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Lu S, White JV, Nwaneshiudu I, Nwaneshiudu A, Monos DS, Solomides CC, Oleszak EL, Platsoucas CD. Human abdominal aortic aneurysm (AAA): Evidence for an autoimmune antigen-driven disease. Clin Exp Rheumatol 2022; 21:103164. [PMID: 35926768 DOI: 10.1016/j.autrev.2022.103164] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 07/29/2022] [Indexed: 11/02/2022]
Abstract
Abdominal aortic aneurism (AAA) is a complex immunological disease with a strong genetic component, and one of the ten leading causes of death of individuals 55-74 years old worldwide. Strong evidence has been accumulated suggesting that AAA is an autoimmune specific antigen-driven disease. Mononuclear cells infiltrating AAA lesions comprised of T and B lymphocytes and other cells expressing early-, intermediate- and late-activation antigens, and the presence of antigen-presenting cells have been documented, demonstrating an ongoing immune response. The three components of the trimolecular complex, T-cell receptor (TCR)/peptide (antigen)/HLA have been identified in AAA, and specifically: (i) clonal expansions of T-cell clones in AAA lesions; (ii) the association of AAA with particular HLA Class I and Class II; and (iii) self or nonself putative AAA-associated antigens. IgG autoantibodies recognizing proteins present in normal aortic tissue have been reported in patients with AAA. Molecular mimicry, defined as the sharing of antigenic epitopes between microorganisms (bacteria, viruses) and self antigens, maybe is responsible for T-cell responses and antibody production in AAA. Also, the frequency and the suppressor activity of CD4 + CD25 + FOXP3+ Tregs and the expression of FOXP3 transcripts and protein have been reported to be significantly impaired in AAA patients vs normal donors.
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Affiliation(s)
- Song Lu
- Mon Health Medical Center, Department of Pathology, Morgantown, WV, USA
| | - John V White
- Department of Surgery, Advocate Lutheran General Hospital & University of Illinois School of Medicine, Park Ridge, IL, USA
| | - Ifeyinwa Nwaneshiudu
- Department of Microbiology and Immunology, Temple University School of Medicine, Philadelphia, PA, USA
| | - Adaobi Nwaneshiudu
- Department of Microbiology and Immunology, Temple University School of Medicine, Philadelphia, PA, USA; Cutis Wellness Dermatology and Dermatopathology PLLC, Laredo, TX, USA
| | - Dimitri S Monos
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Perelman School of Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Charalambos C Solomides
- Department of Pathology & Laboratory Medicine, Thomas Jefferson University Hospital, Philadelphia, PA, USA
| | - Emilia L Oleszak
- Department of Biological Sciences and Center for Molecular Medicine, Old Dominion University, Norfolk, VA, USA
| | - Chris D Platsoucas
- Department of Biological Sciences and Center for Molecular Medicine, Old Dominion University, Norfolk, VA, USA.
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Yuan Z, Lu Y, Wei J, Wu J, Yang J, Cai Z. Abdominal Aortic Aneurysm: Roles of Inflammatory Cells. Front Immunol 2021; 11:609161. [PMID: 33613530 PMCID: PMC7886696 DOI: 10.3389/fimmu.2020.609161] [Citation(s) in RCA: 60] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 12/18/2020] [Indexed: 12/14/2022] Open
Abstract
Abdominal aortic aneurysms (AAAs) are local dilations of infrarenal segment of aortas. Molecular mechanisms underlying the pathogenesis of AAA remain not fully clear. However, inflammation has been considered as a central player in the development of AAA. In the past few decades, studies demonstrated a host of inflammatory cells, including T cells, macrophages, dendritic cells, neutrophils, B cells, and mast cells, etc. infiltrating into aortic walls, which implicated their crucial roles. In addition to direct cell contacts and cytokine or protease secretions, special structures like inflammasomes and neutrophil extracellular traps have been investigated to explore their functions in aneurysm formation. The above-mentioned inflammatory cells and associated structures may initiate and promote AAA expansion. Understanding their impacts and interaction networks formation is meaningful to develop new strategies of screening and pharmacological interventions for AAA. In this review, we aim to discuss the roles and mechanisms of these inflammatory cells in AAA pathogenesis.
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Affiliation(s)
- Zhen Yuan
- Department of Cardiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yi Lu
- Department of Cardiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jia Wei
- Department of Urology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jiaqi Wu
- Translational Medicine Center, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, China
| | - Jin Yang
- Translational Medicine Center, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, China.,Institute of Hepatology and Metabolic Diseases, Hangzhou Normal University, Hangzhou, China
| | - Zhejun Cai
- Department of Cardiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Jiaxing Key Laboratory of Cardiac Rehabilitation, Jiaxing, China
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3
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Knappich C, Spin JM, Eckstein HH, Tsao PS, Maegdefessel L. Involvement of Myeloid Cells and Noncoding RNA in Abdominal Aortic Aneurysm Disease. Antioxid Redox Signal 2020; 33:602-620. [PMID: 31989839 PMCID: PMC7455479 DOI: 10.1089/ars.2020.8035] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Significance: Abdominal aortic aneurysm (AAA) is a potentially fatal condition, featuring the possibility of high-mortality rupture. To date, prophylactic surgery by means of open surgical repair or endovascular aortic repair at specific thresholds is considered standard therapy. Both surgical options hold different risk profiles of short- and long-term morbidity and mortality. Targeting early stages of AAA development to decelerate disease progression is desirable. Recent Advances: Understanding the pathomechanisms that initiate formation, maintain growth, and promote rupture of AAA is crucial to developing new medical therapeutic options. Inflammatory cells, in particular macrophages, have been investigated for their contribution to AAA disease for decades, whereas evidence on lymphocytes, mast cells, and neutrophils is sparse. Recently, there has been increasing interest in noncoding RNAs (ncRNAs) and their involvement in disease development, including AAA. Critical Issues: The current evidence on myeloid cells and ncRNAs in AAA largely originates from small animal models, making clinical extrapolation difficult. Although it is feasible to collect surgical human AAA samples, these tissues reflect end-stage disease, preventing examination of critical mechanisms behind early AAA formation. Future Directions: Gaining more insight into how myeloid cells and ncRNAs contribute to AAA disease, particularly in early stages, might suggest nonsurgical AAA treatment options. The utilization of large animal models might be helpful in this context to help bridge translational results to humans.
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Affiliation(s)
- Christoph Knappich
- Department for Vascular and Endovascular Surgery, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Joshua M Spin
- Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Hans-Henning Eckstein
- Department for Vascular and Endovascular Surgery, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Philip S Tsao
- Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Lars Maegdefessel
- Department for Vascular and Endovascular Surgery, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.,Department of Medicine, Karolinska Institute, Stockholm, Sweden
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4
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Lu S, White JV, Judy RI, Merritt LL, Lin WL, Zhang X, Solomides C, Nwaneshiudu I, Gaughan J, Monos DS, Oleszak EL, Platsoucas CD. Clonally expanded alpha-chain T-cell receptor (TCR) transcripts are present in aneurysmal lesions of patients with Abdominal Aortic Aneurysm (AAA). PLoS One 2019; 14:e0218990. [PMID: 31310631 PMCID: PMC6634378 DOI: 10.1371/journal.pone.0218990] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 06/14/2019] [Indexed: 01/25/2023] Open
Abstract
Abdominal aortic aneurysm (AAA) is a life-threatening immunological disease responsible for 1 to 2% of all deaths in 65 year old or older individuals. Although mononuclear cell infiltrates have been demonstrated in AAA lesions and autoimmunity may be responsible for the initiation and account for the propagation of the disease, the information available about the pathogenesis of AAA is limited. To examine whether AAA lesions from patients with AAA contain clonally expanded α-chain TCR transcripts, we amplified by the non-palindromic adaptor-PCR (NPA-PCR)/Vα-specific PCR and/or the Vα-specific PCR these α-chain TCR transcripts. The amplified transcripts were cloned and sequenced. Substantial proportions of identical α-chain TCR transcripts were identified in AAA lesions of 4 of 5 patients, demonstrating that clonally expanded T cells are present in these AAA lesions. These results were statistically significant by the bimodal distribution. Three of 5 of these patients were typed by DNA-based HLA-typing and all three expressed DRB1 alleles containing the DRβGln70 amino acid residue that has been demonstrated to be associated with AAA. All three patients exhibited clonally expanded T cells in AAA lesions. Four of the 5 patients with AAA who exhibited clonal expansions of α-chain TCR transcripts, also exhibited clonal expansions of β-chain TCR transcripts in AAA lesions, as we have demonstrated previously (J Immunol 192:4897, 2014). αβ TCR-expressing T cells infiltrating AAA lesions contain T-cell clones which have undergone proliferation and clonal expansion in vivo in response to as yet unidentified specific antigens that may be self or nonself. These results provide additional evidence supporting the hypothesis that AAA is a specific antigen-driven T-cell autoimmune disease.
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MESH Headings
- Aged
- Aged, 80 and over
- Amino Acid Sequence/genetics
- Antigens/genetics
- Antigens/immunology
- Aortic Aneurysm, Abdominal/genetics
- Aortic Aneurysm, Abdominal/immunology
- Aortic Aneurysm, Abdominal/pathology
- Cells, Cultured
- Clone Cells/immunology
- Humans
- Male
- Receptors, Antigen, T-Cell, alpha-beta/genetics
- Receptors, Antigen, T-Cell, alpha-beta/immunology
- Sequence Analysis, RNA
- T-Lymphocytes/immunology
- T-Lymphocytes/pathology
- Transcription, Genetic
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Affiliation(s)
- Song Lu
- Department of Microbiology and Immunology, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, United States of America
| | - John V. White
- Department of Surgery, Advocate Lutheran General Hospital and University of Illinois School of Medicine, Park Ridge, IL, United States of America
| | - Raquel I. Judy
- Department of Biological Sciences, Old Dominion University, Norfolk, VA, United States of America
| | - Lisa L. Merritt
- Department of Biological Sciences, Old Dominion University, Norfolk, VA, United States of America
| | - Wan Lu Lin
- Department of Microbiology and Immunology, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, United States of America
| | - Xiaoying Zhang
- Department of Microbiology and Immunology, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, United States of America
| | - Charalambos Solomides
- Department of Pathology and Laboratory Medicine, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, United States of America
| | - Ifeyinwa Nwaneshiudu
- Department of Microbiology and Immunology, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, United States of America
| | - John Gaughan
- Biostatistics Consulting Center, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, United States of America
| | - Dimitri S. Monos
- Department of Pathology and Laboratory Medicine, The Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Emilia L. Oleszak
- Department of Biological Sciences, Old Dominion University, Norfolk, VA, United States of America
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, United States of America
- Center for Molecular Medicine, Old Dominion University, Norfolk, VA, United States of America
| | - Chris D. Platsoucas
- Department of Microbiology and Immunology, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, United States of America
- Department of Biological Sciences, Old Dominion University, Norfolk, VA, United States of America
- Center for Molecular Medicine, Old Dominion University, Norfolk, VA, United States of America
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5
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Chang TW, Gracon ASA, Murphy MP, Wilkes DS. Exploring autoimmunity in the pathogenesis of abdominal aortic aneurysms. Am J Physiol Heart Circ Physiol 2015; 309:H719-27. [DOI: 10.1152/ajpheart.00273.2015] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 06/22/2015] [Indexed: 12/14/2022]
Abstract
The abdominal aortic aneurysm (AAA) is a disease process that carries significant morbidity and mortality in the absence of early identification and treatment. While current management includes surveillance and surgical treatment of low- and high-risk aneurysms, respectively, our narrow understanding of the pathophysiology of AAAs limits our ability to more effectively manage and perhaps even prevent the occurrence of this highly morbid disease. Over the past couple of decades, there has been considerable interest in exploring the role of autoimmunity as an etiological component of AAA. This review covers the current literature pertaining to this immunological process, focusing on research that highlights the local and systemic immune components found in both human patients and murine models. A better understanding of the autoimmune mechanisms in the pathogenesis of AAAs can pave the way to novel and improved treatment strategies in this patient population.
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Affiliation(s)
- Tiffany W. Chang
- Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana; and
| | - Adam S. A. Gracon
- Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana; and
| | - Michael P. Murphy
- Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana; and
| | - David S. Wilkes
- Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
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6
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Zhang L, Wang Y. B lymphocytes in abdominal aortic aneurysms. Atherosclerosis 2015; 242:311-7. [PMID: 26233918 DOI: 10.1016/j.atherosclerosis.2015.07.036] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2015] [Revised: 06/29/2015] [Accepted: 07/20/2015] [Indexed: 01/13/2023]
Abstract
Abdominal aortic aneurysm (AAA) is a progressive inflammatory disease of the artery walls. Immune cells, including B lymphocytes, are implicated in the pathogenesis of AAA through interconnected mechanisms. Many studies have shown that compared with normal abdominal aortic tissue, the amount of B lymphocytes that infiltrate the adventitia of AAAs was significantly higher. Activated B lymphocytes promote AAA by producing immunoglobulins, cytokines, and matrix metalloproteinases (MMPs), resulting in the activation of macrophages, mast cells (MCs) and complement pathways. Finally, all of these factors lead to the degradation of collagen and matrix proteins and to aortic wall remodeling, which are hallmarks of AAA. However, few studies focus on the relative function of B cells, and their precise mechanisms in AAA remain unclear. Thus, we summarize the current knowledge on the role of B cells in AAA and offer recommendations for further investigation of preventing the progression of AAA.
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Affiliation(s)
- Lili Zhang
- Department of Cardiology, Shanghai General Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200080, China
| | - Yi Wang
- Department of Cardiology, Shanghai General Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200080, China.
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7
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Lu S, White JV, Lin WL, Zhang X, Solomides C, Evans K, Ntaoula N, Nwaneshiudu I, Gaughan J, Monos DS, Oleszak EL, Platsoucas CD. Aneurysmal lesions of patients with abdominal aortic aneurysm contain clonally expanded T cells. THE JOURNAL OF IMMUNOLOGY 2014; 192:4897-912. [PMID: 24752442 DOI: 10.4049/jimmunol.1301009] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Abdominal aortic aneurysm (AAA) is a common disease with often life-threatening consequences. This vascular disorder is responsible for 1-2% of all deaths in men aged 65 years or older. Autoimmunity may be responsible for the pathogenesis of AAA. Although it is well documented that infiltrating T cells are essentially always present in AAA lesions, little is known about their role in the initiation and/or progression of the disease. To determine whether T cells infiltrating AAA lesions contain clonally expanded populations of T cells, we amplified β-chain TCR transcripts by the nonpalindromic adaptor-PCR/Vβ-specific PCR and/or Vβ-specific PCR, followed by cloning and sequencing. We report in this article that aortic abdominal aneurysmal lesions from 8 of 10 patients with AAA contained oligoclonal populations of T cells. Multiple identical copies of β-chain TCR transcripts were identified in these patients. These clonal expansions are statistically significant. These results demonstrate that αβ TCR(+) T lymphocytes infiltrating aneurysmal lesions of patients with AAA have undergone proliferation and clonal expansion in vivo at the site of the aneurysmal lesion, in response to unidentified self- or nonself Ags. This evidence supports the hypothesis that AAA is a specific Ag-driven T cell disease.
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Affiliation(s)
- Song Lu
- Department of Microbiology and Immunology, Temple University School of Medicine, Philadelphia, PA 19140
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8
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Assar AN. Pharmacological therapy for patients with abdominal aortic aneurysm. Expert Rev Cardiovasc Ther 2014; 7:999-1009. [DOI: 10.1586/erc.09.56] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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9
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Ando T, Iizuka N, Sato T, Chikada M, Kurokawa MS, Arito M, Okamoto K, Suematsu N, Makuuchi H, Kato T. Autoantigenicity of carbonic anhydrase 1 in patients with abdominal aortic aneurysm, revealed by proteomic surveillance. Hum Immunol 2013; 74:852-7. [PMID: 23557951 DOI: 10.1016/j.humimm.2013.02.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2012] [Revised: 01/25/2013] [Accepted: 02/19/2013] [Indexed: 01/01/2023]
Abstract
Abdominal aortic aneurysm (AAA) is sometimes detected in patients with atherosclerosis. One of the histological characteristics of AAA walls is infiltration of inflammatory cells, in which autoimmunity may be involved. Thereby, we here surveyed autoantigens in AAA walls by proteomics. Specifically, we separated proteins extracted from AAA wall samples by 2-dimensional electrophoresis and detected candidate autoantigens by western blotting. One of the detected candidates was carbonic anhydrase 1 (CA1). ELISA confirmed that the autoantibodies to CA1 were detected more frequently in AAA patients (n=13) than in healthy donors (n=25) (p=0.03). Interestingly, some serum samples from the AAA patients reacted to CA1 of the AAA walls stronger than to CA1 of peripheral blood mononuclear cells from healthy donors. Our data indicate that CA1 in the AAA walls would be modified to express neo-epitope(s) and that the autoimmunity to CA1 may be involved in the pathogenesis of AAA.
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Affiliation(s)
- Takashi Ando
- Clinical Proteomics and Molecular Medicine, St. Marianna University Graduate School of Medicine, Kanagawa, Japan
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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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11
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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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12
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Brykczyński M, Żych A, Gorący I, Mączyńska I, Wojciechowska-Koszko I, Mokrzycki K, Giedrys-Kalemba S, Sielicki P. Evaluation of the level of antibodies against Chlamydophila (Chlamydia) pneumoniae in post-surgery heart ischaemia patients and their clinical conditions - a six-year study. Arch Med Sci 2010; 6:214-20. [PMID: 22371750 PMCID: PMC3281343 DOI: 10.5114/aoms.2010.13898] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2009] [Revised: 09/15/2009] [Accepted: 10/10/2009] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Inflammatory conditions modulated by Chlamydophila (Chlamydia) pneumoniae are considered to play an important role in the onset of atherosclerosis. In this paper we present the results of progressive observation of C. pneumoniae antibody titres in patients who underwent coronary artery bypass graft (CABG). MATERIAL AND METHODS The objective of our research was a prospective observation of antibody titres in IgA and IgG class antibodies against C. pneumoniae using indirect immunofluorescence in a group of 155 post-surgery CABG patients suffering from heart ischaemia. The microbiological test results were compared with patients' present coronary complaints evaluated on the CCS scale during a six-year period. RESULTS Six years after CABG, 128 patients (82.6%) are still alive. During the study a positive serological conversion of antibody titres was observed in 36 patients in the IgA class antibodies, and in 26 patients in the IgG class. The group of patients with no antibodies against C. pneumoniae decreased from 23.2 to 3.4%, while the group of patients with antibodies in both IgG and IgA classes increased from 52.3 to 83.9%. The average CCS degree decreased from 3.18 before CABG to 1.65 in the present study. CONCLUSIONS These results show no connection between the serological symptoms of chronic C. pneumoniae infection and coronary complaints evaluated on the CCS scale during a six-year study on post-CABG patients suffering from heart ischaemia. The surgical treatment of heart ischaemia brought about long-term improvement in the coronary condition of the observed group of patients.
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Affiliation(s)
| | - Andrzej Żych
- Department of Cardiac Surgery, Pomeranian Medical University, Szczecin, Poland
| | - Iwona Gorący
- Department of Laboratory Diagnostics and Molecular Medicine, Pomeranian Medical University, Szczecin, Poland
| | - Iwona Mączyńska
- Department of Microbiology and Immunology, Pomeranian Medical University, Szczecin, Poland
| | | | - Krzysztof Mokrzycki
- Department of Cardiac Surgery, Pomeranian Medical University, Szczecin, Poland
| | | | - Piotr Sielicki
- Department of Cardiac Surgery, Pomeranian Medical University, Szczecin, Poland
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13
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Falkensammer B, Duftner C, Seiler R, Pavlic M, Walder G, Wilflingseder D, Stoiber H, Klein-Weigel P, Dierich M, Fraedrich G, Würzner R, Schirmer M. Lack of microbial DNA in tissue specimens of patients with abdominal aortic aneurysms and positive Chlamydiales serology. Eur J Clin Microbiol Infect Dis 2007; 26:141-5. [PMID: 17216421 DOI: 10.1007/s10096-006-0245-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
In a case-control study that included a total of 98 patients and 83 controls, the possible link between various pathogens and abdominal aortic aneurysms was investigated. For 68 patients with abdominal aortic aneurysm and age-matched controls, no differences were detected in the levels of immunoglobulin (Ig)A and IgG Chlamydiaceae and Chlamydophila pneumoniae antibodies. Patients with IgA titers positive for Chlamydophila pneumoniae showed progressive disease (defined as an annual increase of the aneurysm diameter of > or = 0.5 cm) more frequently than patients with negative IgA titers (p = 0.046). Polymerase chain reactions performed to detect DNA for Chlamydophila pneumoniae, Chlamydia trachomatis, Chlamydophila psittaci, human cytomegalovirus, Borrelia burgdorferi and Helicobacter pylori in tissue specimens of 30 patients and 15 controls were negative. In summary, Chlamydophila pneumoniae may contribute to aortic aneurysm disease progression, but DNA of this and other pathogens was not found in patients' specimens.
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Affiliation(s)
- B Falkensammer
- Department of Hygiene, Microbiology and Social Medicine, Innsbruck Medical University, Fritz-Pregl-Strasse 3, 6020, Innsbruck, Austria
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14
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Mussa FF, Chai H, Wang X, Yao Q, Lumsden AB, Chen C. Chlamydia pneumoniae and vascular disease: an update. J Vasc Surg 2006; 43:1301-7. [PMID: 16765261 DOI: 10.1016/j.jvs.2006.02.050] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2006] [Accepted: 02/26/2006] [Indexed: 11/16/2022]
Abstract
Exposure to Chlamydia pneumoniae is extremely common, and its incidence increases with age. C pneumoniae infection is strongly associated with coronary artery disease, as well as with atherosclerosis of the carotid artery, aorta, and peripheral arteries. This association has been shown in seroepidemiologic studies and by direct detection of the organism in atherosclerotic lesions by immunohistochemistry, polymerase chain reaction, electron microscopy, and tissue culture. Animal models of atherosclerosis have been used to study the role of C pneumoniae in the initiation and progression of atherosclerotic disease. The association of this organism with cardiovascular complications has inspired many human trials of antibiotics for the secondary prevention of atherosclerosis. C pneumoniae can infect several types of cells, including circulating macrophages, arterial smooth muscle cells, and vascular endothelial cells, causing the secretion of proinflammatory cytokines and procoagulants by endothelial cells and foam cell formation by infected macrophages. This report reviews the role of C pneumoniae in atherogenesis in light of recent, large antibiotic treatment trials, animal studies, and in vitro studies. The role of Chlamydia heat shock protein as a potential mediator of this harmful effect is also reviewed.
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Affiliation(s)
- Firas F Mussa
- Molecular Surgeon Research Center, Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas 77030, USA
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Lindholt JS, Shi GP. Chronic Inflammation, Immune Response, and Infection in Abdominal Aortic Aneurysms. Eur J Vasc Endovasc Surg 2006; 31:453-63. [PMID: 16414293 DOI: 10.1016/j.ejvs.2005.10.030] [Citation(s) in RCA: 83] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2005] [Accepted: 10/24/2005] [Indexed: 11/29/2022]
Abstract
Abdominal aortic aneurysms (AAA) are associated with atherosclerosis, transmural degenerative processes, neovascularization, decrease in content of vascular smooth muscle cells, and a chronic infiltration, mainly located in the outer aortic wall. The chronic infiltration consists mainly of macrophages, lymphocytes, and plasma cells. The dominant cells are Th2 restricted CD3+ lymphocytes expressing interleukine 4, 5, 8, and 10, and tumor necrosis factor-alpha for regulation of the local immune response. They also produce interferon-gamma and CD40 ligand to stimulate surrounding cells to produce matrix metalloproteases and cysteine proteases for aortic matrix remodeling. The lymphocyte activation may be mediated by microorganisms as well as autoantigens generated from vascular structural proteins, perhaps through molecular mimicry. As in autoimmune diseases, the risk of AAA is increased by certain genotypes concerning human leucocyte antigen class II. These types are also associated with increased aneurysmal inflammation indicating a genetic susceptibility to aortic inflammation. Chlamydia pneumoniae is often detected in AAA but the validity of the methods can be questioned, and two small antibiotic trials have been disappointing. However, serum antibodies against C. pneumoniae have been associated with AAA growth and cross-react with AAA wall proteins. Thus, immune responses mediated by microorganisms and autoantigens may play a pivotal role in AAA pathogenesis.
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Affiliation(s)
- J S Lindholt
- Vascular Research Unit, Department of Vascular Surgery, Viborg Hospital, Viborg, Denmark.
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Kariv-Inbal Z, Halimi M, Dayan Y, Engelstein R, Gabizon R. Characterization of light chain immunoglobulin in urine from animals and humans infected with prion diseases. J Neuroimmunol 2005; 162:12-8. [PMID: 15833355 DOI: 10.1016/j.jneuroim.2004.12.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2004] [Revised: 12/14/2004] [Accepted: 12/15/2004] [Indexed: 11/26/2022]
Abstract
The necessity of a non-invasive in-vivo test for prion diseases has become more apparent since the transmission of vCJD from the blood of a healthy individual incubating the disease. Here we show that prion urine comprises an array of protease resistant peptides, among them light chain immunoglobulin (LC). This was observed by sequencing gel bands comprising hamster urine samples, as well as by immunoblotting of similar samples with anti mouse IgG reagents for hamster samples, or with anti human IgG reagents for human samples. Our result suggests that urine samples from CJD patients can be identified by the presence of protease resistant proteins such as LC.
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Affiliation(s)
- Zehavit Kariv-Inbal
- Department of Neurology, The Agnes Ginges Center for Human Neurogenetics, Hadassah University Hospital, Jerusalem 91120, Israel
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Ieven MM, Hoymans VY. Involvement of Chlamydia pneumoniae in atherosclerosis: more evidence for lack of evidence. J Clin Microbiol 2005; 43:19-24. [PMID: 15634945 PMCID: PMC540187 DOI: 10.1128/jcm.43.1.19-24.2005] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Affiliation(s)
- Margareta M Ieven
- Department of Medical Microbiology, University of Antwerp-UA, B2610 Wilrijk, Belgium.
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Kotsimbos TC, Snell GI, Levvey B, Spelman DW, Fuller AJ, Wesselingh SL, Williams TJ, Ostergaard L. Chlamydia pneumoniae Serology in Donors and Recipients and the Risk of Bronchiolitis Obliterans Syndrome after Lung Transplantation. Transplantation 2005; 79:269-75. [PMID: 15699755 DOI: 10.1097/01.tp.0000149839.87843.64] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Bronchiolitis obliterans syndrome (BOS) is a common late complication in lung transplant recipients (LTR). Chlamydia pneumoniae (C. pneumoniae) is a common but difficult to diagnose respiratory pathogen with a propensity to latency. METHODS We studied the impact of C. pneumoniae on BOS development using donor-recipient serology obtained before transplantation in a cohort of 76 LTR. RESULTS BOS was present in 29.9% patients (mean follow-up 866 days). High donor C. pneumoniae immunoglobulin (Ig)G titers were associated with BOS in the recipient (area under the curve [AUC] 0.71, 95% confidence interval [CI] 0.52-0.91, P=0.027), whereas high recipient titers were inversely associated with BOS (AUC 0.27, 95% CI 0.11-0.44, P=0.018). The risk of developing BOS was 75.0% in the case of a primary seromismatch for C. pneumoniae (D+/R-), whereas a reverse mismatch had a risk of 4.6% (likelihood ratio 9.8, P=0.02). In a multivariate model that included human leukocyte antigen matching, acute rejection and cytomegalovirus pneumonitis, C. pneumoniae IgG donor 32 or greater and C. pneumoniae IgG recipient 32 or greater remained positive and negative independent risk factors, respectively, for BOS in LTR. In the freedom from BOS analysis, BOS occurred more frequently and earlier in C. pneumoniae seropositive donors, and the reverse was true in seronegative recipients. CONCLUSION C. pneumoniae serology in donor and recipient is associated with the development of BOS in LTR.
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Affiliation(s)
- Thomas C Kotsimbos
- Department of Respiratory Medicine and Heart-Lung Transplant Service, Alfred Hospital, Melbourne, Australia.
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