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Gkaliagkousi E, Lazaridis A, Dogan S, Fraenkel E, Tuna BG, Mozos I, Vukicevic M, Yalcin O, Gopcevic K. Theories and Molecular Basis of Vascular Aging: A Review of the Literature from VascAgeNet Group on Pathophysiological Mechanisms of Vascular Aging. Int J Mol Sci 2022; 23:ijms23158672. [PMID: 35955804 PMCID: PMC9368987 DOI: 10.3390/ijms23158672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 07/25/2022] [Accepted: 07/29/2022] [Indexed: 11/29/2022] Open
Abstract
Vascular aging, characterized by structural and functional alterations of the vascular wall, is a hallmark of aging and is tightly related to the development of cardiovascular mortality and age-associated vascular pathologies. Over the last years, extensive and ongoing research has highlighted several sophisticated molecular mechanisms that are involved in the pathophysiology of vascular aging. A more thorough understanding of these mechanisms could help to provide a new insight into the complex biology of this non-reversible vascular process and direct future interventions to improve longevity. In this review, we discuss the role of the most important molecular pathways involved in vascular ageing including oxidative stress, vascular inflammation, extracellular matrix metalloproteinases activity, epigenetic regulation, telomere shortening, senescence and autophagy.
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Affiliation(s)
- Eugenia Gkaliagkousi
- 3rd Department of Internal Medicine, Papageorgiou Hospital, Faculty of Medicine, Aristotle University of Thessaloniki, 56429 Thessaloniki, Greece
- Correspondence: (E.G.); (K.G.)
| | - Antonios Lazaridis
- 3rd Department of Internal Medicine, Papageorgiou Hospital, Faculty of Medicine, Aristotle University of Thessaloniki, 56429 Thessaloniki, Greece
| | - Soner Dogan
- Department of Medical Biology, School of Medicine, Yeditepe University, 34755 Istanbul, Turkey
| | - Emil Fraenkel
- 1st Department of Internal Medicine, University Hospital, Pavol Jozef Šafárik University of Košice, Trieda SNP 1, 04066 Košice, Slovakia
| | - Bilge Guvenc Tuna
- Department of Biophysics, School of Medicine, Yeditepe University, 34755 Istanbul, Turkey
| | - Ioana Mozos
- Department of Functional Sciences-Pathophysiology, Center for Translational Research and Systems Medicine, “Victor Babes” University of Medicine and Pharmacy, 300173 Timisoara, Romania
| | - Milica Vukicevic
- Cardiac Surgery Clinic, Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Ozlem Yalcin
- Department of Physiology, School of Medicine, Koc University, 34450 Istanbul, Turkey
| | - Kristina Gopcevic
- Laboratory for Analytics of Biomolecules, Department of Chemistry in Medicine, Faculty of Medicine, 11000 Belgrade, Serbia
- Correspondence: (E.G.); (K.G.)
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Varasteh Z, De Rose F, Mohanta S, Li Y, Zhang X, Miritsch B, Scafetta G, Yin C, Sager HB, Glasl S, Gorpas D, Habenicht AJ, Ntziachristos V, Weber WA, Bartolazzi A, Schwaiger M, D'Alessandria C. Imaging atherosclerotic plaques by targeting Galectin-3 and activated macrophages using ( 89Zr)-DFO- Galectin3-F(ab') 2 mAb. Am J Cancer Res 2021; 11:1864-1876. [PMID: 33408786 PMCID: PMC7778602 DOI: 10.7150/thno.50247] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 11/11/2020] [Indexed: 12/12/2022] Open
Abstract
Rationale: The high expression of Galectin-3 (Gal3) in macrophages of atherosclerotic plaques suggests its participation in atherosclerosis pathogenesis, and raises the possibility to use it as a target to image disease severity in vivo. Here, we explored the feasibility of tracking atherosclerosis by targeting Gal3 expression in plaques of apolipoprotein E knockout (ApoE-KO) mice via PET imaging. Methods: Targeting of Gal3 in M0-, M1- and M2 (M2a/M2c)-polarized macrophages was assessed in vitro using a Gal3-F(ab')2 mAb labeled with AlexaFluor®488 and 89Zr- desferrioxamine-thioureyl-phenyl-isothiocyanate (DFO). To visualize plaques in vivo, ApoE-KO mice were injected i.v. with 89Zr-DFO-Gal3-F(ab')2 mAb and imaged via PET/CT 48 h post injection. Whole length aortas harvested from euthanized mice were processed for Sudan-IV staining, autoradiography, and immunostaining for Gal3, CD68 and α-SMA expression. To confirm accumulation of the tracer in plaques, ApoE-KO mice were injected i.v. with Cy5.5-Gal3-F(ab')2 mAb, euthanized 48 h post injection, followed by cryosections of the body and acquisition of fluorescent images. To explore the clinical potential of this imaging modality, immunostaining for Gal3, CD68 and α-SMA expression were carried out in human plaques. Single cell RNA sequencing (scRNA-Seq) analyses were performed to measure LGALS3 (i.e. a synonym for Gal3) gene expression in each macrophage of several subtypes present in murine or human plaques. Results: Preferential binding to M2 macrophages was observed with both AlexaFluor®488-Gal3-F(ab')2 and 89Zr-DFO-Gal3-F(ab')2 mAbs. Focal and specific 89Zr-DFO-Gal3-F(ab')2 mAb uptake was detected in plaques of ApoE-KO mice by PET/CT. Autoradiography and immunohistochemical analyses of aortas confirmed the expression of Gal3 within plaques mainly in macrophages. Moreover, a specific fluorescent signal was visualized within the lesions of vascular structures burdened by plaques in mice. Gal3 expression in human plaques showed similar Gal3 expression patterns when compared to their murine counterparts. Conclusions: Our data reveal that 89Zr-DFO-Gal3-F(ab')2 mAb PET/CT is a potentially novel tool to image atherosclerotic plaques at different stages of development, allowing knowledge-based tailored individual intervention in clinically significant disease.
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The Role of Matrix Metalloproteinase-9 in Atherosclerotic Plaque Instability. Mediators Inflamm 2020; 2020:3872367. [PMID: 33082709 PMCID: PMC7557896 DOI: 10.1155/2020/3872367] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 08/10/2020] [Accepted: 09/23/2020] [Indexed: 02/07/2023] Open
Abstract
Matrix metalloproteinase-9 (MMP-9) belongs to the MMP family and has been widely investigated. Excessive MMP-9 expression can enhance extracellular matrix degradation and promote plaque instability. Studies have demonstrated that MMP-9 levels are higher in vulnerable plaques than in stable plaques. Additionally, several human studies have demonstrated that MMP-9 may be a predictor of atherosclerotic plaque instability and a risk factor for future adverse cardiovascular and cerebrovascular events. MMP-9 deficiency or blocking MMP-9 expression can inhibit plaque inflammation and prevent atherosclerotic plaque instability. All of these results suggest that MMP-9 may be a useful predictive biomarker for vulnerable atherosclerotic plaques, as well as a therapeutic target for preventing atherosclerotic plaque instability. In this review, we describe the structure, function, and regulation of MMP-9. We also discuss the role of MMP-9 in predicting and preventing atherosclerotic plaque instability.
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Extracellular Matrix Remodeling Factors as Markers of Carotid Artery Atherosclerosis. Cardiol Res Pract 2020; 2020:9036157. [PMID: 32850147 PMCID: PMC7441424 DOI: 10.1155/2020/9036157] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 06/17/2020] [Accepted: 07/18/2020] [Indexed: 12/31/2022] Open
Abstract
Materials and Methods 20 patients undergoing routine carotid endarterectomy and 40 healthy volunteers were enrolled in this study. MMPs activity and OPG and FN concentrations were measured in atherosclerotic plaques and nonchanged contiguous tissue after homogenization as well as in plasma from patients and reference group. The activity of MMPs was evaluated by gelatin zymography, and the concentration of OPG and FN was assessed by ELISA. Results OPG concentration and MMP-9 activity showed differences between plaque and nonchanged tissue; OPG was higher in adjacent tissue (P=0.0009), whereas MMP-9 was higher in plaque (proMMP-9 P=0.0003; MMP-9 P < 0.0001). The OPG plasma concentration and both MMPs plasma activity were higher in patients (OPG P < 0.001; proMMP-2 P=0.0292; and proMMP-9 P=0.0374), while FN plasma concentration was lower in patients than in the reference group (P=0.0004). The ROC curves analysis showed the highest AUC for OPG (0.943) with 85.0% sensitivity and 92.1% specificity. Conclusions The atherosclerotic plaque and the contiguous artery wall are biochemically different. OPG shows the highest potential to be a marker of advanced carotid atherosclerosis.
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Varasteh Z, Mohanta S, Li Y, López Armbruster N, Braeuer M, Nekolla SG, Habenicht A, Sager HB, Raes G, Weber W, Hernot S, Schwaiger M. Targeting mannose receptor expression on macrophages in atherosclerotic plaques of apolipoprotein E-knockout mice using 68Ga-NOTA-anti-MMR nanobody: non-invasive imaging of atherosclerotic plaques. EJNMMI Res 2019; 9:5. [PMID: 30666513 PMCID: PMC6340911 DOI: 10.1186/s13550-019-0474-0] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 01/09/2019] [Indexed: 01/03/2023] Open
Abstract
Background Rupture-prone atherosclerotic plaques are characterized by heavy macrophage infiltration, and the presence of certain macrophage subsets might be a sign for plaque vulnerability. The mannose receptor (MR, CD206) is over-expressed in several types of alternatively activated macrophages. In this study, our objective was to evaluate the feasibility of a Gallium-68 (68Ga)-labelled anti-MR nanobody (68Ga-anti-MMR Nb) for the visualization of MR-positive (MR+) macrophages in atherosclerotic plaques of apolipoprotein E-knockout (ApoE-KO) mice. Results NOTA-anti-MMR Nb was labelled with 68Ga with radiochemical purity > 95%. In vitro cell-binding studies demonstrated selective and specific binding of the tracer to M2a macrophages. For in vivo atherosclerotic plaque imaging studies, 68Ga-NOTA-anti-MMR Nb was injected into ApoE-KO and control mice intravenously (i.v.) and scanned 1 h post-injection for 30 min using a dedicated animal PET/CT. Focal signals could be detected in aortic tissue of ApoE-KO mice, whereas no signal was detected in the aortas of control mice. 68Ga-NOTA-anti-MMR Nb uptake was detected in atherosclerotic plaques on autoradiographs and correlated well with Sudan-IV-positive areas. The calculated ratio of plaque-to-normal aortic tissue autoradiographic signal intensity was 7.7 ± 2.6 in aortas excised from ApoE-KO mice. Immunofluorescence analysis of aorta cross-sections confirmed predominant MR expression in macrophages located in the fibrous cap layer and shoulder region of the plaques. Conclusions 68Ga-NOTA-anti-MMR Nb allows non-invasive PET/CT imaging of MR expression in atherosclerotic lesions in a murine model and may represent a promising tool for clinical imaging and evaluation of plaque (in)stability.
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Affiliation(s)
- Zohreh Varasteh
- Department of Nuclear Medicine, Klinikum rechts der Isar der TUM, Ismaninger-Strasse 22, 81675, Munich, Germany.
| | - Sarajo Mohanta
- Institute for Cardiovascular Prevention, University Hospital of Ludwig-Maximilians-University, Munich, Germany
| | - Yuanfang Li
- Institute for Cardiovascular Prevention, University Hospital of Ludwig-Maximilians-University, Munich, Germany
| | - Nicolás López Armbruster
- Deutsches Herzzentrum München, Klinik für Herz und Kreislauferkrankungen, Technical University of Munich, Munich, Germany
| | - Miriam Braeuer
- Department of Nuclear Medicine, Klinikum rechts der Isar der TUM, Ismaninger-Strasse 22, 81675, Munich, Germany
| | - Stephan G Nekolla
- Department of Nuclear Medicine, Klinikum rechts der Isar der TUM, Ismaninger-Strasse 22, 81675, Munich, Germany
| | - Andreas Habenicht
- Institute for Cardiovascular Prevention, University Hospital of Ludwig-Maximilians-University, Munich, Germany
| | - Hendrik B Sager
- Deutsches Herzzentrum München, Klinik für Herz und Kreislauferkrankungen, Technical University of Munich, Munich, Germany
| | - Geert Raes
- Department of Bio-engineering Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Wolfgang Weber
- Department of Nuclear Medicine, Klinikum rechts der Isar der TUM, Ismaninger-Strasse 22, 81675, Munich, Germany
| | - Sophie Hernot
- In Vivo Cellular and Molecular Imaging (ICMI), Vrije Universiteit Brussel, Brussels, Belgium
| | - Markus Schwaiger
- Department of Nuclear Medicine, Klinikum rechts der Isar der TUM, Ismaninger-Strasse 22, 81675, Munich, Germany
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Jager NA, Wallis de Vries BM, Hillebrands JL, Harlaar NJ, Tio RA, Slart RHJA, van Dam GM, Boersma HH, Zeebregts CJ, Westra J. Distribution of Matrix Metalloproteinases in Human Atherosclerotic Carotid Plaques and Their Production by Smooth Muscle Cells and Macrophage Subsets. Mol Imaging Biol 2016; 18:283-91. [PMID: 26377769 PMCID: PMC4783451 DOI: 10.1007/s11307-015-0882-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Purpose In this study, the potential of matrix metalloproteinase (MMP) sense for detection of atherosclerotic plaque instability was explored. Secondly, expression of MMPs by macrophage subtypes and smooth muscle cells (SMCs) was investigated. Procedures Twenty-three consecutive plaques removed during carotid endarterectomy were incubated in MMPSense™ 680 and imaged with IVIS® Spectrum. mRNA levels of MMPs, macrophage markers, and SMCs were determined in plaque specimens, and in in vitro differentiated M1 and M2 macrophages. Results There was a significant difference between autofluorescence signals and MMPSense signals, both on the intraluminal and extraluminal sides of plaques. MMP-9 and CD68 messenger RNA (mRNA) expression was higher in hot spots, whereas MMP-2 and αSMA expression was higher in cold spots. In vitro M2 macrophages had higher mRNA expression of MMP-1, MMP-9, MMP-12, and TIMP-1 compared to M1 macrophages. Conclusion MMP-9 is most dominantly MMP present in atherosclerotic plaques and is produced by M2 rather than M1 macrophages.
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Affiliation(s)
- Nynke A Jager
- Departments of Rheumatology and Clinical Immunology, University Medical Center Groningen, University of Groningen, PB 30.001, 9700 RB, Groningen, The Netherlands
| | - Bastiaan M Wallis de Vries
- Department of Surgery, Division of Vascular Surgery, University Medical Center Groningen, University of Groningen, Groningen, PB 30.001, 9700 RB, Groningen, The Netherlands
| | - Jan-Luuk Hillebrands
- Departments of Pathology and Medical Biology, University Medical Center Groningen, University of Groningen, PB 30.001, 9700 RB, Groningen, The Netherlands
| | - Niels J Harlaar
- Department of Surgery, Division of Vascular Surgery, University Medical Center Groningen, University of Groningen, Groningen, PB 30.001, 9700 RB, Groningen, The Netherlands
| | - René A Tio
- Department of Cardiology, University Medical Center Groningen, University of Groningen, PB 30.001, 9700 RB, Groningen, The Netherlands
| | - Riemer H J A Slart
- Departments of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, PB 30.001, 9700 RB, Groningen, The Netherlands
| | - Gooitzen M van Dam
- Department of Surgery, Division of Vascular Surgery, University Medical Center Groningen, University of Groningen, Groningen, PB 30.001, 9700 RB, Groningen, The Netherlands
| | - Hendrikus H Boersma
- Departments of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, PB 30.001, 9700 RB, Groningen, The Netherlands.,Departments of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, PB 30.001, 9700 RB, Groningen, The Netherlands
| | - Clark J Zeebregts
- Department of Surgery, Division of Vascular Surgery, University Medical Center Groningen, University of Groningen, Groningen, PB 30.001, 9700 RB, Groningen, The Netherlands.
| | - Johanna Westra
- Departments of Rheumatology and Clinical Immunology, University Medical Center Groningen, University of Groningen, PB 30.001, 9700 RB, Groningen, The Netherlands
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Leguina-Ruzzi A, Pereira J, Pereira-Flores K, Valderas JP, Mezzano D, Velarde V, Sáez CG. Increased RhoA/Rho-Kinase Activity and Markers of Endothelial Dysfunction in Young Adult Subjects with Metabolic Syndrome. Metab Syndr Relat Disord 2015; 13:373-80. [DOI: 10.1089/met.2015.0061] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Affiliation(s)
- Alberto Leguina-Ruzzi
- Department of Hematology and Oncology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Jaime Pereira
- Department of Hematology and Oncology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Karla Pereira-Flores
- Department of Hematology and Oncology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Juan P. Valderas
- Departamento de Ciencias Médicas, Facultad de Medicina Odontología, Universidad de Antofagasta, Chile
| | - Diego Mezzano
- Department of Hematology and Oncology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Victoria Velarde
- Department of Physiology, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Claudia G. Sáez
- Department of Hematology and Oncology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
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Sternberg Z, Ghanim H, Gillotti KM, Tario JD, Munschauer F, Curl R, Noor S, Yu J, Ambrus JL, Wallace P, Dandona P. Flow cytometry and gene expression profiling of immune cells of the carotid plaque and peripheral blood. Atherosclerosis 2013; 229:338-47. [PMID: 23880185 DOI: 10.1016/j.atherosclerosis.2013.04.035] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Revised: 04/08/2013] [Accepted: 04/26/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVES The relative contribution of the local vs. peripheral inflammation to the atherothrombotic processes is unknown. We compared the inflammatory status of the immune cells of the carotid plaque with similar cells in peripheral circulation of patients with advanced carotid disease (PCDs). METHODS Mononuclear cells (MNCs) were extracted from carotid endarterectomy (CEA) samples by enzymatic digestion and subsequent magnetic cell sorting. The cell surface antigenic expressions, and mRNA expression levels were compared between CEA MNCs and peripheral MNCs, using flow cytometry and RT-PCR techniques. RESULTS The percentages of resting MNCs were lower, and activated MNCs, particularly monocytes, were higher in the CEAMNCs, as compared to the peripheral MNCs. The percentages of activated T cells and B cells were higher in the peripheral MNCs of PCDs, than in healthy controls (HCs), but the percentages of activated monocytes did not differ between the two groups. The expression levels of both pro-inflammatory/pro-thrombotic (P(38), JNKB-1, Egr-1 PAI-1, MCP-1, TF, MMP-9, HMGB-1, TNF-α, mTOR) and anti-inflammatory (PPAR-γ, TGF-β) mediators were significantly higher in the CEA MNCs as compared to the peripheral MNCs. Furthermore, MMP-9 and PPAR-γ expression levels were higher in the peripheral MNCs of PCDs than HCs. CONCLUSION The inflammatory status is higher in the immune cells of the carotid plaque, as compared to those cells in the peripheral blood. The altered expression levels of both pro-inflammatory/pro-thrombotic and anti-inflammatory mediators in the milieu of the plaque suggest that the balance between these various mediators may play a key role in carotid disease progression.
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Antoniou GA, Tentes IK, Antoniou SA, Simopoulos C, Lazarides MK. Matrix metalloproteinase imbalance in inguinal hernia formation. J INVEST SURG 2011; 24:145-50. [PMID: 21675849 DOI: 10.3109/08941939.2011.558610] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Emerging evidence supports the role of matrix metalloproteinases (MMPs) in hernia formation. However, the imbalance between the proteolytic activity of MMPs and their endogenous inhibitors (TIMPs) has not been investigated. The aim of the present study was to determine changes of MMP and TIMP levels in patients with inguinal hernia. METHODS Two matrix metalloproteinases (MMP-9 and MMP-2) and their main inhibitors TIMP-1 and TIMP-2 were evaluated in consecutive patients undergoing inguinal hernia repair and control subjects. MMP/TIMP quantification was performed using ELISA in abdominal fascia tissue specimens and preoperative plasma samples. RESULTS Tissue explants from hernia patients produced significantly higher levels of MMP-9 and MMP-2, and reduced TIMP-1 and TIMP-2 concentrations compared to those of controls. In plasma, a reverse correlation was found regarding the concentrations of MMPs; the circulating levels of MMP-9 and MMP-2 were significantly lower in patients with inguinal hernia than controls. Furthermore, hernia patients were found to have elevated plasma levels of TIMP-2 and reduced plasma levels of TIMP-1. CONCLUSIONS The imbalance in MMP/TIMP activity indicates a dysregulation of the extracellular matrix degradation process in patients with inguinal hernia. The results of the present study suggest that impaired collagen metabolism may be an underlying pathophysiological mechanism of inguinal hernia formation.
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Affiliation(s)
- George A Antoniou
- Department of Vascular Surgery, Demokritos University of Thrace, Alexandroupolis, Greece.
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V Baroncini LA, Nakao LS, Ramos SG, Filho AP, Murta LO, Ingberman M, Tefé-Silva C, Précoma DB. Assessment of MMP-9, TIMP-1, and COX-2 in normal tissue and in advanced symptomatic and asymptomatic carotid plaques. Thromb J 2011; 9:6. [PMID: 21457581 PMCID: PMC3076223 DOI: 10.1186/1477-9560-9-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2010] [Accepted: 04/03/2011] [Indexed: 12/31/2022] Open
Abstract
Background Mature carotid plaques are complex structures, and their histological classification is challenging. The carotid plaques of asymptomatic and symptomatic patients could exhibit identical histological components. Objectives To investigate whether matrix metalloproteinase 9 (MMP-9), tissue inhibitor of MMP (TIMP), and cyclooxygenase-2 (COX-2) have different expression levels in advanced symptomatic carotid plaques, asymptomatic carotid plaques, and normal tissue. Methods Thirty patients admitted for carotid endarterectomy were selected. Each patient was assigned preoperatively to one of two groups: group I consisted of symptomatic patients (n = 16, 12 males, mean age 66.7 ± 6.8 years), and group II consisted of asymptomatic patients (n = 14, 8 males, mean age 67.6 ± 6.81 years). Nine normal carotid arteries were used as control. Tissue specimens were analyzed for fibromuscular, lipid and calcium contents. The expressions of MMP-9, TIMP-1 and COX-2 in each plaque were quantified. Results Fifty-eight percent of all carotid plaques were classified as Type VI according to the American Heart Association Committee on Vascular Lesions. The control carotid arteries all were classified as Type III. The median percentage of fibromuscular tissue was significantly greater in group II compared to group I (p < 0.05). The median percentage of lipid tissue had a tendency to be greater in group I than in group II (p = 0.057). The percentages of calcification were similar among the two groups. MMP-9 protein expression levels were significantly higher in group II and in the control group when compared with group I (p < 0.001). TIMP-1 expression levels were significantly higher in the control group and in group II when compared to group I, with statistical difference between control group and group I (p = 0.010). COX-2 expression levels did not differ among groups. There was no statistical correlation between MMP-9, COX-2, and TIMP-1 levels and fibrous tissue. Conclusions MMP-9 and TIMP-1 are present in all stages of atherosclerotic plaque progression, from normal tissue to advanced lesions. When sections of a plaque are analyzed without preselection, MMP-9 concentration is higher in normal tissues and asymptomatic surgical specimens than in symptomatic specimens, and TIMP-1 concentration is higher in normal tissue than in symptomatic specimens.
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Affiliation(s)
- Liz Andréa V Baroncini
- Department of Health and Scienses - Pontifícia Universidade Católica do Paraná, Rua Imaculada Conceição 1155, Curitiba - Paraná - CEP:80215901 - Brazil.
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Risinger GM, Updike DL, Bullen EC, Tomasek JJ, Howard EW. TGF-beta suppresses the upregulation of MMP-2 by vascular smooth muscle cells in response to PDGF-BB. Am J Physiol Cell Physiol 2009; 298:C191-201. [PMID: 19846754 DOI: 10.1152/ajpcell.00417.2008] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
During platelet-derived growth factor (PDGF)-BB-mediated recruitment to neovascular sprouts, vascular smooth muscle cells (VSMCs) dedifferentiate from a contractile to a migratory phenotype. This involves the downregulation of contractile markers such as smooth muscle (SM) alpha-actin and the upregulation of promigration genes such as matrix metalloproteinase (MMP)-2. The regulation of MMP-2 in response to PDGF-BB is complex and involves both stimulatory and inhibitory signaling pathways, resulting in a significant delay in upregulation. Here, we provide evidence that the delay in MMP-2 upregulation may be due to the autocrine expression and activation of transforming growth factor (TGF)-beta, which is known to promote the contractile phenotype in VSMCs. Whereas PDGF-BB could induce the loss of stress fibers and focal adhesions, TGF-beta was able to block or reverse this transition to a noncontractile state. TGF-beta did not, however, suppress early signaling events stimulated by PDGF-BB. Over time, though PDGF-BB induced increased TGF-beta1 levels, it suppressed TGF-beta2 and TGF-beta3 expression, leading to a net decrease in the total TGF-beta pool, resulting in the upregulation of MMP-2. Together, these findings indicate that MMP-2 expression is suppressed by a threshold level of active TGF-beta, which in turn promotes a contractile VSMC phenotype that prevents the upregulation of MMP-2.
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Affiliation(s)
- George M Risinger
- Young Blvd., Biomedical Sciences Bldg., Rm 513, Oklahoma City, OK 73104, USA
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Abstract
Background Myocardial infarction results as a consequence of atherosclerotic plaque rupture, with plaque stability largely depending on the lesion forming extracellular matrix components. Lipid enriched non-calcified lesions are considered more instable and rupture prone than calcified lesions. Matrix metalloproteinases (MMPs) are extracellular matrix degrading enzymes with plaque destabilisating characteristics which have been implicated in atherogenesis. We therefore hypothesised MMP-1 and MMP-9 serum levels to be associated with non-calcified lesions as determined by CT-angiography in patients with coronary artery disease. Methods 260 patients with typical or atypical chest pain underwent dual-source multi-slice CT-angiography (0.6-mm collimation, 330-ms gantry rotation time) to exclude coronary artery stenosis. Atherosclerotic plaques were classified as calcified, mixed or non-calcified. Results In multivariable regession analysis, MMP-1 serum levels were associated with total plaque burden (OR: 1.37 (CI: 1.02-1.85); p < 0.05) in a model adjusted for age, sex, BMI, classical cardiovascular risk factors, hsCRP, adiponectin, pericardial fat volume and medication. Specification of plaque morphology revealed significant association of MMP-1 serum levels with non-calcified plaques (OR: 1.16 (CI: 1.0-1.34); p = 0.05) and calcified plaques (OR: 1.22 (CI: 1,03-1.45); p < 0.05) while association with mixed plaques was lost in the fully adjusted model. No associations were found between MMP9 serum levels and total plaque burden or plaque morphology. Conclusion MMP-1 serum levels are associated with total plaque burden but do not allow a specification of plaque morphology.
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Sapienza P, Borrelli V, di Marzo L, Cavallaro A. MMP and TIMP alterations in asymptomatic and symptomatic severe recurrent carotid artery stenosis. Eur J Vasc Endovasc Surg 2009; 37:525-30. [PMID: 19297218 DOI: 10.1016/j.ejvs.2009.01.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2008] [Accepted: 01/22/2009] [Indexed: 10/21/2022]
Abstract
OBJECTIVES This study aimed to determine whether the plasma levels of matrix metalloproteinases (MMPs)-2 and -9 and their specific inhibitors (tissue inhibitors of metalloproteinases (TIMPs-1 and -2)) were altered in patients with symptomatic and asymptomatic, severe, recurrent carotid artery stenosis. PATIENTS Fifty-two patients (out of a total of 621) who had undergone successful carotid artery endarterectomy (CEA) between 1999 and 2003 and developed recurrent carotid artery stenosis (>/=70%) were included in the study. Restenosis was symptomatic in 23 patients and asymptomatic in 29 patients. METHODS Recurrent carotid artery stenosis was classified based on presentation, and as early-intermediate (6 months to 3 years) or late (>3 years). A detailed clinical history was taken and two blood samples were drawn from each patient to determine plasma levels of MMPs and TIMPs along with other biological parameters. Recurrent stenosis was confirmed with computed tomographic angiography. RESULTS Patients with symptomatic restenosis had significantly (p<0.001) higher active MMP-2 and -9 plasma values and significantly (p<0.001) lower TIMP-1 and -2 plasma values when compared to patients with asymptomatic restenosis. Plasma concentrations of active MMPs were higher and TIMPs lower in patients affected with late recurrent stenosis as compared to early-intermediate restenosis (p<0.001). No differences were recorded in latent MMP plasma values. Multivariate analysis showed that active MMP-2 and -9 were independent predictors of late recurrent carotid artery stenosis (p<0.03 and p<0.001, respectively). CONCLUSIONS Higher plasma concentrations of active MMP-2 and -9 were associated with an increased risk of carotid restenosis with plaque recurrence.
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Affiliation(s)
- P Sapienza
- Department of Surgery "Pietro Valdoni", University of Rome "La Sapienza", Policlinico Umberto I degrees , Viale del Policlinico 155, 00161 Rome, Italy
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Papas TT, Maltezos CK, Papanas N, Kopadis G, Marakis J, Maltezos E, Bastounis E. High-Sensitivity CRP Is Correlated With Neurologic Symptoms and Plaque Instability in Patients With Severe Stenosis of the Carotid Bifurcation. Vasc Endovascular Surg 2008; 42:249-55. [DOI: 10.1177/1538574408314437] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The aim of this study is to investigate the correlation of high-sensitivity C-reactive protein and E-selectin with clinical manifestations and plaque characteristics in 88 patients (69 with and 19 without neurological symptoms) with high-grade stenosis of the carotid bifurcation who underwent endarterectomy. The grade of stenosis was quantified by duplex ultrasonography and digital subtraction angiography. Preoperatively, serum high-sensitivity C-reactive protein and E-selectin were measured. Postoperatively, carotid plaque morphology was established according to the American Heart Association classification. High-sensitivity C-reactive protein levels were significantly ( P < .001) higher in symptomatic than in asymptomatic patients, as well as in patients with unstable compared with those with stable plaques ( P < .001). Serum high-sensitivity C-reactive protein levels correlated significantly ( P < .05) with macrophage count on the plaque. In conclusion, serum high-sensitivity C-reactive protein levels are associated with presence of neurological symptoms and plaque instability in patients with high-grade stenosis of the carotid bifurcation.
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Affiliation(s)
- Theophanis T. Papas
- Department of Vascular Surgery, General Hospital “Georgios Gennimatas,” Athens,
| | | | - Nikolaos Papanas
- Second Department of Internal Medicine, Democritus University of Thrace, Alexandroupolis
| | - Georgios Kopadis
- Department of Vascular Surgery, General Hospital “Georgios Gennimatas,” Athens
| | - Joseph Marakis
- Department of Vascular Surgery, General Hospital “Georgios Gennimatas,” Athens
| | - Efstratios Maltezos
- Second Department of Internal Medicine, Democritus University of Thrace, Alexandroupolis
| | - Elias Bastounis
- Department of Surgery, University of Athens, Laiko Hospital Athens, Greece
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15
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Serum Matrix Metalloproteinase-2 Levels Indicate Blood–CSF Barrier Damage in Patients with Infectious Meningitis. Inflammation 2008; 31:99-104. [DOI: 10.1007/s10753-007-9054-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2007] [Accepted: 12/07/2007] [Indexed: 10/22/2022]
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16
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Taurino M, Raffa S, Mastroddi M, Visco V, Rizzo L, Torrisi MR, Faraglia V. Metalloproteinase Expression in Carotid Plaque and Its Correlation With Plasma Levels Before and After Carotid Endarterectomy. Vasc Endovascular Surg 2008; 41:516-21. [DOI: 10.1177/1538574407307405] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose To assess baseline and follow-up plasma concentrations of metalloproteinase-9 (MMP-9), MMP-2, and tissue inhibitor of metalloproteinase-2 (TIMP-2) in patients undergoing carotid thromboendarterectomy (TEA) in relation to tissue expression and diagnostic features. Basic Methods Using sandwich enzyme-linked immunosorbent assay, plasma levels of enzymes were determined in 15 patients undergoing carotid TEA. Tissue sections were incubated with specific antibodies and fluorescence intensity was analyzed. Principal Findings MMP-9 levels were higher in patients with carotid stenosis versus controls, significantly in those with cerebral lesions at neuroimaging. MMP-9 levels decreased in 93.4% of the patients at 1 month. MMP-2 levels tended to increase 30 days after surgery. TIMP-2 showed no difference. Conclusions High concentrations of MMP-9 found in patients with carotid stenosis and cerebral lesions suggest that MMP-9 assay could be useful in the evaluation of all carotid lesions to help identify those at highest risk of a neurologic event.
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Affiliation(s)
- Maurizio Taurino
- U.O.C. Chirurgia Vascolare, "S. Andrea" Hospital, 2nd Medical School, University of Rome "La Sapienza," Rome, Italy, maurizio.taurino@ uniroma1.it
| | - Salvatore Raffa
- U.O.C. Diagnostica Cellulare “S. Andrea" Hospital, 2nd Medical School, University of Rome “La Sapienza," Rome, Italy
| | - Massimo Mastroddi
- U.O.C. Chirurgia Vascolare, "S. Andrea" Hospital, 2nd Medical School, University of Rome "La Sapienza," Rome, Italy
| | - Vincenzo Visco
- U.O.C. Diagnostica Cellulare “S. Andrea" Hospital, 2nd Medical School, University of Rome “La Sapienza," Rome, Italy
| | - Luigi Rizzo
- U.O.C. Chirurgia Vascolare, "S. Andrea" Hospital, 2nd Medical School, University of Rome "La Sapienza," Rome, Italy
| | - Maria Rosaria Torrisi
- U.O.C. Diagnostica Cellulare “S. Andrea" Hospital, 2nd Medical School, University of Rome “La Sapienza," Rome, Italy
| | - Vittorio Faraglia
- U.O.C. Chirurgia Vascolare, "S. Andrea" Hospital, 2nd Medical School, University of Rome "La Sapienza," Rome, Italy
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17
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Gao P, Chen ZQ, Bao YH, Jiao LQ, Ling F. Correlation between carotid intraplaque hemorrhage and clinical symptoms: systematic review of observational studies. Stroke 2007; 38:2382-90. [PMID: 17600232 DOI: 10.1161/strokeaha.107.482760] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE We sought to investigate the association between carotid intraplaque hemorrhage (IPH) and ipsilateral symptoms of cerebral ischemia. METHODS A search was performed for clinical observational studies comparing the incidence of IPH between symptomatic and asymptomatic patients. Odds ratios (ORs) for IPH as a factor in the pathogenesis of neurologic events were calculated and combined by a meta-analysis. Interstudy heterogeneity, estimated effects, and methodologic quality of the studies were assessed. RESULTS Thirty-one studies were included for analysis. The reported ORs varied widely. Overall, the incidence of IPH in the symptomatic groups was significantly higher than in the asymptomatic group. However, there was an apparent trend for heterogeneity (P<0.00001) between studies. The random-effects summary estimator of ORs was 2.25 (95% CI, 1.57 to 3.22; P<0.00001). To identify potential sources of heterogeneity, subgroup analyses were performed. The pooled ORs varied greatly by stratification. Major heterogeneity was found among studies with low quality, microscopic methods of examination, significant effects, small sizes, early publication, and unequal severity of carotid stenosis in both groups. Large, recent, macroscopic, or high-quality studies, as well as studies with equal degrees of stenosis, tended to yield insignificant associations. The methods in defining and evaluating hemorrhage were very heterogeneous. Characterizations of the age, size, number, and location of hemorrhages were poorly reported and highly variable. In addition, a lack of control of confounders and selection bias were frequently identified among studies. CONCLUSIONS Statistical inferences have suggested a plausible role in the production of cerebral ischemia; however, reliable interpretation was strongly undermined by poor methodologic quality, substantial heterogeneity, and suspicious publication bias. To preciously estimate the underlying correlation, a well-designed study with uniformity in definition and evaluation for IPH might be warranted.
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Affiliation(s)
- Peng Gao
- 389 Xincun Rd, Putuo District, Shanghai 200065, China.
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Abstract
Matrix metalloproteinases (MMPs) are involved in the pathophysiology of several central nervous system diseases that share common pathogeneses, such as disruption of the blood-brain barrier (BBB), neuroinflammation, oxidative stress, and remodeling of the extracellular matrix (ECM). In early ischemic injury, MMPs participate in disruption of the BBB by digesting the basal lamina of capillaries and ECM, leading to vasogenic edema and hemorrhagic transformation. However, ECM degradation and remodeling are essential for tissue recovery, with MMPs having a key role as modulators of homeostasis between neuronal death and tissue regeneration. Thus, MMPs may be a double-edged sword that has a deleterious or beneficial role depending on the stage of brain injury.
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Affiliation(s)
- Hahn Young Kim
- Department of Neurology, Konkuk University Hospital, Center for Geriatric Neuroscience Research, Institute of Biomedical Science and Technology, Konkuk University, Seoul, Korea
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