic elastase infusion to induce diabetes and experimental AAAs, respectively. Aminoguanidine (AGE formation inhibitor, 200 mg/kg), alagebrium (AGE-ECM cross-linking disrupter, 20 mg/kg), or vehicle was administered daily to mice from the last day following streptozotocin injection. AAAs were assessed via serial aortic diameter measurements, histopathology, and in vitro medial elastolysis assays. Treatment with aminoguanidine, not alagebrium, diminished AGEs in diabetic AAAs. Treatment with both inhibitors enhanced aortic enlargement in diabetic mice as compared with vehicle treatment. Neither enhanced AAA enlargement in nondiabetic mice. AAA enhancement in diabetic mice by aminoguanidine or alagebrium treatment promoted elastin degradation, smooth muscle cell depletion, mural macrophage accumulation, and neoangiogenesis without affecting matrix metalloproteinases, C-C motif chemokine ligand 2, or serum glucose concentration. Additionally, treatment with both inhibitors reversed suppression of diabetic aortic medial elastolysis by porcine pancreatic elastase in vitro. Conclusions Inhibiting AGE formation or AGE-ECM cross-linking enhances experimental AAAs in diabetes. These findings support the hypothesis that AGEs attenuate experimental AAAs in diabetes. These findings underscore the potential translational value of enhanced ECM cross-linking as an inhibitory strategy for early AAA disease.
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Affiliation(s)
- Yankui Li
- Department of SurgeryStanford University School of MedicineStanfordCAUSA
- Department of Vascular SurgeryTianjin Medical University Second HospitalTianjinChina
| | - Xiaoya Zheng
- Department of SurgeryStanford University School of MedicineStanfordCAUSA
- Department of EndocrinologyThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Jia Guo
- Department of SurgeryStanford University School of MedicineStanfordCAUSA
| | - Makoto Samura
- Department of SurgeryStanford University School of MedicineStanfordCAUSA
| | - Yingbin Ge
- Department of PhysiologyNanjing Medical UniversityNanjingChina
| | - Sihai Zhao
- Department of SurgeryStanford University School of MedicineStanfordCAUSA
| | - Gang Li
- Department of SurgeryStanford University School of MedicineStanfordCAUSA
| | - Xiaofeng Chen
- Department of Radiation OncologyIndiana University School of MedicineIndianapolisINUSA
| | - Takahiro Shoji
- Department of SurgeryStanford University School of MedicineStanfordCAUSA
| | - Toru Ikezoe
- Department of SurgeryStanford University School of MedicineStanfordCAUSA
| | - Masaaki Miyata
- School of Health SciencesKagoshima University Faculty of MedicineKagoshimaJapan
| | - Baohui Xu
- Department of SurgeryStanford University School of MedicineStanfordCAUSA
| | - Ronald L. Dalman
- Department of SurgeryStanford University School of MedicineStanfordCAUSA
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Taimour S, Franzén S, Zarrouk M, Acosta S, Nilsson P, Miftaraj M, Eliasson B, Svensson AM, Gottsäter A. Nationwide comparison of long-term survival and cardiovascular morbidity after acute aortic aneurysm repair in patients with and without type 2 diabetes. J Vasc Surg 2020; 71:30-38.e3. [DOI: 10.1016/j.jvs.2019.01.063] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 01/20/2019] [Indexed: 12/18/2022]
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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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Taimour S, Avdic T, Franzén S, Zarrouk M, Acosta S, Nilsson P, Miftaraj M, Eliasson B, Svensson AM, Gottsäter A. Survival, cardiovascular morbidity, and reinterventions after elective endovascular aortic aneurysm repair in patients with and without diabetes: A nationwide propensity-adjusted analysis. Vasc Med 2019; 24:539-546. [PMID: 31441381 DOI: 10.1177/1358863x19870243] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Epidemiological data indicate decreased risk for development and growth of abdominal aortic aneurysm (AAA) among patients with diabetes mellitus (DM). On the other hand, DM adds to increased cardiovascular (CV) morbidity and mortality. In a nationwide observational cohort study of patients registered in the Swedish Vascular Register and the Swedish National Diabetes Register, we evaluated potential effects of DM on total mortality, CV morbidity, and the need for reintervention after elective endovascular aneurysm repair (EVAR) for AAA. We compared 748 patients with and 2630 without DM with propensity score-adjusted analysis, during a median 4.22 years of follow-up for patients with DM, and 4.05 years for those without. In adjusted analysis, diabetic patients showed higher rates of acute myocardial infarction (AMI) during follow-up (relative risk (RR) 1.44, 95% CI 1.06-1.95; p = 0.02), but lower need for reintervention (RR 0.12, CI 0.02-0.91; p = 0.04). There were no differences in total (RR 0.88, CI 0.74-1.05; p = 0.15) or CV (RR 1.58, CI 0.87-2.86; p = 0.13) mortality, or stroke (RR 0.95, CI 0.68-1.32; p = 0.75) during follow-up. In conclusion, patients with DM had higher rates of AMI and lower need for reintervention after elective EVAR than those without DM, whereas neither total nor CV mortality differed between groups. The putative protective effects of DM towards further AAA enlargement and late sac rupture may help explain the lower need for reintervention and absence of excess mortality.
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Affiliation(s)
- Soumia Taimour
- Department of Vascular Diseases, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Tarik Avdic
- Swedish National Diabetes Register, Gothenburg, Sweden
| | | | - Moncef Zarrouk
- Department of Vascular Diseases, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Stefan Acosta
- Department of Vascular Diseases, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Peter Nilsson
- Department of Internal Medicine, Clinical Research Unit, Lund University, Skåne University Hospital, Malmö, Sweden
| | | | - Björn Eliasson
- Swedish National Diabetes Register, Gothenburg, Sweden.,Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | | | - Anders Gottsäter
- Department of Vascular Diseases, Lund University, Skåne University Hospital, Malmö, Sweden
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Taimour S, Zarrouk M, Holst J, Rosengren AH, Groop L, Nilsson PM, Gottsäter A. Aortic diameter at age 65 in men with newly diagnosed type 2 diabetes. SCAND CARDIOVASC J 2017; 51:202-206. [DOI: 10.1080/14017431.2017.1319971] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Soumia Taimour
- Department of Vascular Diseases, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Moncef Zarrouk
- Department of Vascular Diseases, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Jan Holst
- Department of Vascular Diseases, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Anders H. Rosengren
- Department of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
- Department of Internal Medicine, Clinical Research Unit, Skåne University Hospital, Malmö, Sweden
| | - Leif Groop
- Department of Internal Medicine, Clinical Research Unit, Skåne University Hospital, Malmö, Sweden
| | - Peter M. Nilsson
- Department of Internal Medicine, Clinical Research Unit, Skåne University Hospital, Malmö, Sweden
| | - Anders Gottsäter
- Department of Vascular Diseases, Lund University, Skåne University Hospital, Malmö, Sweden
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