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Zhang S, Liu Z, Xie N, Huang C, Li Z, Yu F, Fu Y, Cui Q, Kong W. Pan-HDAC (Histone Deacetylase) Inhibitors Increase Susceptibility of Thoracic Aortic Aneurysm and Dissection in Mice. Arterioscler Thromb Vasc Biol 2021; 41:2848-2850. [PMID: 34525846 PMCID: PMC8545242 DOI: 10.1161/atvbaha.121.316808] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Shumin Zhang
- Department of Physiology and Pathophysiology (S.Z., Z. Liu, N.X., Z. Li, F.Y., Y.F., W.K.), School of Basic Medical Sciences, Peking University, Beijing, China
- Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing, China (S.Z., Z. Liu, N.X., Z. Li, F.Y., Y.F., W.K., C.H., Q.C.)
| | - Zhujiang Liu
- Department of Physiology and Pathophysiology (S.Z., Z. Liu, N.X., Z. Li, F.Y., Y.F., W.K.), School of Basic Medical Sciences, Peking University, Beijing, China
- Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing, China (S.Z., Z. Liu, N.X., Z. Li, F.Y., Y.F., W.K., C.H., Q.C.)
| | - Nan Xie
- Department of Physiology and Pathophysiology (S.Z., Z. Liu, N.X., Z. Li, F.Y., Y.F., W.K.), School of Basic Medical Sciences, Peking University, Beijing, China
- Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing, China (S.Z., Z. Liu, N.X., Z. Li, F.Y., Y.F., W.K., C.H., Q.C.)
| | - Chuanbo Huang
- Department of Biomedical Informatics, Department of Physiology and Pathophysiology, Center for Noncoding RNA Medicine (C.H., Q.C.), School of Basic Medical Sciences, Peking University, Beijing, China
- Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing, China (S.Z., Z. Liu, N.X., Z. Li, F.Y., Y.F., W.K., C.H., Q.C.)
| | - Zhiqing Li
- Department of Physiology and Pathophysiology (S.Z., Z. Liu, N.X., Z. Li, F.Y., Y.F., W.K.), School of Basic Medical Sciences, Peking University, Beijing, China
- Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing, China (S.Z., Z. Liu, N.X., Z. Li, F.Y., Y.F., W.K., C.H., Q.C.)
| | - Fang Yu
- Department of Physiology and Pathophysiology (S.Z., Z. Liu, N.X., Z. Li, F.Y., Y.F., W.K.), School of Basic Medical Sciences, Peking University, Beijing, China
- Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing, China (S.Z., Z. Liu, N.X., Z. Li, F.Y., Y.F., W.K., C.H., Q.C.)
| | - Yi Fu
- Department of Physiology and Pathophysiology (S.Z., Z. Liu, N.X., Z. Li, F.Y., Y.F., W.K.), School of Basic Medical Sciences, Peking University, Beijing, China
- Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing, China (S.Z., Z. Liu, N.X., Z. Li, F.Y., Y.F., W.K., C.H., Q.C.)
| | - Qinghua Cui
- Department of Biomedical Informatics, Department of Physiology and Pathophysiology, Center for Noncoding RNA Medicine (C.H., Q.C.), School of Basic Medical Sciences, Peking University, Beijing, China
- Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing, China (S.Z., Z. Liu, N.X., Z. Li, F.Y., Y.F., W.K., C.H., Q.C.)
| | - Wei Kong
- Department of Physiology and Pathophysiology (S.Z., Z. Liu, N.X., Z. Li, F.Y., Y.F., W.K.), School of Basic Medical Sciences, Peking University, Beijing, China
- Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing, China (S.Z., Z. Liu, N.X., Z. Li, F.Y., Y.F., W.K., C.H., Q.C.)
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Caescu CI, Hansen J, Crockett B, Xiao W, Arnaud P, Spronck B, Weinberg A, Hashimoto T, Murtada SI, Borkar R, Gallo JM, Jondeau G, Boileau C, Humphrey JD, He JC, Iyengar R, Ramirez F. Inhibition of HIPK2 Alleviates Thoracic Aortic Disease in Mice With Progressively Severe Marfan Syndrome. Arterioscler Thromb Vasc Biol 2021; 41:2483-2493. [PMID: 34320838 PMCID: PMC8530207 DOI: 10.1161/atvbaha.121.316464] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective Despite considerable research, the goal of finding nonsurgical remedies against thoracic aortic aneurysm and acute aortic dissection remains elusive. We sought to identify a novel aortic PK (protein kinase) that can be pharmacologically targeted to mitigate aneurysmal disease in a well-established mouse model of early-onset progressively severe Marfan syndrome (MFS). Approach and Results Computational analyses of transcriptomic data derived from the ascending aorta of MFS mice predicted a probable association between thoracic aortic aneurysm and acute aortic dissection development and the multifunctional, stress-activated HIPK2 (homeodomain-interacting protein kinase 2). Consistent with this prediction, Hipk2 gene inactivation significantly extended the survival of MFS mice by slowing aneurysm growth and delaying transmural rupture. HIPK2 also ranked among the top predicted PKs in computational analyses of DEGs (differentially expressed genes) in the dilated aorta of 3 MFS patients, which strengthened the clinical relevance of the experimental finding. Additional in silico analyses of the human and mouse data sets identified the TGF (transforming growth factor)-β/Smad3 signaling pathway as a potential target of HIPK2 in the MFS aorta. Chronic treatment of MFS mice with an allosteric inhibitor of HIPK2-mediated stimulation of Smad3 signaling validated this prediction by mitigating thoracic aortic aneurysm and acute aortic dissection pathology and partially improving aortic material stiffness. Conclusions HIPK2 is a previously unrecognized determinant of aneurysmal disease and an attractive new target for antithoracic aortic aneurysm and acute aortic dissection multidrug therapy.
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MESH Headings
- Adult
- Aortic Dissection/enzymology
- Aortic Dissection/genetics
- Aortic Dissection/pathology
- Aortic Dissection/prevention & control
- Animals
- Aorta, Thoracic/drug effects
- Aorta, Thoracic/enzymology
- Aorta, Thoracic/pathology
- Aortic Aneurysm, Thoracic/enzymology
- Aortic Aneurysm, Thoracic/genetics
- Aortic Aneurysm, Thoracic/pathology
- Aortic Aneurysm, Thoracic/prevention & control
- Carrier Proteins/genetics
- Carrier Proteins/metabolism
- Dilatation, Pathologic
- Disease Models, Animal
- Disease Progression
- Fibrillin-1/genetics
- Humans
- Male
- Marfan Syndrome/complications
- Marfan Syndrome/genetics
- Mice, 129 Strain
- Mice, Inbred C57BL
- Mice, Knockout
- Protein Kinase Inhibitors/pharmacology
- Protein Serine-Threonine Kinases/antagonists & inhibitors
- Protein Serine-Threonine Kinases/genetics
- Protein Serine-Threonine Kinases/metabolism
- Severity of Illness Index
- Signal Transduction
- Smad3 Protein/metabolism
- Vascular Remodeling/drug effects
- Mice
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Affiliation(s)
- Cristina I Caescu
- Department of Pharmacological Sciences, Institute for Systems Biomedicine (C.I.C., J.H., B.C., T.H., R.I., F.R.), Icahn School of Medicine at Mount Sinai, New York
| | - Jens Hansen
- Department of Pharmacological Sciences, Institute for Systems Biomedicine (C.I.C., J.H., B.C., T.H., R.I., F.R.), Icahn School of Medicine at Mount Sinai, New York
| | - Brittany Crockett
- Department of Pharmacological Sciences, Institute for Systems Biomedicine (C.I.C., J.H., B.C., T.H., R.I., F.R.), Icahn School of Medicine at Mount Sinai, New York
| | - Wenzhen Xiao
- Division of Nephrology, Department of Medicine (W.X., J.C.H.), Icahn School of Medicine at Mount Sinai, New York
| | - Pauline Arnaud
- Département de Génétique et Centre de Référence Maladies Rares Syndrome de Marfan et Pathologies Apparentées, Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, France (P.A., G.J., C.B.)
- LVTS, INSERM U1148, Université de Paris, Hôpital Bichat, France (P.A., G.J., C.B.)
| | - Bart Spronck
- Department of Biomedical Engineering, Yale University, New Haven, CT (B.S., S.-I.M., J.D.H.)
| | - Alan Weinberg
- Department of Population Health Science and Policy (A.W.), Icahn School of Medicine at Mount Sinai, New York
| | - Takeshi Hashimoto
- Department of Pharmacological Sciences, Institute for Systems Biomedicine (C.I.C., J.H., B.C., T.H., R.I., F.R.), Icahn School of Medicine at Mount Sinai, New York
| | - Sae-Il Murtada
- Department of Biomedical Engineering, Yale University, New Haven, CT (B.S., S.-I.M., J.D.H.)
| | - Roshan Borkar
- Department of Pharmaceutical Sciences, State University of New York, Buffalo (R.B., J.M.G.)
| | - James M Gallo
- Department of Pharmaceutical Sciences, State University of New York, Buffalo (R.B., J.M.G.)
| | - Guillaume Jondeau
- Département de Génétique et Centre de Référence Maladies Rares Syndrome de Marfan et Pathologies Apparentées, Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, France (P.A., G.J., C.B.)
- LVTS, INSERM U1148, Université de Paris, Hôpital Bichat, France (P.A., G.J., C.B.)
| | - Catherine Boileau
- Département de Génétique et Centre de Référence Maladies Rares Syndrome de Marfan et Pathologies Apparentées, Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, France (P.A., G.J., C.B.)
- LVTS, INSERM U1148, Université de Paris, Hôpital Bichat, France (P.A., G.J., C.B.)
| | - Jay D Humphrey
- Department of Biomedical Engineering, Yale University, New Haven, CT (B.S., S.-I.M., J.D.H.)
| | - John Cijiang He
- Division of Nephrology, Department of Medicine (W.X., J.C.H.), Icahn School of Medicine at Mount Sinai, New York
| | - Ravi Iyengar
- Department of Pharmacological Sciences, Institute for Systems Biomedicine (C.I.C., J.H., B.C., T.H., R.I., F.R.), Icahn School of Medicine at Mount Sinai, New York
| | - Francesco Ramirez
- Department of Pharmacological Sciences, Institute for Systems Biomedicine (C.I.C., J.H., B.C., T.H., R.I., F.R.), Icahn School of Medicine at Mount Sinai, New York
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Abstract
PURPOSE Advancing age is the major risk factor for thoracic aortic aneurysm/dissection (TAAD). However, the causative link between age-related molecules and TAAD remains elusive. Here, we investigated the role of Sirtuin 1 (SIRT1, also known as class III histone deacetylase), the best studied member of the longevity-related Sirtuin family, in TAAD development in vivo. METHODS We used male smooth muscle-specific SIRT1 transgenic (ST-Tg) mice, smooth muscle-specific SIRT1 knockout (ST-KO) mice, and their wild-type (WT) littermates on a C57BL/6J background to establish a TAAD model induced by oral administration of 3-aminopropionitrile fumarate (BAPN). We analyzed the incidence and fatality rates of TAAD in the groups. We examined matrix metallopeptidase 2 (MMP2) and MMP9 expression in aortas or cultured A7r5 cells via western blotting and real-time polymerase chain reaction (PCR). We performed chromatin immunoprecipitation (ChIP) to clarify the epigenetic mechanism of SIRT1-regulated MMP2 expression in vascular smooth muscle cells (VSMCs). RESULTS BAPN treatment markedly increased the incidence of TAAD in WT mice but caused less disease in ST-Tg mice. Moreover, ST-KO mice had the highest BAPN-induced TAAD fatality rate of all the groups. Mechanistically, SIRT1 overexpression resulted in lower MMP2 and MMP9 expression after BAPN treatment in both mouse aortas and cultured A7r5 cells. The downregulation of BAPN-induced MMP2 expression by SIRT1 was mediated by deacetylation of histone H3 lysine 9 (H3K9) on the Mmp2 promoter in the A7r5 cells. CONCLUSION Our findings suggest that SIRT1 expression in SMCs protects against TAAD and could be a novel therapeutic target for TAAD management.
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MESH Headings
- Acetylation
- Aortic Dissection/enzymology
- Aortic Dissection/genetics
- Aortic Dissection/pathology
- Aortic Dissection/prevention & control
- Animals
- Aorta, Thoracic/enzymology
- Aorta, Thoracic/pathology
- Aortic Aneurysm, Thoracic/enzymology
- Aortic Aneurysm, Thoracic/genetics
- Aortic Aneurysm, Thoracic/pathology
- Aortic Aneurysm, Thoracic/prevention & control
- Cell Line
- Disease Models, Animal
- Histones/metabolism
- Male
- Matrix Metalloproteinase 2/genetics
- Matrix Metalloproteinase 2/metabolism
- Matrix Metalloproteinase 9/genetics
- Matrix Metalloproteinase 9/metabolism
- Mice, Inbred C57BL
- Mice, Transgenic
- Muscle, Smooth, Vascular/enzymology
- Muscle, Smooth, Vascular/pathology
- Myocytes, Smooth Muscle/enzymology
- Myocytes, Smooth Muscle/pathology
- Signal Transduction
- Sirtuin 1/genetics
- Sirtuin 1/metabolism
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Affiliation(s)
- Fang Wang
- Department of Cardiology, China-Japan Friendship Hospital, Beijing, China
| | - Yimin Tu
- Department of Cardiology, China-Japan Friendship Hospital, Beijing, China
| | - Yanxiang Gao
- Department of Cardiology, China-Japan Friendship Hospital, Beijing, China
| | - Houzao Chen
- State Key Laboratory of Medical Molecular Biology, Department of Biochemistry and Molecular Biology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Jinjing Liu
- Key Laboratory of Rheumatology and Clinical Rheumatology, Ministry of Education, National Clinical Research Center for Dermatologic and Immunologic Diseases, Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
| | - Jingang Zheng
- Department of Cardiology, China-Japan Friendship Hospital, Beijing, China.
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Takagi H, Hari Y, Nakashima K, Kuno T, Ando T. Matrix metalloproteinases and acute aortic dissection: Et Tu, Brute? Interact Cardiovasc Thorac Surg 2020; 30:465-476. [PMID: 31808522 DOI: 10.1093/icvts/ivz286] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 10/21/2019] [Accepted: 11/01/2019] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES To summarize the present evidence for the association of matrix metalloproteinases (MMPs) with acute aortic dissection (AAD), we performed the first meta-analysis of all currently available case-control studies comparing circulating MMP levels between AAD patients and control subjects. METHODS To identify all studies investigating the levels of circulating MMPs in AAD patients, PubMed and Web of Science were searched up to July 2019. The levels of MMPs in AAD patients and control subjects were extracted from each study, and the standardized mean differences (SMDs) in MMP levels were generated. The study-specific estimates were combined in the random-effects model. RESULTS Twelve studies enrolling a total of 458 AAD patients and 711 control subjects were identified and included. Pooled analyses demonstrated no significant differences in MMP-1 (4 studies; P = 0.21), MMP-2 (5 studies; P = 0.62) and MMP-3 levels (2 studies; P = 0.94) between AAD patients and control subjects; and significantly higher MMP-8 (2 studies; SMD 2.11; P = 0.020), MMP-9 (9 studies; SMD 1.54; P < 0.001) and MMP-12 levels (2 studies; SMD 1.33; P < 0.001) in AAD patients than in control subjects. CONCLUSION High circulating MMP-9 levels are associated with AAD, and MMP-8 and MMP-12 levels may be related to AAD.
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Affiliation(s)
- Hisato Takagi
- Department of Cardiovascular Surgery, Shizuoka Medical Center, Shizuoka, Japan
- Department of Cardiovascular Surgery, Kitasato University School of Medicine, Sagamihara, Japan
| | - Yosuke Hari
- Department of Cardiovascular Surgery, Shizuoka Medical Center, Shizuoka, Japan
- Department of Cardiovascular Surgery, Kitasato University School of Medicine, Sagamihara, Japan
| | - Kouki Nakashima
- Department of Cardiovascular Surgery, Shizuoka Medical Center, Shizuoka, Japan
- Department of Cardiovascular Surgery, Kitasato University School of Medicine, Sagamihara, Japan
| | - Toshiki Kuno
- Department of Medicine, Mount Sinai Beth Israel Medical Center, New York, NY, USA
| | - Tomo Ando
- Division of Interventional Cardiology, Department of Cardiology, New York Presbyterian Hospital/Columbia University Medical Center, New York, NY, USA
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5
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Xia L, Sun C, Zhu H, Zhai M, Zhang L, Jiang L, Hou P, Li J, Li K, Liu Z, Li B, Wang X, Yi W, Liang H, Jin Z, Yang J, Yi D, Liu J, Yu S, Duan W. Melatonin protects against thoracic aortic aneurysm and dissection through SIRT1-dependent regulation of oxidative stress and vascular smooth muscle cell loss. J Pineal Res 2020; 69:e12661. [PMID: 32329099 DOI: 10.1111/jpi.12661] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Revised: 04/07/2020] [Accepted: 04/14/2020] [Indexed: 12/12/2022]
Abstract
Melatonin functions as an endogenous protective molecule in multiple vascular diseases, whereas its effects on thoracic aortic aneurysm and dissection (TAAD) and underlying mechanisms have not been reported. In this study, TAAD mouse model was successfully induced by β-aminopropionitrile fumarate (BAPN). We found that melatonin treatment remarkably prevented the deterioration of TAAD, evidenced by decreased incidence, ameliorated aneurysmal dilation and vascular stiffness, improved aortic morphology, and inhibited elastin degradation, macrophage infiltration, and matrix metalloproteinase expression. Moreover, melatonin blunted oxidative stress damage and vascular smooth muscle cell (VSMC) loss. Notably, BAPN induced a decrease in SIRT1 expression and activity of mouse aorta, whereas melatonin treatment reversed it. Further mechanistic study demonstrated that blocking SIRT1 signaling partially inhibited these beneficial effects of melatonin on TAAD. Additionally, the melatonin receptor was involved in this phenomenon. Our study is the first to report that melatonin exerts therapeutic effects against TAAD by reducing oxidative stress and VSMC loss via activation of SIRT1 signaling in a receptor-dependent manner, thus suggesting a novel therapeutic strategy for TAAD.
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Affiliation(s)
- Lin Xia
- Department of Cardiovascular Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Chang Sun
- Department of Orthopedics, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Hanzhao Zhu
- Department of Cardiovascular Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Mengen Zhai
- Department of Cardiovascular Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Liyun Zhang
- Department of Cardiovascular Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Liqing Jiang
- Department of Cardiovascular Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Peng Hou
- Department of Cardiovascular Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Junfeng Li
- Department of Cardiovascular Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Kaifeng Li
- Institute of Material Medical, School of Pharmacy, The Fourth Military Medical University, Xi'an, China
| | - Zhenhua Liu
- Department of Cardiovascular Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Buying Li
- Department of Cardiovascular Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Xiaowu Wang
- Department of Cardiovascular Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Wei Yi
- Department of Cardiovascular Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Hongliang Liang
- Department of Cardiovascular Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Zhenxiao Jin
- Department of Cardiovascular Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Jian Yang
- Department of Cardiovascular Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Dinghua Yi
- Department of Cardiovascular Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Jincheng Liu
- Department of Cardiovascular Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Shiqiang Yu
- Department of Cardiovascular Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Weixun Duan
- Department of Cardiovascular Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
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Shalhub S, Regalado ES, Guo DC, Milewicz DM. The natural history of type B aortic dissection in patients with PRKG1 mutation c.530G>A (p.Arg177Gln). J Vasc Surg 2019; 70:718-723. [PMID: 30871887 DOI: 10.1016/j.jvs.2018.12.032] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 12/11/2018] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The c.530G>A (p.Arg177Gln) mutation in PRKG1 has been shown to be associated with thoracic aortic aneurysms and dissections. This rare mutation accounts for an estimated 1% of nonsyndromic heritable thoracic aortic disease. We sought to describe the clinical presentation of type B aortic dissection (TBAD), management, and outcomes in patients with this mutation. METHODS This is a descriptive multi-institutional retrospective study of patients from six families with the PRKG1 mutation. Patients with TBAD were selected for analysis. Demographics, family histories, TBAD management, and outcomes were reviewed. RESULTS Of the 29 individuals diagnosed with the PRKG1 mutation, 12 (41.3%) had TBAD (50% male, TBAD median age: 31 years [range, 16-58 years], median follow-up: 6 years [range, 3-15 years] after TBAD). All had a family history of aortic dissections and none had features of Marfan syndrome. The median size of the descending thoracic aorta (DTA) at TBAD was 4.1 cm (range, 3.8-5 cm). Most cases (9 acute TBAD, 1 incidental TBAD diagnosis during screening) were managed medically. One case had open DTA repair the acute phase. Repair for dissection-related aneurysmal degeneration was performed in seven cases (58.3%) in the chronic phase at a median of 2 years (range, 1-8 years) after TBAD. In four cases (33.3%), the DTA remained stable in size over a range of 1 to 7 years after TBAD. Type A aortic dissection subsequent to TBAD occurred in three cases (25%). There were four (33.3%) deaths in the series, all aortic related at a median age of 24 years (range, 19-43 years). CONCLUSIONS The PRKG1 (p.Arg177Gln) mutation although rare is associated with nonsyndromic TBAD in young and middle-aged patients. Workup for this gene mutation should be included as part of the workup for TBAD etiology in relatively young patients and those with familial history of aortic dissections. Once diagnosed, testing of first-degree family members is warranted. In all individuals with a PRKG1 mutation, close follow-up for aortic root dilatation and hypertension control is essential to reduce the risk of type A or type B aortic dissection, and in cases of TBAD, to decrease the risk of dissection-related aneurysmal degeneration.
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Affiliation(s)
- Sherene Shalhub
- Division of Vascular Surgery, Department of Surgery, University of Washington School of Medicine, Seattle, Wash.
| | - Ellen S Regalado
- Division of Medical Genetics, Department of Internal Medicine, The University of Texas Health Science Center at Houston, Houston, Tex
| | - Dong-Chuan Guo
- Division of Medical Genetics, Department of Internal Medicine, The University of Texas Health Science Center at Houston, Houston, Tex
| | - Dianna M Milewicz
- Division of Medical Genetics, Department of Internal Medicine, The University of Texas Health Science Center at Houston, Houston, Tex
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7
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Zhou B, Li W, Zhao G, Yu B, Ma B, Liu Z, Xie N, Fu Y, Gong Z, Dai R, Zhang X, Kong W. Rapamycin prevents thoracic aortic aneurysm and dissection in mice. J Vasc Surg 2018; 69:921-932.e3. [PMID: 30253896 DOI: 10.1016/j.jvs.2018.05.246] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 05/25/2018] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate whether rapamycin inhibits the development of thoracic aortic aneurysm and dissection (TAAD) in mice. METHODS Three-week-old C57BL/6J male mice were fed a normal diet and randomized into a control group (n = 6), β-aminopropionitrile fumarate (BAPN) group (Gp A; n = 15), BAPN plus rapamycin (5 mg) group (Gp B; n = 8), and BAPN plus rapamycin (10 mg) group (Gp C; n = 8). Gp A, Gp B, and Gp C were administered BAPN (1 g/kg/d) for 4 weeks. One week after BAPN administration, Gp B and Gp C were treated with rapamycin (5 mg/kg/d or 10 mg/kg/d) through gavage for 21 days. Thoracic aortas were harvested for Western blot and immunofluorescence staining at day 14 and for morphologic and histologic analyses at day 28. RESULTS BAPN treatment induced TAAD formation in mice. The incidence of TAAD in control, Gp A, Gp B, and Gp C mice was 0%, 80%, 25%, and 37.5%, respectively. Smaller thoracic aortic diameters (ascending aorta and arch) were observed in Gp B and Gp C mice than in Gp A mice (Gp B vs Gp A: ascending aorta, ex vivo, 1.07 ± 0.21 mm vs 1.80 ± 0.67 mm [P < .05]; aortic arch, ex vivo, 1.51 ± 0.40 mm vs 2.70 ± 1.06 mm [P < .05]; Gp C vs Gp A: ascending aortas, ex vivo, 1.10 ± 0.33 mm vs 1.80 ± 0.67 mm [P < .05]; aortic arch, ex vivo, 1.55 ± 0.56 mm vs 2.70 ± 1.06 mm [P < .05]). TAAD mice exhibited elastin fragmentation, abundant inflammatory cell infiltration, and significantly increased matrix metalloproteinase production in the aorta, and rapamycin treatment alleviated these changes. The protein levels of p-S6K and p-S6 in TAAD aortic tissues increased significantly, whereas they were suppressed by rapamycin. CONCLUSIONS Rapamycin suppressed TAAD formation, probably by inhibition of mechanistic target of rapamycin signaling and reduction of inflammatory cell infiltration and matrix metalloproteinase 9 production. Targeting of the mechanistic target of rapamycin signaling pathway using rapamycin may be a favorable modulation for the clinical treatment of TAAD.
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MESH Headings
- Aminopropionitrile
- Aortic Dissection/chemically induced
- Aortic Dissection/enzymology
- Aortic Dissection/pathology
- Aortic Dissection/prevention & control
- Animals
- Anti-Inflammatory Agents/pharmacology
- Aorta, Thoracic/drug effects
- Aorta, Thoracic/enzymology
- Aorta, Thoracic/pathology
- Aortic Aneurysm, Thoracic/chemically induced
- Aortic Aneurysm, Thoracic/enzymology
- Aortic Aneurysm, Thoracic/pathology
- Aortic Aneurysm, Thoracic/prevention & control
- Dilatation, Pathologic
- Disease Models, Animal
- Male
- Matrix Metalloproteinase 9/metabolism
- Mice, Inbred C57BL
- Phosphorylation
- Protein Kinase Inhibitors/pharmacology
- Ribosomal Protein S6 Kinases/metabolism
- Signal Transduction/drug effects
- Sirolimus/pharmacology
- TOR Serine-Threonine Kinases/antagonists & inhibitors
- TOR Serine-Threonine Kinases/metabolism
- Vascular Remodeling/drug effects
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Affiliation(s)
- Biao Zhou
- Department of Vascular Surgery, Peking University People's Hospital, Peking University, Beijing, China
| | - Wei Li
- Department of Vascular Surgery, Peking University People's Hospital, Peking University, Beijing, China
| | - Guizhen Zhao
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Peking University, Beijing, China; Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing, China
| | - Bing Yu
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Peking University, Beijing, China; Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing, China
| | - Baihui Ma
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Peking University, Beijing, China; Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing, China
| | - Zhujiang Liu
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Peking University, Beijing, China; Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing, China
| | - Nan Xie
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Peking University, Beijing, China; Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing, China
| | - Yi Fu
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Peking University, Beijing, China; Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing, China
| | - Ze Gong
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Peking University, Beijing, China; Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing, China
| | - Rongbo Dai
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Peking University, Beijing, China; Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing, China
| | - Xiaoming Zhang
- Department of Vascular Surgery, Peking University People's Hospital, Peking University, Beijing, China.
| | - Wei Kong
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Peking University, Beijing, China; Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing, China
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8
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Li R, Yi X, Wei X, Huo B, Guo X, Cheng C, Fang ZM, Wang J, Feng X, Zheng P, Su YS, Masau JF, Zhu XH, Jiang DS. EZH2 inhibits autophagic cell death of aortic vascular smooth muscle cells to affect aortic dissection. Cell Death Dis 2018; 9:180. [PMID: 29416002 PMCID: PMC5833461 DOI: 10.1038/s41419-017-0213-2] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 12/04/2017] [Accepted: 12/06/2017] [Indexed: 12/16/2022]
Abstract
Enhancer of zeste homolog 2 (EZH2), a methyltransferase that di- and tri-methylates lysine-27 of histone H3, largely functions as a transcriptional repressor, and plays a critical role in various kinds of cancers. Here we report a novel function of EZH2 in regulating autophagic cell death (ACD) of vascular smooth muscle cells (VSMCs) that affect aortic dissection (AD). Inhibition of EZH2 activity by UNC1999 or knockdown EZH2 resulted in VSMC loss, while overexpression of EZH2 facilitated VSMC growth, and these effects of EZH2 on VSMCs were independent of proliferation and apoptosis. Interestingly, more autophagic vacuoles and increased LC3II protein levels were identified in VSMCs with EZH2 inhibition or deficiency. Moreover, when compared with counterparts, chloroquine alone, or chloroquine with rapamycin treatment led to more LC3II accumulation in EZH2 inhibited or knockdown VSMCs, which indicated that EZH2 negatively regulated autophagosome formation. In conjunction to this, ATG5 and ATG7 protein levels were remarkably increased in EZH2 inhibited or deficient VSMCs, and ATG5 or ATG7 knockdown virtually rescued VSMC loss induced by EZH2 inhibition or knockdown. In addition, we found that the MEK-ERK1/2 signaling pathway, but not AMPKα, mTOR, or AKT pathway, is responsible for the impact of EZH2 on ACD of VSMCs. Additionally, the adverse effects of EZH2 inhibition or knockdown on VSMCs were largely reversed by PD98059, an inhibitor of MEK1. More importantly, decreased EZH2 expression levels in the aortic wall of patients with AD indicated its contribution to VSMC loss and AD occurrence. Overall, these findings revealed that EZH2 affects ACD of VSMCs and the pathologic process of AD via regulating ATG5 and ATG7 expression and MEK-ERK1/2 signaling. Our hitherto unrecognized findings indicate that EZH2 activation has therapeutic or preventive potential for AD.
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Affiliation(s)
- Rui Li
- Division of Cardiothoracic and Vascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Xin Yi
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, 430060, China
- Cardiovascular Research Institute, Wuhan University, Wuhan, 430060, China
- Hubei Key Laboratory of Cardiology, Wuhan, 430060, China
| | - Xiang Wei
- Division of Cardiothoracic and Vascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- Key Laboratory of Organ Transplantation, Ministry of Education, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- Key Laboratory of Organ Transplantation, Ministry of Health, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Bo Huo
- Division of Cardiothoracic and Vascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Xian Guo
- Division of Cardiothoracic and Vascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Cai Cheng
- Division of Cardiothoracic and Vascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Ze-Min Fang
- Division of Cardiothoracic and Vascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Jing Wang
- Division of Cardiothoracic and Vascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Xin Feng
- Division of Cardiothoracic and Vascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Ping Zheng
- Division of Cardiothoracic and Vascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yun-Shu Su
- Division of Cardiothoracic and Vascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Jackson Ferdinand Masau
- Division of Cardiothoracic and Vascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Xue-Hai Zhu
- Division of Cardiothoracic and Vascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- Key Laboratory of Organ Transplantation, Ministry of Education, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- Key Laboratory of Organ Transplantation, Ministry of Health, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Ding-Sheng Jiang
- Division of Cardiothoracic and Vascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
- Key Laboratory of Organ Transplantation, Ministry of Education, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
- Key Laboratory of Organ Transplantation, Ministry of Health, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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9
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Li B, Wang Z, Hu Z, Zhang M, Ren Z, Zhou Z, Huang J, Hu X. P38 MAPK Signaling Pathway Mediates Angiotensin II-Induced miR143/145 Gene Cluster Downregulation during Aortic Dissection Formation. Ann Vasc Surg 2017; 40:262-273. [PMID: 28167124 DOI: 10.1016/j.avsg.2016.09.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 08/18/2016] [Accepted: 09/09/2016] [Indexed: 02/02/2023]
Abstract
BACKGROUND We endeavored to prove that angiotensin II (Ang II) regulates both the expression of micro-RNA143/145 (miR143/145) and differentiation of vascular smooth muscle cells (VSMCs) during the formation of aortic dissection (AD). We also studied the contribution of p38 mitogen-activated protein kinase (MAPK) signaling pathway toward this process. METHODS Ascending aortic tissues were harvested from the patients with AD and organ donors. Tissues were immunostained with labeled antibodies targeting p38 MAPK, phospho-p38 MAPK, alpha-smooth muscle actin (α-SMA), and osteopontin (OPN). Next, we treated mouse aortic VSMCs with different regimens of Ang II (duration and dosages) in vitro and determined expression levels of miR143/145 and VSMC phenotype marker proteins (α-SMA and OPN) by quantitative polymerase chain reaction and/or western blotting. SB203580 was used to inhibit the p38 MAPK signaling pathway. Finally, the VSMC phenotype was validated by immunofluorescence microscopy. RESULTS Expression of phospho-p38 MAPK was significantly greater in the AD tissue. Ang II induced the phenotypic switching of VSMCs along with the downregulation of an miR143/145 gene cluster. Expression of OPN and phospho-p38 was significantly increased in VSMCs treated with 0.1 μM Ang II for 12 hr. Furthermore, the expression of miR143 and miR145 was downregulated by Ang II treatment. When the p38 MAPK signaling pathway was blocked by pretreatment with an SB203580 inhibitor, the expression of miR143, miR145, and VSMC phenotypic markers was not affected by Ang II. Immunohistochemical staining of aortic tissues donated by AD patients and healthy donors showed that the expression of α-SMA decreased in pathological tissue, while the OPN increased and the arrangement of the smooth muscle cells of the media was dysregulated, which we verified in vitro. CONCLUSIONS Ang II could regulate the expression of miR143/145 gene cluster and the phenotypic switching of VSMCs via the p38 MAPK signaling pathway. This may play an important role in the pathogenesis of AD.
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MESH Headings
- Actins/metabolism
- Adult
- Aortic Dissection/enzymology
- Aortic Dissection/genetics
- Aortic Dissection/pathology
- Angiotensin II/pharmacology
- Animals
- Aortic Aneurysm/enzymology
- Aortic Aneurysm/genetics
- Aortic Aneurysm/pathology
- Case-Control Studies
- Cells, Cultured
- Dose-Response Relationship, Drug
- Female
- Humans
- Male
- Mice, Inbred C57BL
- MicroRNAs/genetics
- MicroRNAs/metabolism
- Middle Aged
- Multigene Family
- Muscle, Smooth, Vascular/drug effects
- Muscle, Smooth, Vascular/enzymology
- Muscle, Smooth, Vascular/pathology
- Myocytes, Smooth Muscle/drug effects
- Myocytes, Smooth Muscle/enzymology
- Myocytes, Smooth Muscle/pathology
- Phosphorylation
- Signal Transduction/drug effects
- Time Factors
- p38 Mitogen-Activated Protein Kinases/metabolism
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Affiliation(s)
- Bowen Li
- Department of Cardiovascular Surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, People's Republic of China
| | - Zhiwei Wang
- Department of Cardiovascular Surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, People's Republic of China.
| | - Zhipeng Hu
- Department of Cardiovascular Surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, People's Republic of China
| | - Min Zhang
- Department of Cardiovascular Surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, People's Republic of China
| | - Zongli Ren
- Department of Cardiovascular Surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, People's Republic of China
| | - Zhen Zhou
- Department of Cardiovascular Surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, People's Republic of China
| | - Jizhen Huang
- Department of Cardiovascular Surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, People's Republic of China
| | - Xiaoping Hu
- Department of Cardiovascular Surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, People's Republic of China
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10
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Gao Y, Wu W, Yu C, Zhong F, Li G, Kong W, Zheng J. A disintegrin and metalloproteinase with thrombospondin motif 1 (ADAMTS1) expression increases in acute aortic dissection. Sci China Life Sci 2015; 59:59-67. [PMID: 26563155 DOI: 10.1007/s11427-015-4959-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Accepted: 10/10/2015] [Indexed: 11/26/2022]
Abstract
Acute aortic dissection (AAD) is a life-threatening cardiovascular disease caused by progressive medial degeneration of the aortic wall. A disintegrin and metalloproteinase with thrombospondin motifs 1 (ADAMTS1) is a recently identified extracellular metalloproteinase participating in the development of vascular disease, such as atherosclerosis. In the present study, we found that ADAMTS1 was significantly elevated in blood samples from AAD patients compared with patients with acute myocardial infarction and healthy volunteers. Based on these findings, we established an AAD model by infusing angiotensin II in older mice. AAD was successfully developed in aorta tissues, with an incidence of 42% after 14 days in the angiotensin II group. Macrophage and neutrophil infiltration was observed in the media of the aorta, and ADAMTS1 overexpression was found in the aorta by Western blot and immunohistochemistry. Double immunofluorescence staining showed the expression of ADAMTS1 in macrophages and neutrophils. Consistent with the upregulation of ADAMTS1 in aortic dissection tissues, versican (a proteoglycan substrate of ADAMTS1) was degraded significantly more in these tissues than in control aortic tissues. These data suggest that the increased expression of ADAMTS1 protein in macrophages and neutrophils that infiltrated aortic tissues may promote the progression of AAD by degrading versican.
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Affiliation(s)
- Yanxiang Gao
- Department of Cardiology, China-Japan Friendship Hospital, Beijing, 100029, China
| | - Wenjing Wu
- Department of Cardiology, China-Japan Friendship Hospital, Beijing, 100029, China
| | - Changan Yu
- Central Laboratory of Cardiovascular Disease, China-Japan Friendship Hospital, Beijing, 100029, China
| | - Fangming Zhong
- Department of Cardiology, China-Japan Friendship Hospital, Beijing, 100029, China
| | - Geng Li
- Central Laboratory of Cardiovascular Disease, China-Japan Friendship Hospital, Beijing, 100029, China
| | - Wei Kong
- Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Peking University, Beijing, 100191, China
| | - Jingang Zheng
- Department of Cardiology, China-Japan Friendship Hospital, Beijing, 100029, China.
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11
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Starke RM, Komotar RJ, Connolly ES. Molecular mechanisms behind aneurysm and dissection formation. Neurosurgery 2013; 73:N10-1. [PMID: 24257335 DOI: 10.1227/01.neu.0000438330.64943.51] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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12
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Song Y, Xie Y, Liu F, Zhao C, Yu R, Ban S, Ye Q, Wen J, Wan H, Li X, Ma R, Meng Z. Expression of matrix metalloproteinase-12 in aortic dissection. BMC Cardiovasc Disord 2013; 13:34. [PMID: 23642232 PMCID: PMC3660235 DOI: 10.1186/1471-2261-13-34] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2013] [Accepted: 04/30/2013] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Aortic dissection(AD) is an acute process of large blood vessels characterized by dangerous pathogenic conditions and high disability and high mortality. The pathogenesis of AD remains debated. Matrix metalloproteinase-12 (MMP-12) participates in many pathological processes such as abdominal aortic aneurysm, atherosclerosis, emphysema and cancer. However, this elastase has rarely been assessed in the presence of AD. The aim of the present study was to investigate the expression of MMP-12 in aortic tissue so as to offer a better understanding of the possible mechanisms of AD. METHODS The protein expression levels of MMP-12 were analyzed and compared in aorta tissue and the blood serum samples by reverse transcription polymerase chain reaction(RT-PCR), Western blotting, immuno-histochemistry, fluorescence resonance energy transfer ( FRET ) activity assay and enzyme-linked immuno sorbent assay ( ELISA ), respectively. Ascending aorta tissue specimens were obtained from 12 patients with an acute Stanford A-dissection at the time of aortic replacement, and from 4 patients with coronary artery disease (CAD) undergoing coronary artery bypass surgery. Meanwhile, serum samples were harvested from 15 patients with an acute Stanford A-dissection and 10 healthy individuals who served as the control group. RESULTS MMP-12 activity could be detected in both AD and CAD groups, but the level in the AD group was higher than those in the CAD group (P < 0.05). MMP-12 proteolysis existed in both serum samples of the AD and healthy groups, and the activity level in the AD group was clearly higher than in the healthy group (P < 0.05). For AD patients, MMP-12 activity in serum was higher than in the aorta wall (P < 0.05). MMP-12 activity in the aortic wall tissue can be inhibited by MMP inhibitor v (P < 0.05). CONCLUSION The present study directly demonstrates that MMP-12 proteolytic activity exists within the aorta specimens and blood samples from aortic dissection patients. MMP-12 might be of potential relevance as a clinically diagnostic tool and therapeutic target in vascular injury and repair.
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Affiliation(s)
- Yi Song
- Laboratory of Molecular Cardiology, Department of Cardiology; The First Affiliated Hospital Of Kunming Medical University, Kunming, 650032, China
- The Department of Cardiovascular Surgery, The Second Hospital of Yunnan Province, Kunming, 650032, China
| | - Yuehui Xie
- Laboratory of Molecular Cardiology, Department of Cardiology; The First Affiliated Hospital Of Kunming Medical University, Kunming, 650032, China
- Department of Computer Science, The Faculty of Basic Medicine, Kunming Medical University, Kunming, 650031, China
| | - Feng Liu
- Laboratory of Molecular Cardiology, Department of Cardiology; The First Affiliated Hospital Of Kunming Medical University, Kunming, 650032, China
| | - Chong Zhao
- Laboratory of Molecular Cardiology, Department of Cardiology; The First Affiliated Hospital Of Kunming Medical University, Kunming, 650032, China
| | - Rui Yu
- Laboratory of Molecular Cardiology, Department of Cardiology; The First Affiliated Hospital Of Kunming Medical University, Kunming, 650032, China
| | - Shao Ban
- Laboratory of Molecular Cardiology, Department of Cardiology; The First Affiliated Hospital Of Kunming Medical University, Kunming, 650032, China
| | - Qiufang Ye
- Laboratory of Molecular Cardiology, Department of Cardiology; The First Affiliated Hospital Of Kunming Medical University, Kunming, 650032, China
| | - Jianxion Wen
- Laboratory of Molecular Cardiology, Department of Cardiology; The First Affiliated Hospital Of Kunming Medical University, Kunming, 650032, China
| | - Haibo Wan
- Laboratory of Molecular Cardiology, Department of Cardiology; The First Affiliated Hospital Of Kunming Medical University, Kunming, 650032, China
| | - Xiang Li
- The Department of Cardiovascular Surgery, The Second Hospital of Yunnan Province, Kunming, 650032, China
| | - Runwei Ma
- Laboratory of Molecular Cardiology, Department of Cardiology; The First Affiliated Hospital Of Kunming Medical University, Kunming, 650032, China
- The Department of Cardiovascular Surgery, The Second Hospital of Yunnan Province, Kunming, 650032, China
| | - Zhaohui Meng
- Laboratory of Molecular Cardiology, Department of Cardiology; The First Affiliated Hospital Of Kunming Medical University, Kunming, 650032, China
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13
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Lesauskaite V, Sinkunaite-Marsalkiene G, Tamosiunas A, Benetis R. Protective effects of angiotensin-converting enzyme I/I and matrix metalloproteinase-3 6A/6A polymorphisms on dilatative pathology within the ascending thoracic aorta. Eur J Cardiothorac Surg 2010; 40:23-7. [PMID: 21111627 DOI: 10.1016/j.ejcts.2010.10.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2010] [Revised: 10/05/2010] [Accepted: 10/07/2010] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Activation of matrix metalloproteinases and the renin/angiotensin signaling pathways is under investigation with regard to their potential pathogenesis in dilatative pathology of the aorta. The purpose of this study was to explore matrix metalloproteinase-3 5A/6A and angiotensin-converting enzyme I/D polymorphisms as predisposing factors to dilatative pathology of the aorta. METHODS We studied 107 patients who underwent aortic reconstruction surgery due to dilatative pathology of ascending thoracic aorta and a random sample of the population (n = 773), all from Lithuania. The insertion/deletion (-1171 5A/6A) polymorphism in the promoter region of matrix metalloproteinase-3 studied by real-time polymerase-chain-reaction amplification and the D and I alleles were identified on the basis of standard polymerase-chain-reaction amplification of the respective fragments from intron 16 of the angiotensin-converting enzyme gene. RESULTS The frequency of the angiotensin-converting enzyme D allele was significantly higher in dilatative pathology of ascending thoracic aorta patients than in the reference group subjects (0.55 vs 0.48, respectively). The latter group had a significantly higher frequency of the angiotensin-converting enzyme I/I genotype than in dilatative pathology of ascending thoracic aorta patients (27.4% vs 16.5%, respectively). In the reference group, the frequency of combined angiotensin-converting enzyme I/I and matrix metalloproteinase-3 6A/6A genotypes was 7.5%, while in the dilatative pathology of ascending thoracic aorta patient group, there was no one carrying that combined genotype (p = 0.001). CONCLUSIONS The present study showing a role of angiotensin-converting enzyme and matrix metalloproteinase-3 in the development of dilatative pathology of ascending thoracic aorta permits us to entertain a possible protective mechanism for the combined effects of the angiotensin-converting enzyme I/I and the matrix metalloproteinase-3 6A/6A genotypes.
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Affiliation(s)
- Vaiva Lesauskaite
- Laboratory of Molecular Cardiology, Institute of Cardiology, Kaunas University of Medicine, Kaunas, Lithuania.
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14
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Abstract
Thoracic aortic dissection, one of the major diseases affecting the aorta, carries a very high mortality rate. Improving our understanding of the pathobiology of this disease may help us develop medical treatments to prevent dissection and subsequent aneurysm formation and rupture. Dissection is associated with degeneration of the aortic media. Recent studies have shown increased expression and activation of a family of proteolytic enzymes-called matrix metalloproteinases (MMPs)-in dissected aortic tissue, suggesting that MMPs may play a major role in this disease. Inhibition of MMPs may be beneficial in reducing MMP-mediated aortic damage associated with dissection. This article reviews the recent literature and summarizes our current understanding of the role of MMPs in the pathobiology of thoracic aortic dissection. The potential importance of MMP inhibition as a future treatment of aortic dissection is also discussed.
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Affiliation(s)
- Xiaoming Zhang
- Cardiovascular Surgery Service, Texas Heart Institute at St. Luke's Episcopal Hospital, The Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA
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15
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Chan YC, Cheuk B, Cheng SW. How important are metalloproteinases in aortic dissection? Int J Clin Pract 2008; 62:1468-9. [PMID: 18822019 DOI: 10.1111/j.1742-1241.2007.01633.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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16
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Kuhlenbäumer G, Friedrichs F, Kis B, Berlit P, Maintz D, Nassenstein I, Nabavi D, Dittrich R, Stoll M, Ringelstein B. Association between single nucleotide polymorphisms in the lysyl oxidase-like 1 gene and spontaneous cervical artery dissection. Cerebrovasc Dis 2007; 24:343-8. [PMID: 17690546 DOI: 10.1159/000106980] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2007] [Accepted: 04/13/2007] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Spontaneous cervical artery dissection (sCAD) is a common cause of stroke in patients below 55 years. Dermal connective tissue abnormalities have been observed in up to 60% of patients. A chromosomal locus for connective tissue abnormalities associated with sCAD has been mapped to chromosome 15q24 to a candidate region containing the lysyl oxidase-like 1 gene (LOXL1). LOXL1 an excellent candidate susceptibility gene for non-familial sCAD was investigated by mutation analysis and a genetic association study. METHODS We sequenced the whole coding region of the LOXL1 gene in 15 sCAD patients and performed a genetic association study in 157 sCAD patients using 12 single nucleotide polymorphisms (SNP). RESULTS The SNP rs3825942 (Gly153Asp) showed marginal association with sCAD on an allele basis and in the dominant genetic model, and intronic SNP rs893817 under a recessive model only. None of the SNP haplotypes was associated with sCAD. CONCLUSIONS Genetic variation in LOXL1 might play a role as a risk factor for sCAD.
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Affiliation(s)
- G Kuhlenbäumer
- Leibniz Institute of Atherosclerosis Research, University of Münster, Münster, Germany.
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17
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Sangiorgi G, Trimarchi S, Mauriello A, Righini P, Bossone E, Suzuki T, Rampoldi V, Eagle KA. Plasma levels of metalloproteinases-9 and -2 in the acute and subacute phases of type A and type B aortic dissection. J Cardiovasc Med (Hagerstown) 2006; 7:307-15. [PMID: 16645407 DOI: 10.2459/01.jcm.0000223251.26988.c5] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES Aortic dissection is characterized by an acute phase of medial dissection and a subacute-chronic phase of vessel wall repair. Matrix metalloproteinases (MMPs), through degradation of extracellular matrix, may play an important role in these processes. Elevation of MMPs might represent an opportunity to diagnostically characterize acute or chronic aortic processes. We examined the potential diagnostic role of MMP-9 and MMP-2 in different phases of aortic dissection. METHODS Plasma levels of MMPs were evaluated by enzyme-linked immunosorbent assay technique in 13 patients affected by acute aortic dissection (nine type A, four type B). Ten healthy subjects were used as controls. In patients with type B aortic dissection treated medically, plasma curves (1, 3, 6, 12, 24, 48 and 96 h; 1 and 2 weeks; and 2 months from symptom onset) were also assessed. Aortic tissue samples obtained during surgery were evaluated by immunohistochemistry and western blot for MM-9 and tissue inhibitor of metalloproteinase-1 expression. RESULTS MMP-9 plasma levels were increased in patients affected by type A and type B aortic dissection presenting within 1 h from onset of symptoms compared to controls (29.3 +/- 16.1 and 16.7 +/- 2.1 ng/ml versus 7.74 +/- 1.6 ng/ml, P < 0.03, respectively). No differences were detected in MMP-2 plasma levels compared to controls (4.84 +/- 1.2 ng/ml for type A and 6.16 +/- 0.6 ng/ml versus 3.17 +/- 1.0 ng/ml for controls, P = NS, respectively). In type B aortic dissection, mean MMP-9 plasma levels increased significantly from hospital admission to 2-month follow-up (16.7 +/- 2.1 ng/ml versus 58.0 +/- 8.2 ng/ml, P < 0.0001). Conversely, no difference in MMP-2 plasma levels was evident during follow-up (6.16 +/- 0.6 ng/ml versus 4.28 +/- 0.4 ng/ml, P = NS, respectively). Low-moderate (+/++) expression of MMP-9 was evident at immunohistochemistry in the acute phase whereas a marked expression (++++) was detected in the subacute phase. CONCLUSIONS This pilot study suggests that the acute and subacute phase of both type A and type B aortic dissection is characterized by an increase of MMP-9 plasma levels. A marked increase is also evident in the subacute phase of medically treated type B aortic dissection as an expression of aortic wall remodelling. An increase of proteolytic activity could accompany attempts of the dissected aorta to heal itself but such a phenomena might further weaken the aortic wall, predisposing it to dilation and/or rupture.
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Affiliation(s)
- Giuseppe Sangiorgi
- Department of Cardiovascular Diseases, Istituto Policlinico San Donato, University of Milan, Milan, Italy.
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Song WH, Dang AM, Zhu JM, Lü NQ, Liu GZ, Hui RT. [MMP-9 gene -1562C/T polymorphism in aortic dissection in Chinese hypertensive patients]. Zhonghua Nei Ke Za Zhi 2006; 45:376-8. [PMID: 16780738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
OBJECTIVE To investigate the association of matrix metalloproteinase 9 (MMP-9) gene -1562C/T polymorphism with the pathogenesis and site involved range of aortic dissection in Chinese population. METHODS 142 hypertensive patients with aortic dissection and 130 hypertensive patients without aortic dissection were enrolled. Genomic DNAs were extracted from peripheral blood leucocytes. MMP-9 gene -1562C/T polymorphism was determined with PCR-RFLP. MMP-9 gene -1562C/T genotype and allele frequency were compared between hypertensive patients with aortic dissection and without. In addition, associations of MMP-9 gene -1562C/T polymorphism with clinical aspects were analyzed in hypertensive patients with aortic dissection. RESULTS There was a significant difference in the T allele frequency of the C-1562T MMP-9 polymorphism between the two groups, with more T allele (17.6%) observed in hypertensive patients with aortic dissection as compared with these without (11.2%) (P = 0.033). The genotype distribution for the MMP-9 -1562C/T polymorphism in hypertensive patients with aortic dissection (-1562CC: 69.0%; -1562 CT: 26.8%; -1562TT: 4.2%) and those without (-1562CC: 79.2%; -1562CT: 19.2%; -1562TT: 1.6%; P = 0.118) showed no remarkable difference, but hypertensive patients with aortic dissection possessing T allele showed a higher odds ratio for involving ascending aorta (OR = 2.063, 95% CI = 0.998 - 4.264, P = 0.049) as compared with those without T allele. CONCLUSIONS The T variant of MMP-9 gene -1562C/T polymorphism was significantly associated with aortic dissection in hypertensive patients and may represent an important genetic component contributing to aortic dissection susceptibility. Furthermore, hypertensive patients with aortic dissection possessing MMP-9 gene -1562T allele are more prone to involvement of ascending aorta.
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Affiliation(s)
- Wei-hua Song
- Cardiovascular Institute and Fuwai Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing 100037, China
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Akiyama M, Ohtani H, Sato E, Nagura H, Tabayashi K. Up-regulation of matrix metalloproteinase-2 and membrane-type 1-matrix metalloproteinase were coupled with that of type I procollagen in granulation tissue response after the onset of aortic dissection. Virchows Arch 2006; 448:811-21. [PMID: 16609908 DOI: 10.1007/s00428-006-0194-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2005] [Accepted: 11/18/2005] [Indexed: 11/25/2022]
Abstract
The pathophysiological significance of matrix metalloproteinases (MMPs) in aortic dissection remains poorly understood. The purpose of the present study is to clarify the significance of MMPs in aortic dissection. The activities and distributions of MMP-2, membrane-type 1-MMP (MT1-MMP), and MMP-9 were evaluated by gelatin zymography, immunohistochemistry, and in situ hybridization in 29 patients and seven autopsy cases. To assess if these MMPs are related to a tissue remodeling process, we compared the expression of these MMPs with that of type I procollagen and platelet-derived growth factor receptor beta chain (PDGF Rbeta). Patients were divided into three groups based on histological findings: acute, intermediate, and healed groups. The most remarkable changes were observed in the intermediate group, in which MMP-2 activity peaked and tissue expression of mRNAs for MMP-2 and MT1-MMP were observed in spindle-shaped cells in the neointima, organizing thrombus, and the adventitia. These expression patterns were essentially coupled with those of type I procollagen mRNA and PDGF-Rbeta protein. The association of MMP-2, MT1-MMP, type I procollagen, and PDGF-Rbeta suggests that MMP-2 and MT1-MMP could be involved not only in the degradation of aortic tissue but also in tissue remodeling, which may be associated with the healing process.
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Affiliation(s)
- Masatoshi Akiyama
- Department of Cardiovascular Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Sendai 980-8574, Japan.
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Nakajima M, Tsuchiya K, Fukuda S, Morimoto H, Mitsumori Y, Kato K. Aortic operation after previous coronary artery bypass grafting. Gen Thorac Cardiovasc Surg 2006; 54:155-9. [PMID: 16642921 DOI: 10.1007/bf02662470] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Aortic surgery for progressive aortic valve disease or aortic aneurysm after previous coronary artery bypass grafting (CABG) is a challenging procedure. We report the outcome of aortic reoperation after previous CABG and evaluate our management of patent grafts and our methods for obtaining myocardial protection. METHODS From February 2001 to July 2003, 6 patients with progressive aortic valve disease and aneurysm of the thoracic aorta were operated on. The group comprised 3 men and 3 women with a mean age of 67.6 years. There were 4 patients with an aneurysm of the aortic arch, 1 with chronic ascending aortic dissection, and 1 with progressive aortic valve stenosis. The interval between previous CABG and aortic surgery was 74.0 +/- 44.2 months. All reoperations were performed via median resternotomy. Myocardial protection was obtained by hypothermic perfusion of patent in-situ arterial grafts following cold-blood cardioplegia administration via the aortic root under aortic cross clamping. RESULTS The operative procedure was aortic arch replacement in 4 patients, ascending aortic replacement with double CABG in 1, and aortic valve replacement in 1. All patients survived the reoperation. Postoperative maximum creatine kinase-MB was 49.2 +/- 29.8 and no new Q-waves occurred in the electrocardiogram nor were any new wall motion abnormalities recognized on echocardiography. There were no late deaths during a follow-up of 30.7 months. CONCLUSION Reoperative aortic procedures after CABG can be performed safely with myocardial protection via hypothermic perfusion of a patent in-situ arterial graft.
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Affiliation(s)
- Masato Nakajima
- Department of Cardiovascular Surgery, Yamanashi Central Hospital, Yamanashi, Japan
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21
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Abstract
BACKGROUND A chemical-induced, nonlethal, dissecting aortic aneurysm (DAA) is described following in utero exposure to semicarbazide, an inhibitor of the vascular enzyme semicarbazide sensitive amine oxidase (SSAO). METHODS Sprague-Dawley rat dams were given semicarbazide (0.096-49.000 mg/kg/day) by IP injection on gestation days (GDs) 14-20, a period of rapid aortic development. Newborn rats (day 1) were killed and their thoracic organs were removed en bloc for near-serial cross sections and routine histopathology, Movat stain for elastin, and immunohistochemistry to differentiate cells involved in the evolution of the DAA. In subsequent experiments, pups from treated dams (0.096-6.125 mg/kg/day) were allowed to survive for 7 or 28 days. RESULTS DAA occurred in nearly 100% of the rats at all doses except the lowest tested (1.530, 0.096 mg/kg/day). Dissections frequently extended to the carotids and, less frequently, to the abdominal aorta. Remodeling of vascular lesions proceeded by organization of collections of blood in vascular media (the "false lumen"), proliferation of vascular smooth muscle cells, fibrosis, and formation of irregular frayed elastic lamellae in healed vascular media. Biochemical quantitation and Western blot analysis of main extracellular matrix proteins on GD 20 showed no overt difference in expression of collagen type I, fibrillin-1, or elastin. CONCLUSION This developmental model provides investigators an opportunity to explore the pathologic mechanisms of DAA and to examine the potential long-term effects of vascular remodeling of DAA.
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MESH Headings
- Amine Oxidase (Copper-Containing)/antagonists & inhibitors
- Analysis of Variance
- Aortic Dissection/chemically induced
- Aortic Dissection/enzymology
- Aortic Dissection/metabolism
- Aortic Dissection/pathology
- Animals
- Animals, Newborn
- Aorta, Thoracic/drug effects
- Aorta, Thoracic/enzymology
- Aorta, Thoracic/growth & development
- Aorta, Thoracic/metabolism
- Aorta, Thoracic/pathology
- Aortic Aneurysm, Thoracic/chemically induced
- Aortic Aneurysm, Thoracic/enzymology
- Aortic Aneurysm, Thoracic/metabolism
- Aortic Aneurysm, Thoracic/pathology
- Collagen/analysis
- Collagen/metabolism
- Dose-Response Relationship, Drug
- Elastin/analysis
- Elastin/metabolism
- Female
- Gestational Age
- Immunohistochemistry
- Injections, Intraperitoneal
- Models, Biological
- Pregnancy
- Rats
- Rats, Sprague-Dawley
- Semicarbazides/administration & dosage
- Semicarbazides/toxicity
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Affiliation(s)
- Bin Gong
- Department of Pathology, University of Texas Medical Branch, Galveston, Texas 77555, USA
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22
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Yotsumoto G, Toyohira H, Moriyama Y, Watanabe S, Iguro Y, Masuda H, Hisatomi K, Shimokawa S, Taira A. [Cerebral cytochrome oxidase monitoring by near infrared spectroscopy during selective cerebral perfusion]. Nihon Kyobu Geka Gakkai Zasshi 1997; 45:970-3. [PMID: 9256633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
To evaluate selective cerebral perfusion (SCP) for brain protection, the redox state of cytochrome oxidase (Cyt. aa3) in brain tissue were studied in 27 patients with thoracic aortic repair. The redox state of Cyt. aa3 was monitored by near infrared spectroscopy (NIRS) (OM-110, Shimazu). There were no significant changes in the Cyt. aa3 redox state in 13 (Group I), the oxidation state of Cyt. aa3 decreased then recovered to control levels in 12 (Group II), and the oxidation state decreased but did not recover in 2 patients (Group III). Postoperative cerebral damage was observed in 5 patients; blindness occurred in one patient in Group I (8.3%), 2 patients developed hemiplegia in Group II (15.4%), and the 2 patients in Group III failed to reawaken (100%). The incidence of cerebral damage was significantly higher in Group III than in Groups I and II (p < 0.05). We conclude that monitoring the redox state of Cyt. aa3 using NIRS is useful in predicting postoperative cerebral damage. However, it is necessary to increase the number of measurement sites since NIRS can reflect the state in only a small area of the brain.
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Affiliation(s)
- G Yotsumoto
- Second Department of Surgery, Kagoshima University Faculty of Medicine, Japan
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Thal DR, Schober R, Schlote W. Carotid artery dissection in a young adult: cystic medial necrosis associated with an increased elastase content. Clin Neuropathol 1997; 16:180-4. [PMID: 9266141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
A dissecting aneurysm of the right internal carotid artery was found in a 22-year-old man, who rapidly became unconscious and hemiparetic after an accident occurring during sport. The dissection was limited to the intima and internal elastic lamina. Patterns of cystic medial necrosis with mucoid degeneration were present in the right internal carotid artery proximal to the site of dissection, in the thoracic aorta, and in several visceral arteries. In the region of the right internal carotid artery affected with cystic medial necrosis, calcification and also splitting of the internal elastic lamina was found. Such calcification was also present at the site of the dissection, at the tip of the ruptured and recoiled elastic lamina. These changes, dissection as well as cystic medial necrosis, were associated with an elevated elastase content, a decrease of desmin and an increase of vimentin expression. Ultrastructurally, in areas affected by cystic medial necrosis a corresponding transformation of medial smooth muscle cell phenotype from the contractile to the metabolic state was found. The topographical relation of dissecting aneurysm, cystic medial necrosis, and an increased elastase content is suggestive of a causal relation, and the possibility of common etiological factors is discussed.
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Affiliation(s)
- D R Thal
- Department of Neuropathology, University of Frankfurt, Main, Germany
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Kotoh K, Ueyama T, Yasuda M. [Study on the change in serum enzyme activity during acute aortic dissection]. Rinsho Kyobu Geka 1989; 9:567-72. [PMID: 9308662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Cases of acute aortic dissection presenting to the First Department of Surgery at Toyama Medical and Pharmaceutical University Hospital were divided into 2 groups according to the presence or absence of complications such as electrocardiographic abnormalities, hepatic or renal dysfunction, intestinal necrosis, and leg ischemia. After hospitalization such complications were completely absent in the "complication-free group", but were present in the "complication group". Fluctuations in serum enzyme activity (CK, LDH, GOT, GPT) were measured, and the 2 groups compared. In the complication-free group, serum CK activity was significantly elevated at 273.3 +/- 154.5 IU/l, reaching a peak on the first day, after which it decreased to normal by the fourth day. In the complication group, fluctuations in the serum enzyme activity levels corresponded to the type of complication, with the fluctuations paralleling changes in the clinical course. Also, CK activity was measured in aortic wall specimens obtained at autopsy, and the CK activity of 585.0 +/- 35.3 IU/g protein demonstrated. From the above it was thought the transient elevation of serum CK activity found in uncomplicated aortic dissection is due to the CK released from the dissected aortic wall into blood.
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