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Villard C, Wågsäter D, Swedenborg J, Eriksson P, Hultgren R. Biomarkers for Abdominal Aortic Aneurysms From a Sex Perspective. ACTA ACUST UNITED AC 2012; 9:259-266.e2. [DOI: 10.1016/j.genm.2012.05.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2012] [Revised: 05/18/2012] [Accepted: 05/26/2012] [Indexed: 01/08/2023]
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Ehsan S, Ball G, Choke E, Molyneux KM, London NJM, Herbert KE, Barratt J, Sayers RD, Bown MJ. Disease specific biomarkers of abdominal aortic aneurysms detected by surface enhanced laser desorption ionization time of flight mass spectrometry. Eur J Vasc Endovasc Surg 2012; 44:52-4. [PMID: 22595147 DOI: 10.1016/j.ejvs.2012.04.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2011] [Accepted: 04/20/2012] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Biomarkers have the potential to improve the clinical management of patients with AAA. REPORT A prospective, proteomics discovery study was undertaken to compare patients with AAA (n = 20) to matched screened controls (n = 19) for plasma protein expression. Surface-Enhanced-Laser-Desorption-Ionization Time of Flight Mass Spectrometry (SELDI ToF MS) coupled with Artificial Neural Networks (ANN) analysis identified six protein related diagnostic biomarker ions with a combined AUC of 0.89. DISCUSSION This study discovered a signature plasma protein profile for patients with AAA and demonstrated that mass spectrometric based research for disease specific biomarker of AAA is feasible.
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Affiliation(s)
- S Ehsan
- Department of Cardiovascular Sciences, University of Leicester, UK.
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53
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De Haro J, Acin F, Bleda S, Varela C, Medina FJ, Esparza L. Prediction of asymptomatic abdominal aortic aneurysm expansion by means of rate of variation of C-reactive protein plasma levels. J Vasc Surg 2012; 56:45-52. [PMID: 22551908 DOI: 10.1016/j.jvs.2012.01.003] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2011] [Revised: 12/29/2011] [Accepted: 01/03/2012] [Indexed: 11/18/2022]
Abstract
OBJECTIVE C-reactive protein (CRP) is an independent risk factor for arteriosclerosis, but its role in abdominal aortic aneurysm (AAA) expansion remains not completely verified. There are no data about the prognostic significance of rates of variation of the CRP levels in asymptomatic AAAs. This study investigated the association between plasma CRP levels and AAA diameter and assessed the relationship between the gradient of CRP levels and rates of expansion in asymptomatic AAAs. METHODS Plasma levels of high-sensitive CRP (hs-CRP) were measured using a high-sensitivity technique and AAA size was determined by computed tomography in 435 patients with asymptomatic AAAs followed up in our outpatient department. RESULTS The median hs-CRP level was 4.23 mg/L. The aorta diameter increased in the four groups of patients determined according to hs-CRP quartiles (35 ± 2, 40 ± 3, 49 ± 4, and 58 ± 5 mm; P = .01). The median rate of CRP level variation per year was 1.4 mg/L. Patients with an elevation >1.4 mg/L had an expansion rate of 4.8 mm vs 3.9 mm in those <1.4 mg/L (P < .01). The multivariate age-adjusted logistic model confirmed initial diameter and variation of CRP level were the only factors associated with expansion, with odds ratios (95% confidence intervals) of 6.3 (3.1-7.5) and 3.4 (2.1-5.6). CONCLUSIONS These results confirm a statistical association between AAA diameter and hs-CRP plasma levels. This cohort study corroborates this potential causal association and contributes information about the value of the hs-CRP plasma level gradient as a marker of disease progression and rate of expansion.
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Affiliation(s)
- Joaquin De Haro
- Angiology and Vascular Surgery Department of Hospital Universitario Getafe, Madrid, Spain.
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54
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Metabolomic study of plasma of patients with abdominal aortic aneurysm. Anal Bioanal Chem 2012; 403:1651-60. [DOI: 10.1007/s00216-012-5982-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2011] [Revised: 03/25/2012] [Accepted: 03/26/2012] [Indexed: 10/28/2022]
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Plasma profiling by a protein array approach identifies IGFBP-1 as a novel biomarker of abdominal aortic aneurysm. Atherosclerosis 2012; 221:544-50. [DOI: 10.1016/j.atherosclerosis.2012.01.009] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2011] [Revised: 01/04/2012] [Accepted: 01/04/2012] [Indexed: 01/05/2023]
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Sun J, Sukhova GK, Zhang J, Chen H, Sjöberg S, Libby P, Xiang M, Wang J, Peters C, Reinheckel T, Shi GP. Cathepsin L activity is essential to elastase perfusion-induced abdominal aortic aneurysms in mice. Arterioscler Thromb Vasc Biol 2012; 31:2500-8. [PMID: 21868704 DOI: 10.1161/atvbaha.111.230201] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVE The development of abdominal aortic aneurysms (AAA) requires extensive aortic wall matrix degradation. Human AAA lesions express high levels of cathepsin L (CatL), one of the most potent mammalian elastases. Whether this protease participates directly in AAA pathogenesis, however, is unknown. METHODS AND RESULTS We generated experimental AAA with aortic elastase perfusion in mice and established an essential role of CatL in AAA formation. After 14 days postperfusion, most wild-type (Ctsl(+/+)) mice developed AAA, but none of the CatL-deficient (Ctsl(-/-)) mice did. AAA lesion macrophage contents, CD4(+) T cell numbers, CD31(+) and laminin-5 angiogenic fragment γ2(+) microvessel numbers, and elastin fragmentation were all significantly lower in Ctsl(-/-) mice than in Ctsl(+/+) mice. While lesions from Ctsl(-/-) mice contained fewer Ki67(+) proliferating cells than did Ctsl(+/+) mice, the absence of CatL did not affect lesion apoptotic cell contents or medial smooth-muscle cell loss significantly. Mechanistic studies indicated that the absence of CatL reduced lesion chemokine monocyte chemotactic protein-1 content, macrophage and T-cell in vitro transmigration, and angiogenesis, and altered the expression and activities of matrix metalloproteinases and other cysteinyl cathepsins in inflammatory cells, vascular cells, and AAA lesions. CONCLUSION CatL contributes to AAA formation by promoting lesion inflammatory cell accumulation, angiogenesis, and protease expression.
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Affiliation(s)
- Jiusong Sun
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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Hope TA, Hope MD. Improved risk assessment for abdominal aortic aneurysm rupture: off-the-wall imaging. J Am Coll Cardiol 2012; 58:2531-2. [PMID: 22133854 DOI: 10.1016/j.jacc.2011.09.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2011] [Accepted: 09/12/2011] [Indexed: 11/26/2022]
Affiliation(s)
- Thomas A Hope
- Department of Radiology and Biomedical Imaging, University of California-San Francisco, CA, USA
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Wallinder J, Bergström J, Henriksson AE. Discovery of a novel circulating biomarker in patients with abdominal aortic aneurysm: a pilot study using a proteomic approach. Clin Transl Sci 2012; 5:56-9. [PMID: 22376258 DOI: 10.1111/j.1752-8062.2011.00372.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Abdominal aortic aneurysm (AAA) is a common condition with high mortality when ruptured. Most clinicians agree that small AAAs are best managed by ultrasonographic surveillance. However, it has been stated in recent reviews that a serum/plasma biomarker that predicts AAA rupture risk would be a powerful tool in stratifying patients with small AAA. Identification of such circulating biomarkers has been to date unsuccessful. In this study, we used a proteomic approach to find new, potential plasma AAA biomarker candidates. Prefractionated plasma samples were analyzed by two-dimensional differential in-gel electrophoresis to identify differentially expressed proteins between four patients with small AAA and four controls without aneurysm. Protein spots that differed significantly between patients and controls were selected and identified by mass spectrometry. Three protein spots had significantly different expression between patients and controls. The most interesting finding was that patients with small AAA had increased levels of the enzyme glycosylphosphatidylinositol-specific phospholipase D (GPI-PLD) compared with the controls without aneurysm. In conclusion, by using a proteomic approach, this pilot-study provides evidence of GPI-PLD as a novel potential plasma biomarker for AAA.
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Affiliation(s)
- Jonas Wallinder
- Department of Surgery, Sundsvall County Hospital, Sundsvall, Sweden
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Assessment of Abdominal Aortic Aneurysm Wall Distensibility With Electrocardiography-Gated Computed Tomography. Ann Vasc Surg 2011; 25:1036-42. [DOI: 10.1016/j.avsg.2011.05.034] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2010] [Revised: 02/28/2011] [Accepted: 05/03/2011] [Indexed: 11/19/2022]
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Theruvath TP, Jones JA, Ikonomidis JS. Matrix metalloproteinases and descending aortic aneurysms: parity, disparity, and switch. J Card Surg 2011; 27:81-90. [PMID: 21958052 DOI: 10.1111/j.1540-8191.2011.01315.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Central to the pathologic changes in developing aortic aneurysms are alterations in the abundance and activity of proteases, of which the most important for aneurysm production comprise the matrix metalloproteinase (MMP) family. In this review, literature demonstrating the role of MMPs in the development of aortic aneurysms is presented, with emphasis on the parity and disparity between the thoracic and abdominal aorta. Furthermore, the role of embryologic cellular origins and evidence of phenotypic switch will be addressed in terms of how this process alters MMP production during aneurysm development.
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Affiliation(s)
- Tom P Theruvath
- Division of Cardiothoracic Surgery, Department of Surgery, Medical University of South Carolina, Charleston, South Carolina 29425, USA
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Pulinx B, Hellenthal FAMVI, Hamulyák K, van Dieijen-Visser MP, Schurink GWH, Wodzig WKWH. Differential protein expression in serum of abdominal aortic aneurysm patients - a proteomic approach. Eur J Vasc Endovasc Surg 2011; 42:563-70. [PMID: 21843957 DOI: 10.1016/j.ejvs.2011.07.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2011] [Accepted: 07/16/2011] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The aim of the study is to investigate the differential expression of proteins in serum of abdominal aortic aneurysm (AAA) patients in relation to aneurysm size (D(max)) and progression. METHODS Two-dimensional differential in-gel electrophoresis (2D-DIGE) together with tandem mass spectrometry (MS/MS) was used to analyse the serum proteome from patients with small (D(max) 30-54 mm) AAA, either stable (increase D(max) <5 mm year⁻¹; n = 8) or progressive (increase D(max) ≥5 mm year⁻¹; n = 8), and large (D(max) ≥ 55 mm; n = 8) AAA. The identified proteins were quantitatively validated in a larger population (n = 80). RESULTS Several proteins were differentially expressed in serum of small stable, small progressive and large AAA. Three validated proteins (immunoglobulin G (IgG), α1-antitrypsin (α1-AT) and Factor XII activity) showed strong correlation with D(max). Size combined with either Factor XII activity or α1-antitrypsin had minimal effect on the prognostic value in predicting aneurysm progression compared with size alone (area under the curve (AUC), 0.85; 95% confidence interval (CI), 0.73-0.97; p < 0.001 and AUC, 0.85; 95% CI, 0.72-0.98; p < 0.001 vs. AUC, 0.83; 95% CI, 0.71-0.96; p < 0.001, respectively). CONCLUSION The present study indicates that both Factor XII and α1-antitrypsin are found in increased amounts in the serum of patients with expanding AAA. However, combination of either Factor XII or α1-antitrypsin with aneurysm diameter had little effect on prediction of aneurysm progression versus diameter alone.
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Affiliation(s)
- B Pulinx
- Department of Clinical Chemistry, Maastricht University Medical Centre, Maastricht, The Netherlands
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Vega de Céniga M. Comments regarding 'Increased circulating levels of basement-membrane components in patients with abdominal aortic aneurysms--a pilot study'. Eur J Vasc Endovasc Surg 2011; 42:488. [PMID: 21742518 DOI: 10.1016/j.ejvs.2011.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2011] [Accepted: 06/06/2011] [Indexed: 11/16/2022]
Affiliation(s)
- M Vega de Céniga
- Department of Angiology and Vascular Surgery, Hospital de Galdakao-Usansolo, 48960 Galdakao, Bizkaia, Spain.
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Yates CM, Abdelhamid M, Adam DJ, Nash GB, Bradbury AW, Rainger GE. Endovascular aneurysm repair reverses the increased titer and the inflammatory activity of interleukin-1α in the serum of patients with abdominal aortic aneurysm. J Vasc Surg 2011; 54:497-503. [PMID: 21620624 DOI: 10.1016/j.jvs.2011.02.061] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2010] [Revised: 02/23/2011] [Accepted: 02/26/2011] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To examine serum cytokine/chemokine profiles before and 6 months after endovascular repair (EVAR) of abdominal aortic aneurysm (AAA) and to determine whether they correlate with serum inflammatory activity using an in vitro model of leukocyte recruitment. METHODS Serum IL-1-α, IL-1β, IL-4, IL-6, IL-8, IL-10, IFN-γ, IP-10, MCP-1, TNF-α, and TNF-β were measured using a cytometry-based immunoassay. To test patient serum for direct inflammatory activity, human endothelial cells (EC) were stimulated with 30% patient serum for 24 hours. To test patient serum for the ability to prime EC for inflammatory responses, EC were incubated with 30% patient serum for 24 hours, followed by stimulation with low-dose (5 U/mL) TNF for 4 hours. Under both regimens of stimulation, the degree of EC activation was assessed by assaying neutrophil recruitment in a flow-based model. RESULTS Only IL-1α (67.9 ± 10.4 pg/mL vs 41.9 ± 7.4 pg/mL) and IL-8 (51.5 ± 5.1 vs 32.6 ± 4.7 pg/mL) changed significantly after surgery. Patient serum alone was unable to activate EC. However, serum from both time points could prime EC responses to low-dose TNF. Thus, after priming with preoperative serum, EC stimulated with TNF could recruit 76.7 ± 12.0 neutrophils/mm(2) into the subendothelial cell space. Post-EVAR serum was significantly less effective (44.4 ± 10.2 neutrophils/mm(2)). This reduction in neutrophil recruitment correlated with reduced IL-1α in post-EVAR serum. The addition of a neutralizing antibody against IL-1α to pre-EVAR serum inhibited EC priming and neutrophil recruitment, strongly implying that this cytokine was the priming agent. CONCLUSION EVAR reduces serum IL-1α and its inflammatory activity in patient serum. IL-1α is, therefore, implicated in the molecular pathology of AAAs and may have potential as a clinically useful biomarker.
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Affiliation(s)
- Clara M Yates
- School of Clinical and Experimental Medicine, The University of Birmingham, Birmingham, UK
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Pharmacological Interventions to Attenuate the Expansion of Abdominal Aortic Aneurysm (AAA) – A Systematic Review. Eur J Vasc Endovasc Surg 2011; 41:663-7. [DOI: 10.1016/j.ejvs.2011.01.009] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2010] [Accepted: 01/10/2011] [Indexed: 11/20/2022]
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Moxon JV, Parr A, Emeto TI, Walker P, Norman PE, Golledge J. Diagnosis and monitoring of abdominal aortic aneurysm: current status and future prospects. Curr Probl Cardiol 2011; 35:512-48. [PMID: 20932435 DOI: 10.1016/j.cpcardiol.2010.08.004] [Citation(s) in RCA: 99] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abdominal aortic aneurysm (AAA) remains an important cause of morbidity and mortality in elderly men, and prevalence is predicted to increase in parallel with a global aging population. AAA is commonly asymptomatic, and in the absence of routine screening, diagnosis is usually incidental when imaging to assess unrelated medical complaints. In the absence of approved diagnostic and prognostic markers, AAAs are monitored conservatively via medical imaging until aortic diameter approaches 50-55 mm and surgical repair is performed. There is currently significant interest in identifying molecular markers of diagnostic and prognostic value for AAA. Here we outline the current guidelines for AAA management and discuss modern scientific techniques currently employed to identify improved diagnostic and prognostic markers.
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Martinez-Pinna R, Ramos-Mozo P, Madrigal-Matute J, Blanco-Colio LM, Lopez JA, Calvo E, Camafeita E, Lindholt JS, Meilhac O, Delbosc S, Michel JB, de Ceniga MV, Egido J, Martin-Ventura JL. Identification of Peroxiredoxin-1 as a Novel Biomarker of Abdominal Aortic Aneurysm. Arterioscler Thromb Vasc Biol 2011; 31:935-43. [DOI: 10.1161/atvbaha.110.214429] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Roxana Martinez-Pinna
- From the Vascular Research Laboratory, Instituto de Investigación Sanitaria-Fundación Jiménez Diaz-Autonoma University, Madrid, Spain (R.M.-P., P.R.-M., J.M.-M., L.M.B.-C., J.E., J.L.M.-V.); Unidad de Proteómica, Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain (J.A.L., E. Calvo, E. Camafeita); Vascular Research Unit, Viborg Hospital, Viborg, Denmark (J.S.L.); Institut National de la Santé et de la Recherche Médicale U698, Paris, France (O.M., S.D., J.-B.M.); Université Denis
| | - Priscila Ramos-Mozo
- From the Vascular Research Laboratory, Instituto de Investigación Sanitaria-Fundación Jiménez Diaz-Autonoma University, Madrid, Spain (R.M.-P., P.R.-M., J.M.-M., L.M.B.-C., J.E., J.L.M.-V.); Unidad de Proteómica, Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain (J.A.L., E. Calvo, E. Camafeita); Vascular Research Unit, Viborg Hospital, Viborg, Denmark (J.S.L.); Institut National de la Santé et de la Recherche Médicale U698, Paris, France (O.M., S.D., J.-B.M.); Université Denis
| | - Julio Madrigal-Matute
- From the Vascular Research Laboratory, Instituto de Investigación Sanitaria-Fundación Jiménez Diaz-Autonoma University, Madrid, Spain (R.M.-P., P.R.-M., J.M.-M., L.M.B.-C., J.E., J.L.M.-V.); Unidad de Proteómica, Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain (J.A.L., E. Calvo, E. Camafeita); Vascular Research Unit, Viborg Hospital, Viborg, Denmark (J.S.L.); Institut National de la Santé et de la Recherche Médicale U698, Paris, France (O.M., S.D., J.-B.M.); Université Denis
| | - Luis M. Blanco-Colio
- From the Vascular Research Laboratory, Instituto de Investigación Sanitaria-Fundación Jiménez Diaz-Autonoma University, Madrid, Spain (R.M.-P., P.R.-M., J.M.-M., L.M.B.-C., J.E., J.L.M.-V.); Unidad de Proteómica, Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain (J.A.L., E. Calvo, E. Camafeita); Vascular Research Unit, Viborg Hospital, Viborg, Denmark (J.S.L.); Institut National de la Santé et de la Recherche Médicale U698, Paris, France (O.M., S.D., J.-B.M.); Université Denis
| | - Juan A. Lopez
- From the Vascular Research Laboratory, Instituto de Investigación Sanitaria-Fundación Jiménez Diaz-Autonoma University, Madrid, Spain (R.M.-P., P.R.-M., J.M.-M., L.M.B.-C., J.E., J.L.M.-V.); Unidad de Proteómica, Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain (J.A.L., E. Calvo, E. Camafeita); Vascular Research Unit, Viborg Hospital, Viborg, Denmark (J.S.L.); Institut National de la Santé et de la Recherche Médicale U698, Paris, France (O.M., S.D., J.-B.M.); Université Denis
| | - Enrique Calvo
- From the Vascular Research Laboratory, Instituto de Investigación Sanitaria-Fundación Jiménez Diaz-Autonoma University, Madrid, Spain (R.M.-P., P.R.-M., J.M.-M., L.M.B.-C., J.E., J.L.M.-V.); Unidad de Proteómica, Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain (J.A.L., E. Calvo, E. Camafeita); Vascular Research Unit, Viborg Hospital, Viborg, Denmark (J.S.L.); Institut National de la Santé et de la Recherche Médicale U698, Paris, France (O.M., S.D., J.-B.M.); Université Denis
| | - Emilio Camafeita
- From the Vascular Research Laboratory, Instituto de Investigación Sanitaria-Fundación Jiménez Diaz-Autonoma University, Madrid, Spain (R.M.-P., P.R.-M., J.M.-M., L.M.B.-C., J.E., J.L.M.-V.); Unidad de Proteómica, Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain (J.A.L., E. Calvo, E. Camafeita); Vascular Research Unit, Viborg Hospital, Viborg, Denmark (J.S.L.); Institut National de la Santé et de la Recherche Médicale U698, Paris, France (O.M., S.D., J.-B.M.); Université Denis
| | - Jes S. Lindholt
- From the Vascular Research Laboratory, Instituto de Investigación Sanitaria-Fundación Jiménez Diaz-Autonoma University, Madrid, Spain (R.M.-P., P.R.-M., J.M.-M., L.M.B.-C., J.E., J.L.M.-V.); Unidad de Proteómica, Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain (J.A.L., E. Calvo, E. Camafeita); Vascular Research Unit, Viborg Hospital, Viborg, Denmark (J.S.L.); Institut National de la Santé et de la Recherche Médicale U698, Paris, France (O.M., S.D., J.-B.M.); Université Denis
| | - Olivier Meilhac
- From the Vascular Research Laboratory, Instituto de Investigación Sanitaria-Fundación Jiménez Diaz-Autonoma University, Madrid, Spain (R.M.-P., P.R.-M., J.M.-M., L.M.B.-C., J.E., J.L.M.-V.); Unidad de Proteómica, Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain (J.A.L., E. Calvo, E. Camafeita); Vascular Research Unit, Viborg Hospital, Viborg, Denmark (J.S.L.); Institut National de la Santé et de la Recherche Médicale U698, Paris, France (O.M., S.D., J.-B.M.); Université Denis
| | - Sandrine Delbosc
- From the Vascular Research Laboratory, Instituto de Investigación Sanitaria-Fundación Jiménez Diaz-Autonoma University, Madrid, Spain (R.M.-P., P.R.-M., J.M.-M., L.M.B.-C., J.E., J.L.M.-V.); Unidad de Proteómica, Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain (J.A.L., E. Calvo, E. Camafeita); Vascular Research Unit, Viborg Hospital, Viborg, Denmark (J.S.L.); Institut National de la Santé et de la Recherche Médicale U698, Paris, France (O.M., S.D., J.-B.M.); Université Denis
| | - Jean-Baptiste Michel
- From the Vascular Research Laboratory, Instituto de Investigación Sanitaria-Fundación Jiménez Diaz-Autonoma University, Madrid, Spain (R.M.-P., P.R.-M., J.M.-M., L.M.B.-C., J.E., J.L.M.-V.); Unidad de Proteómica, Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain (J.A.L., E. Calvo, E. Camafeita); Vascular Research Unit, Viborg Hospital, Viborg, Denmark (J.S.L.); Institut National de la Santé et de la Recherche Médicale U698, Paris, France (O.M., S.D., J.-B.M.); Université Denis
| | - Melina Vega de Ceniga
- From the Vascular Research Laboratory, Instituto de Investigación Sanitaria-Fundación Jiménez Diaz-Autonoma University, Madrid, Spain (R.M.-P., P.R.-M., J.M.-M., L.M.B.-C., J.E., J.L.M.-V.); Unidad de Proteómica, Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain (J.A.L., E. Calvo, E. Camafeita); Vascular Research Unit, Viborg Hospital, Viborg, Denmark (J.S.L.); Institut National de la Santé et de la Recherche Médicale U698, Paris, France (O.M., S.D., J.-B.M.); Université Denis
| | - Jesus Egido
- From the Vascular Research Laboratory, Instituto de Investigación Sanitaria-Fundación Jiménez Diaz-Autonoma University, Madrid, Spain (R.M.-P., P.R.-M., J.M.-M., L.M.B.-C., J.E., J.L.M.-V.); Unidad de Proteómica, Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain (J.A.L., E. Calvo, E. Camafeita); Vascular Research Unit, Viborg Hospital, Viborg, Denmark (J.S.L.); Institut National de la Santé et de la Recherche Médicale U698, Paris, France (O.M., S.D., J.-B.M.); Université Denis
| | - Jose L. Martin-Ventura
- From the Vascular Research Laboratory, Instituto de Investigación Sanitaria-Fundación Jiménez Diaz-Autonoma University, Madrid, Spain (R.M.-P., P.R.-M., J.M.-M., L.M.B.-C., J.E., J.L.M.-V.); Unidad de Proteómica, Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain (J.A.L., E. Calvo, E. Camafeita); Vascular Research Unit, Viborg Hospital, Viborg, Denmark (J.S.L.); Institut National de la Santé et de la Recherche Médicale U698, Paris, France (O.M., S.D., J.-B.M.); Université Denis
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Michel JB, Martin-Ventura JL, Egido J, Sakalihasan N, Treska V, Lindholt J, Allaire E, Thorsteinsdottir U, Cockerill G, Swedenborg J. Novel aspects of the pathogenesis of aneurysms of the abdominal aorta in humans. Cardiovasc Res 2011; 90:18-27. [PMID: 21037321 PMCID: PMC3058728 DOI: 10.1093/cvr/cvq337] [Citation(s) in RCA: 239] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2010] [Revised: 10/04/2010] [Accepted: 10/20/2010] [Indexed: 01/22/2023] Open
Abstract
Aneurysm of the abdominal aorta (AAA) is a particular, specifically localized form of atherothrombosis, providing a unique human model of this disease. The pathogenesis of AAA is characterized by a breakdown of the extracellular matrix due to an excessive proteolytic activity, leading to potential arterial wall rupture. The roles of matrix metalloproteinases and plasmin generation in progression of AAA have been demonstrated both in animal models and in clinical studies. In the present review, we highlight recent studies addressing the role of the haemoglobin-rich, intraluminal thrombus and the adventitial response in the development of human AAA. The intraluminal thrombus exerts its pathogenic effect through platelet activation, fibrin formation, binding of plasminogen and its activators, and trapping of erythrocytes and neutrophils, leading to oxidative and proteolytic injury of the arterial wall. These events occur mainly at the intraluminal thrombus-circulating blood interface, and pathological mediators are conveyed outwards, where they promote matrix degradation of the arterial wall. In response, neo-angiogenesis, phagocytosis by mononuclear cells, and a shift from innate to adaptive immunity in the adventitia are observed. Abdominal aortic aneurysm thus represents an accessible spatiotemporal model of human atherothrombotic progression towards clinical events, the study of which should allow further understanding of its pathogenesis and the translation of pathogenic biological activities into diagnostic and therapeutic applications.
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Affiliation(s)
- Jean-Baptiste Michel
- Inserm Unit 698, Cardiovascular Remodelling, Denis Diderot University, Hôpital X. Bichat, Paris, France.
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Nordon IM, Brar R, Hinchliffe RJ, Cockerill G, Thompson MM. Proteomics and pitfalls in the search for potential biomarkers of abdominal aortic aneurysms. Vascular 2010; 18:264-8. [PMID: 20822720 DOI: 10.2310/6670.2010.00046] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Proteomics is evolving as an important research technique in cardiovascular disease. We present exploratory research for a systemic biomarker of abdominal aortic aneurysm (AAA) in serum. Forty patients, 20 with large AAAs and 20 matched controls, were prospectively recruited. Serum was harvested, enriched, and mined for differential protein expression. Difference in gel electrophoresis using a two-dimensional platform, cyanine labeling, and Progenesis SameSpots software identified protein spots with significantly altered intensity. Liquid chromatography mass spectrometry aligned to the Seaquest protein database characterized proteins of interest, and 436 protein spots were demonstrated from the 20 processed gels. Thirteen spots of interest, demonstrating fold change (1.7-4) between the two patient cohorts and consistent significant differential expression (analysis of variance, p </= .003), were picked for identification. Four of 13 spots were identified according to their tandem mass spectra. These were fragments of serum albumin, hemoglobin, and apolipoprotein C-II precursor. Identified spots represented proteins highly abundant in serum, not candidate biomarkers. Issues of variability surrounding serum harvest, processing, enrichment, and the challenge of identifying minimally expressed proteins currently limit this avenue of research. No proteins identified in this study had the biologic plausibility to represent a possible biomarker of aneurysmal disease. The tissue proteome may be a more rewarding approach for preliminary investigation of plausible biomarkers.
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Affiliation(s)
- Ian M Nordon
- St. George's Vascular Institute, St. George's Hospital, Blackshaw Road, London, UK.
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69
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Trimarchi S, Sangiorgi G, Sang X, Rampoldi V, Suzuki T, Eagle KA, Elefteriades JA. In search of blood tests for thoracic aortic diseases. Ann Thorac Surg 2010; 90:1735-42. [PMID: 20971314 DOI: 10.1016/j.athoracsur.2010.04.111] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2010] [Revised: 04/15/2010] [Accepted: 04/16/2010] [Indexed: 10/18/2022]
Abstract
A number of new diagnostic screening tools have been developed for the assessment of acute and chronic diseases of the thoracic aorta. Although standardized blood-based tests capable of detecting individuals at risk for aortic aneurysm and dissection disease are not yet available, our current knowledge is expanding at a rapid rate and the future is very promising. In this review, an update of the contemporary knowledge on blood tests for detecting thoracic aortic diseases in both preclinical and clinical settings is provided, offering the potential to predict adverse aortic events, such as enlargement, rupture, and dissection.
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Affiliation(s)
- Santi Trimarchi
- Policlinico San Donato IRCCS, Cardiovascular Center E. Malan, University of Milano, Milan, Italy.
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70
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Activation of transglutaminase type 2 for aortic wall protection in a rat abdominal aortic aneurysm formation. J Vasc Surg 2010; 52:967-74. [DOI: 10.1016/j.jvs.2010.04.049] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2010] [Revised: 04/15/2010] [Accepted: 04/17/2010] [Indexed: 11/21/2022]
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71
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Patient-specific biomechanical profiling in abdominal aortic aneurysm development and rupture. J Vasc Surg 2010; 52:480-8. [DOI: 10.1016/j.jvs.2010.01.029] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2009] [Revised: 01/07/2010] [Accepted: 01/10/2010] [Indexed: 11/20/2022]
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72
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Urbonavicius S, Lindholt JS, Delbosc S, Urbonaviciene G, Henneberg EW, Vorum H, Meilhac O, Honoré B. Proteins associated with the size and expansion rate of the abdominal aortic aneurysm wall as identified by proteomic analysis. Interact Cardiovasc Thorac Surg 2010; 11:433-41. [PMID: 20675398 DOI: 10.1510/icvts.2010.238139] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES Identification of biomarkers for the natural history of abdominal aortic aneurysms (AAA) holds the key to non-surgical intervention and improved selection for AAA repair. We aimed to associate the basic proteomic composition of AAA wall tissue with the expansion rate and size in patients with AAA. METHODS A proteomic approach was used, consisting of two-dimensional polyacrylamide gel electrophoresis (2D-PAGE) and mass spectrometry (MS) to identify differentially expressed proteins in AAA tissue. Relevant protein spots were identified by liquid chromatography-tandem mass spectrometry (LC-MS/MS). RESULTS Spearman's correlation analysis revealed 16 protein spots were strongly correlated with AAA expansion rate (ρ>±0.75). Nine protein spots were identified. Six protein spots showed correlation with AAA size (ρ>±0.5). Three protein spots were identified: vitronectin with traces of calreticulin, albumin and a spot containing two proteins: collagen α-3(VI) chain and vitamin D binding protein. Interestingly, in our previous study vitronectin was shown to be down-regulated in a ruptured AAA group compared with non-ruptured AAA. Western blot analysis in the present study confirmed a correlation of vitronectin bands with AAA size in aortic aneurysm tissue. CONCLUSION A proteomic approach seems valuable, and identified several candidates not previously associated with AAA. Larger studies are required to confirm the potential and clinical role of the identified proteins.
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Affiliation(s)
- Sigitas Urbonavicius
- Department of Vascular Surgery, Vascular Research Unit, Viborg Hospital, Denmark.
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Flondell-Sité D, Lindblad B, Kölbel T, Gottsäter A. Markers of Proteolysis, Fibrinolysis, and Coagulation in Relation to Size and Growth Rate of Abdominal Aortic Aneurysms. Vasc Endovascular Surg 2010; 44:262-8. [DOI: 10.1177/1538574410361971] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We evaluated whether matrix metalloproteinases (MMPs) 2 and 9, their inhibitors, markers for fibrinolysis, and thrombin activation are associated with diameter and growth of abdominal aortic aneurysms (AAAs). Material and Methods: Matrix metalloproteinases 2 and 9, tissue inhibitor of MMPs (TIMP-1), serpine-1, tPa-serpine-1, and activated protein C— protein C inhibitor (APC-PCI) complex were analyzed in 353 patients with AAA grouped according to AAA size, and 219 gender- and age-matched healthy individuals. Follow-up of AAA growth for up to 7 years was possible in 178 of 353 patients. Results: At baseline, all groups of patients with AAA showed lower levels of MMP-2 and -9, and higher levels of TIMP-1, serpine-1, and t-Pa-serpine-1 than controls. Matrix metalloproteinase 2 correlated inversely and APC-PCI complex correlated directly with AAA diameter. We found no correlations between markers for proteolysis, fibrinolysis, coagulation, and yearly AAA growth. Conclusion: Matrix metalloproteinase 2 is lower and APC-PCI higher in patients with larger AAA, but the relevance of the markers for AAA growth is far from clarified.
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Affiliation(s)
| | - Bengt Lindblad
- University of Lund, Vascular Centre, Malmö University Hospital, Malmö, Sweden
| | - Tilo Kölbel
- University of Lund, Vascular Centre, Malmö University Hospital, Malmö, Sweden
| | - Anders Gottsäter
- University of Lund, Vascular Centre, Malmö University Hospital, Malmö, Sweden
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75
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Busti C, Falcinelli E, Momi S, Gresele P. Matrix metalloproteinases and peripheral arterial disease. Intern Emerg Med 2010; 5:13-25. [PMID: 19626421 DOI: 10.1007/s11739-009-0283-y] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2009] [Accepted: 06/18/2009] [Indexed: 01/01/2023]
Abstract
Matrix metalloproteinases (MMPs), a family of enzymes that degrade extracellular matrix, are emerging as important modulators of atherothrombosis. MMPs are produced by inflammatory cells; some of them are also released by activated platelets and play a crucial role in the remodeling processes, leading to atherosclerotic plaque formation, plaque rupture, arterial aneurysm development, and critical limb ischemia. Independent from their matrix degrading activity, MMPs also regulate some cell functions relevant to atherothrombosis, such as platelet activation, neutrophil activation, and vascular reactivity. Plasma levels of some MMPs are increasingly being recognized as a biomarker of atherosclerosis and cardiovascular risk. In peripheral arterial disease, MMPs have been shown to be involved in angiogenesis, arteriogenesis, and the development of arterial calcifications. Increased plasma levels of some MMPs (MMP-2, MMP-9) have been correlated with PAD development and severity. Single nucleotide polymorphisms of the genes encoding for some MMPs have also been associated with the risk of developing peripheral arterial disease and critical limb ischemia. Large prospective observational studies are needed to further demonstrate the role of MMPs in PAD. In perspective, pharmacologic targeting of the expression or activity of MMPs may represent a novel, attractive approach for the treatment of peripheral arterial disease.
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Affiliation(s)
- Chiara Busti
- Division of Internal and Cardiovascular Medicine, Department of Internal Medicine, University of Perugia, Via E. dal Pozzo, 06126, Perugia, Italy
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76
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Thompson AR, Cooper JA, Ashton HA, Hafez H. Growth rates of small abdominal aortic aneurysms correlate with clinical events. Br J Surg 2009; 97:37-44. [PMID: 20013940 DOI: 10.1002/bjs.6779] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
Background
This retrospective analysis of prospectively collected abdominal aortic aneurysm (AAA) screening data aimed to identify predictors of AAA-related events (surgery or death) with a view to better targeting of screening.
Methods
For the interval 1984–2007, data for 1649 subjects with an AAA were collected prospectively as part of the Chichester AAA screening programme. This included serial aortic size measurements, blood pressure, risk factors for arterial disease and concurrent medications. AAA growth rates were adjusted for risk factor confounders using flexible hierarchical modelling. AAA growth distribution was analysed using Silverman's test of multimodality.
Results
Some 1231 subjects met the inclusion criteria of having more than one scan and a surveillance interval of over 3 months. AAA growth showed a bimodal pattern with nearly 50 per cent of all aneurysms never progressing to surgery or rupture. Adjusted annual AAA growth rates of at least 2 mm significantly predicted AAA-related events.
Conclusion
This analysis identified a bimodal growth pattern for AAA, with a significant association between annual AAA growth rate of at least 2 mm and AAA-related events.
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Affiliation(s)
- A R Thompson
- Department of Vascular Surgery, Western Sussex Hospital NHS Trust, Chichester, UK
- Centre for Cardiovascular Genetics, British Heart Foundation Laboratories, University College London, London, UK
| | - J A Cooper
- Centre for Cardiovascular Genetics, British Heart Foundation Laboratories, University College London, London, UK
| | - H A Ashton
- Department of Vascular Surgery, Western Sussex Hospital NHS Trust, Chichester, UK
| | - H Hafez
- Department of Vascular Surgery, Western Sussex Hospital NHS Trust, Chichester, UK
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Schmitz-Rixen T, Lang W. Entwicklung der Gefäß- und Endovaskularchirurgie in den nächsten 20 Jahren. Chirurg 2009; 80:1126-31. [DOI: 10.1007/s00104-009-1776-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Flondell-Sité D, Lindblad B, Gottsäter A. High Levels of Endothelin (ET)-1 and Aneurysm Diameter Independently Predict Growth of Stable Abdominal Aortic Aneurysms. Angiology 2009; 61:324-8. [DOI: 10.1177/0003319709344190] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The etiology of abdominal aortic aneurysm (AAA) includes inflammation and endothelial dysfunction. To evaluate relations between these mechanisms and AAA growth, endothelin (ET)-1, tumor necrosis factor (TNF)-α, interleukin (IL)-6, and CD40 ligand were related to yearly AAA growth for 2.9 ± 1.6 years (mean ± SD) in 178 patients with conservatively followed AAA. Total number of follow-up years was 491. Abdominal aortic aneurysm diameter increased by 3.3 ± 4.0 mm during the first year and by 4.9 ± 4.4 mm during the first 2 years. Median (range) growth was 2.5 (—1.0 to 30.6) mm/year. When patients with AAA growth above or below median were compared, initial AAA diameter (46.1 ± 5.8 vs 42.0 ± 8.3 mm; P < .0001), age (75 ± 7 vs 72 ± 8 years; P < .029), and initial ET-1 levels (1.31 ± 0.50 vs 1.13 ± 0.49 pg/mL; P < .0177) were higher in patients with growth above median. Endothelin 1 (P = .0230) and initial AAA diameter (P = .0019) predicted AAA growth above median in logistic regression. In conclusion, higher initial levels of ET-1 and initial AAA diameter independently predict AAA growth.
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Affiliation(s)
| | - Bengt Lindblad
- University of Lund, Vascular Centre, Malmö University Hospital, Malmö, Sweden
| | - Anders Gottsäter
- University of Lund, Vascular Centre, Malmö University Hospital, Malmö, Sweden
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79
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Nordon I, Brar R, Hinchliffe R, Cockerill G, Loftus I, Thompson M. The role of proteomic research in vascular disease. J Vasc Surg 2009; 49:1602-12. [DOI: 10.1016/j.jvs.2009.02.242] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2008] [Revised: 02/20/2009] [Accepted: 02/28/2009] [Indexed: 12/23/2022]
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Nordon IM, Hinchliffe RJ, Holt PJ, Loftus IM, Thompson MM. Review of Current Theories for Abdominal Aortic Aneurysm Pathogenesis. Vascular 2009; 17:253-63. [DOI: 10.2310/6670.2009.00046] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Atherosclerotic plaques are a feature of abdominal aortic aneurysms (AAAs). Atherosclerosis and AAA appear to share similar risk factors. These observations have led to the conclusion that AAAs are a consequence of advanced atherosclerosis. This review explores current theories regarding the pathogenesis of AAA and their implications for treatment. A systematic literature search was conducted using the search terms abdominal aortic aneurysm, atherosclerosis, pathogenesis, and systemic disease. Articles were categorized according to the association of AAAs with atherosclerosis, arteriomegaly, peripheral aneurysm, systemic expression, genetics, autoimmunity, oxidative stress, and systemic disease. Twenty-nine articles reporting changes in the systemic vasculature associated with AAA and 12 articles examining the shared risk factor hypothesis were identified. There is insufficient evidence to confirm that AAAs are the result of advanced atherosclerosis. The bulk of evidence points to AAA disease being a systemic disease of the vasculature, with a predetermined genetic susceptibility leading to a phenotype governed by environmental factors.
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Affiliation(s)
- Ian M. Nordon
- *St George's Vascular Institute, St James' Wing, St George's Hospital, London, UK
| | - Robert J. Hinchliffe
- *St George's Vascular Institute, St James' Wing, St George's Hospital, London, UK
| | - Peter J. Holt
- *St George's Vascular Institute, St James' Wing, St George's Hospital, London, UK
| | - Ian M. Loftus
- *St George's Vascular Institute, St James' Wing, St George's Hospital, London, UK
| | - Matthew M. Thompson
- *St George's Vascular Institute, St James' Wing, St George's Hospital, London, UK
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