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Mougin Z, Huguet Herrero J, Boileau C, Le Goff C. ADAMTS Proteins and Vascular Remodeling in Aortic Aneurysms. Biomolecules 2021; 12:12. [PMID: 35053160 PMCID: PMC8773774 DOI: 10.3390/biom12010012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 12/16/2021] [Accepted: 12/20/2021] [Indexed: 12/11/2022] Open
Abstract
Extracellular matrix (ECM) in the vascular wall is a highly dynamic structure composed of a set of different molecules such as elastins, collagens, fibronectin (Fn), laminins, proteoglycans, and polysaccharides. ECM undergoes remodeling processes to regulate vascular smooth muscle and endothelial cells' proliferation, differentiation, and adhesion. Abnormalities affecting the ECM can lead to alteration in cellular behavior and from this, this can conduce to the development of pathologies. Metalloproteases play a key role in maintaining the homeostasis of ECM by mediating the cleavage of different ECM components. There are different types of metalloproteases: matrix metalloproteinases (MMPs), disintegrin and metalloproteinases (ADAMs), and ADAMs with thrombospondin motifs (ADAMTSs). ADAMTSs have been found to participate in cardiovascular physiology and diseases and specifically in aortic aneurysms. This review aims to decipher the potential role of ADAMTS proteins in the physiopathologic development of Thoracic Aortic Aneurysms (TAA) and Abdominal Aortic Aneurysms (AAA). This review will focus on what is known on the ADAMTS family involved in human aneurysms from human tissues to mouse models. The recent findings on THSD4 (encoding ADAMTSL6) mutations in TAA give a new insight on the involvement of the ADAMTS family in TAA.
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Affiliation(s)
- Zakaria Mougin
- INSERM U1148, Laboratory of Vascular Translational Science, Université de Paris, Hôpital Bichat, F-75018 Paris, France; (Z.M.); (J.H.H.); (C.B.)
| | - Julia Huguet Herrero
- INSERM U1148, Laboratory of Vascular Translational Science, Université de Paris, Hôpital Bichat, F-75018 Paris, France; (Z.M.); (J.H.H.); (C.B.)
| | - Catherine Boileau
- INSERM U1148, Laboratory of Vascular Translational Science, Université de Paris, Hôpital Bichat, F-75018 Paris, France; (Z.M.); (J.H.H.); (C.B.)
- Département de Génétique, AP-HP, Hôpital Bichat, F-75018 Paris, France
| | - Carine Le Goff
- INSERM U1148, Laboratory of Vascular Translational Science, Université de Paris, Hôpital Bichat, F-75018 Paris, France; (Z.M.); (J.H.H.); (C.B.)
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Zhang S, Liu Z, Xie N, Huang C, Li Z, Yu F, Fu Y, Cui Q, Kong W. Pan-HDAC (Histone Deacetylase) Inhibitors Increase Susceptibility of Thoracic Aortic Aneurysm and Dissection in Mice. Arterioscler Thromb Vasc Biol 2021; 41:2848-2850. [PMID: 34525846 PMCID: PMC8545242 DOI: 10.1161/atvbaha.121.316808] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Shumin Zhang
- Department of Physiology and Pathophysiology (S.Z., Z. Liu, N.X., Z. Li, F.Y., Y.F., W.K.), School of Basic Medical Sciences, Peking University, Beijing, China
- Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing, China (S.Z., Z. Liu, N.X., Z. Li, F.Y., Y.F., W.K., C.H., Q.C.)
| | - Zhujiang Liu
- Department of Physiology and Pathophysiology (S.Z., Z. Liu, N.X., Z. Li, F.Y., Y.F., W.K.), School of Basic Medical Sciences, Peking University, Beijing, China
- Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing, China (S.Z., Z. Liu, N.X., Z. Li, F.Y., Y.F., W.K., C.H., Q.C.)
| | - Nan Xie
- Department of Physiology and Pathophysiology (S.Z., Z. Liu, N.X., Z. Li, F.Y., Y.F., W.K.), School of Basic Medical Sciences, Peking University, Beijing, China
- Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing, China (S.Z., Z. Liu, N.X., Z. Li, F.Y., Y.F., W.K., C.H., Q.C.)
| | - Chuanbo Huang
- Department of Biomedical Informatics, Department of Physiology and Pathophysiology, Center for Noncoding RNA Medicine (C.H., Q.C.), School of Basic Medical Sciences, Peking University, Beijing, China
- Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing, China (S.Z., Z. Liu, N.X., Z. Li, F.Y., Y.F., W.K., C.H., Q.C.)
| | - Zhiqing Li
- Department of Physiology and Pathophysiology (S.Z., Z. Liu, N.X., Z. Li, F.Y., Y.F., W.K.), School of Basic Medical Sciences, Peking University, Beijing, China
- Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing, China (S.Z., Z. Liu, N.X., Z. Li, F.Y., Y.F., W.K., C.H., Q.C.)
| | - Fang Yu
- Department of Physiology and Pathophysiology (S.Z., Z. Liu, N.X., Z. Li, F.Y., Y.F., W.K.), School of Basic Medical Sciences, Peking University, Beijing, China
- Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing, China (S.Z., Z. Liu, N.X., Z. Li, F.Y., Y.F., W.K., C.H., Q.C.)
| | - Yi Fu
- Department of Physiology and Pathophysiology (S.Z., Z. Liu, N.X., Z. Li, F.Y., Y.F., W.K.), School of Basic Medical Sciences, Peking University, Beijing, China
- Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing, China (S.Z., Z. Liu, N.X., Z. Li, F.Y., Y.F., W.K., C.H., Q.C.)
| | - Qinghua Cui
- Department of Biomedical Informatics, Department of Physiology and Pathophysiology, Center for Noncoding RNA Medicine (C.H., Q.C.), School of Basic Medical Sciences, Peking University, Beijing, China
- Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing, China (S.Z., Z. Liu, N.X., Z. Li, F.Y., Y.F., W.K., C.H., Q.C.)
| | - Wei Kong
- Department of Physiology and Pathophysiology (S.Z., Z. Liu, N.X., Z. Li, F.Y., Y.F., W.K.), School of Basic Medical Sciences, Peking University, Beijing, China
- Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing, China (S.Z., Z. Liu, N.X., Z. Li, F.Y., Y.F., W.K., C.H., Q.C.)
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Caescu CI, Hansen J, Crockett B, Xiao W, Arnaud P, Spronck B, Weinberg A, Hashimoto T, Murtada SI, Borkar R, Gallo JM, Jondeau G, Boileau C, Humphrey JD, He JC, Iyengar R, Ramirez F. Inhibition of HIPK2 Alleviates Thoracic Aortic Disease in Mice With Progressively Severe Marfan Syndrome. Arterioscler Thromb Vasc Biol 2021; 41:2483-2493. [PMID: 34320838 PMCID: PMC8530207 DOI: 10.1161/atvbaha.121.316464] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective Despite considerable research, the goal of finding nonsurgical remedies against thoracic aortic aneurysm and acute aortic dissection remains elusive. We sought to identify a novel aortic PK (protein kinase) that can be pharmacologically targeted to mitigate aneurysmal disease in a well-established mouse model of early-onset progressively severe Marfan syndrome (MFS). Approach and Results Computational analyses of transcriptomic data derived from the ascending aorta of MFS mice predicted a probable association between thoracic aortic aneurysm and acute aortic dissection development and the multifunctional, stress-activated HIPK2 (homeodomain-interacting protein kinase 2). Consistent with this prediction, Hipk2 gene inactivation significantly extended the survival of MFS mice by slowing aneurysm growth and delaying transmural rupture. HIPK2 also ranked among the top predicted PKs in computational analyses of DEGs (differentially expressed genes) in the dilated aorta of 3 MFS patients, which strengthened the clinical relevance of the experimental finding. Additional in silico analyses of the human and mouse data sets identified the TGF (transforming growth factor)-β/Smad3 signaling pathway as a potential target of HIPK2 in the MFS aorta. Chronic treatment of MFS mice with an allosteric inhibitor of HIPK2-mediated stimulation of Smad3 signaling validated this prediction by mitigating thoracic aortic aneurysm and acute aortic dissection pathology and partially improving aortic material stiffness. Conclusions HIPK2 is a previously unrecognized determinant of aneurysmal disease and an attractive new target for antithoracic aortic aneurysm and acute aortic dissection multidrug therapy.
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MESH Headings
- Adult
- Aortic Dissection/enzymology
- Aortic Dissection/genetics
- Aortic Dissection/pathology
- Aortic Dissection/prevention & control
- Animals
- Aorta, Thoracic/drug effects
- Aorta, Thoracic/enzymology
- Aorta, Thoracic/pathology
- Aortic Aneurysm, Thoracic/enzymology
- Aortic Aneurysm, Thoracic/genetics
- Aortic Aneurysm, Thoracic/pathology
- Aortic Aneurysm, Thoracic/prevention & control
- Carrier Proteins/genetics
- Carrier Proteins/metabolism
- Dilatation, Pathologic
- Disease Models, Animal
- Disease Progression
- Fibrillin-1/genetics
- Humans
- Male
- Marfan Syndrome/complications
- Marfan Syndrome/genetics
- Mice, 129 Strain
- Mice, Inbred C57BL
- Mice, Knockout
- Protein Kinase Inhibitors/pharmacology
- Protein Serine-Threonine Kinases/antagonists & inhibitors
- Protein Serine-Threonine Kinases/genetics
- Protein Serine-Threonine Kinases/metabolism
- Severity of Illness Index
- Signal Transduction
- Smad3 Protein/metabolism
- Vascular Remodeling/drug effects
- Mice
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Affiliation(s)
- Cristina I Caescu
- Department of Pharmacological Sciences, Institute for Systems Biomedicine (C.I.C., J.H., B.C., T.H., R.I., F.R.), Icahn School of Medicine at Mount Sinai, New York
| | - Jens Hansen
- Department of Pharmacological Sciences, Institute for Systems Biomedicine (C.I.C., J.H., B.C., T.H., R.I., F.R.), Icahn School of Medicine at Mount Sinai, New York
| | - Brittany Crockett
- Department of Pharmacological Sciences, Institute for Systems Biomedicine (C.I.C., J.H., B.C., T.H., R.I., F.R.), Icahn School of Medicine at Mount Sinai, New York
| | - Wenzhen Xiao
- Division of Nephrology, Department of Medicine (W.X., J.C.H.), Icahn School of Medicine at Mount Sinai, New York
| | - Pauline Arnaud
- Département de Génétique et Centre de Référence Maladies Rares Syndrome de Marfan et Pathologies Apparentées, Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, France (P.A., G.J., C.B.)
- LVTS, INSERM U1148, Université de Paris, Hôpital Bichat, France (P.A., G.J., C.B.)
| | - Bart Spronck
- Department of Biomedical Engineering, Yale University, New Haven, CT (B.S., S.-I.M., J.D.H.)
| | - Alan Weinberg
- Department of Population Health Science and Policy (A.W.), Icahn School of Medicine at Mount Sinai, New York
| | - Takeshi Hashimoto
- Department of Pharmacological Sciences, Institute for Systems Biomedicine (C.I.C., J.H., B.C., T.H., R.I., F.R.), Icahn School of Medicine at Mount Sinai, New York
| | - Sae-Il Murtada
- Department of Biomedical Engineering, Yale University, New Haven, CT (B.S., S.-I.M., J.D.H.)
| | - Roshan Borkar
- Department of Pharmaceutical Sciences, State University of New York, Buffalo (R.B., J.M.G.)
| | - James M Gallo
- Department of Pharmaceutical Sciences, State University of New York, Buffalo (R.B., J.M.G.)
| | - Guillaume Jondeau
- Département de Génétique et Centre de Référence Maladies Rares Syndrome de Marfan et Pathologies Apparentées, Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, France (P.A., G.J., C.B.)
- LVTS, INSERM U1148, Université de Paris, Hôpital Bichat, France (P.A., G.J., C.B.)
| | - Catherine Boileau
- Département de Génétique et Centre de Référence Maladies Rares Syndrome de Marfan et Pathologies Apparentées, Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, France (P.A., G.J., C.B.)
- LVTS, INSERM U1148, Université de Paris, Hôpital Bichat, France (P.A., G.J., C.B.)
| | - Jay D Humphrey
- Department of Biomedical Engineering, Yale University, New Haven, CT (B.S., S.-I.M., J.D.H.)
| | - John Cijiang He
- Division of Nephrology, Department of Medicine (W.X., J.C.H.), Icahn School of Medicine at Mount Sinai, New York
| | - Ravi Iyengar
- Department of Pharmacological Sciences, Institute for Systems Biomedicine (C.I.C., J.H., B.C., T.H., R.I., F.R.), Icahn School of Medicine at Mount Sinai, New York
| | - Francesco Ramirez
- Department of Pharmacological Sciences, Institute for Systems Biomedicine (C.I.C., J.H., B.C., T.H., R.I., F.R.), Icahn School of Medicine at Mount Sinai, New York
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Abstract
PURPOSE Advancing age is the major risk factor for thoracic aortic aneurysm/dissection (TAAD). However, the causative link between age-related molecules and TAAD remains elusive. Here, we investigated the role of Sirtuin 1 (SIRT1, also known as class III histone deacetylase), the best studied member of the longevity-related Sirtuin family, in TAAD development in vivo. METHODS We used male smooth muscle-specific SIRT1 transgenic (ST-Tg) mice, smooth muscle-specific SIRT1 knockout (ST-KO) mice, and their wild-type (WT) littermates on a C57BL/6J background to establish a TAAD model induced by oral administration of 3-aminopropionitrile fumarate (BAPN). We analyzed the incidence and fatality rates of TAAD in the groups. We examined matrix metallopeptidase 2 (MMP2) and MMP9 expression in aortas or cultured A7r5 cells via western blotting and real-time polymerase chain reaction (PCR). We performed chromatin immunoprecipitation (ChIP) to clarify the epigenetic mechanism of SIRT1-regulated MMP2 expression in vascular smooth muscle cells (VSMCs). RESULTS BAPN treatment markedly increased the incidence of TAAD in WT mice but caused less disease in ST-Tg mice. Moreover, ST-KO mice had the highest BAPN-induced TAAD fatality rate of all the groups. Mechanistically, SIRT1 overexpression resulted in lower MMP2 and MMP9 expression after BAPN treatment in both mouse aortas and cultured A7r5 cells. The downregulation of BAPN-induced MMP2 expression by SIRT1 was mediated by deacetylation of histone H3 lysine 9 (H3K9) on the Mmp2 promoter in the A7r5 cells. CONCLUSION Our findings suggest that SIRT1 expression in SMCs protects against TAAD and could be a novel therapeutic target for TAAD management.
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MESH Headings
- Acetylation
- Aortic Dissection/enzymology
- Aortic Dissection/genetics
- Aortic Dissection/pathology
- Aortic Dissection/prevention & control
- Animals
- Aorta, Thoracic/enzymology
- Aorta, Thoracic/pathology
- Aortic Aneurysm, Thoracic/enzymology
- Aortic Aneurysm, Thoracic/genetics
- Aortic Aneurysm, Thoracic/pathology
- Aortic Aneurysm, Thoracic/prevention & control
- Cell Line
- Disease Models, Animal
- Histones/metabolism
- Male
- Matrix Metalloproteinase 2/genetics
- Matrix Metalloproteinase 2/metabolism
- Matrix Metalloproteinase 9/genetics
- Matrix Metalloproteinase 9/metabolism
- Mice, Inbred C57BL
- Mice, Transgenic
- Muscle, Smooth, Vascular/enzymology
- Muscle, Smooth, Vascular/pathology
- Myocytes, Smooth Muscle/enzymology
- Myocytes, Smooth Muscle/pathology
- Signal Transduction
- Sirtuin 1/genetics
- Sirtuin 1/metabolism
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Affiliation(s)
- Fang Wang
- Department of Cardiology, China-Japan Friendship Hospital, Beijing, China
| | - Yimin Tu
- Department of Cardiology, China-Japan Friendship Hospital, Beijing, China
| | - Yanxiang Gao
- Department of Cardiology, China-Japan Friendship Hospital, Beijing, China
| | - Houzao Chen
- State Key Laboratory of Medical Molecular Biology, Department of Biochemistry and Molecular Biology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Jinjing Liu
- Key Laboratory of Rheumatology and Clinical Rheumatology, Ministry of Education, National Clinical Research Center for Dermatologic and Immunologic Diseases, Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
| | - Jingang Zheng
- Department of Cardiology, China-Japan Friendship Hospital, Beijing, China.
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Xia L, Sun C, Zhu H, Zhai M, Zhang L, Jiang L, Hou P, Li J, Li K, Liu Z, Li B, Wang X, Yi W, Liang H, Jin Z, Yang J, Yi D, Liu J, Yu S, Duan W. Melatonin protects against thoracic aortic aneurysm and dissection through SIRT1-dependent regulation of oxidative stress and vascular smooth muscle cell loss. J Pineal Res 2020; 69:e12661. [PMID: 32329099 DOI: 10.1111/jpi.12661] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Revised: 04/07/2020] [Accepted: 04/14/2020] [Indexed: 12/12/2022]
Abstract
Melatonin functions as an endogenous protective molecule in multiple vascular diseases, whereas its effects on thoracic aortic aneurysm and dissection (TAAD) and underlying mechanisms have not been reported. In this study, TAAD mouse model was successfully induced by β-aminopropionitrile fumarate (BAPN). We found that melatonin treatment remarkably prevented the deterioration of TAAD, evidenced by decreased incidence, ameliorated aneurysmal dilation and vascular stiffness, improved aortic morphology, and inhibited elastin degradation, macrophage infiltration, and matrix metalloproteinase expression. Moreover, melatonin blunted oxidative stress damage and vascular smooth muscle cell (VSMC) loss. Notably, BAPN induced a decrease in SIRT1 expression and activity of mouse aorta, whereas melatonin treatment reversed it. Further mechanistic study demonstrated that blocking SIRT1 signaling partially inhibited these beneficial effects of melatonin on TAAD. Additionally, the melatonin receptor was involved in this phenomenon. Our study is the first to report that melatonin exerts therapeutic effects against TAAD by reducing oxidative stress and VSMC loss via activation of SIRT1 signaling in a receptor-dependent manner, thus suggesting a novel therapeutic strategy for TAAD.
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Affiliation(s)
- Lin Xia
- Department of Cardiovascular Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Chang Sun
- Department of Orthopedics, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Hanzhao Zhu
- Department of Cardiovascular Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Mengen Zhai
- Department of Cardiovascular Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Liyun Zhang
- Department of Cardiovascular Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Liqing Jiang
- Department of Cardiovascular Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Peng Hou
- Department of Cardiovascular Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Junfeng Li
- Department of Cardiovascular Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Kaifeng Li
- Institute of Material Medical, School of Pharmacy, The Fourth Military Medical University, Xi'an, China
| | - Zhenhua Liu
- Department of Cardiovascular Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Buying Li
- Department of Cardiovascular Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Xiaowu Wang
- Department of Cardiovascular Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Wei Yi
- Department of Cardiovascular Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Hongliang Liang
- Department of Cardiovascular Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Zhenxiao Jin
- Department of Cardiovascular Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Jian Yang
- Department of Cardiovascular Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Dinghua Yi
- Department of Cardiovascular Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Jincheng Liu
- Department of Cardiovascular Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Shiqiang Yu
- Department of Cardiovascular Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Weixun Duan
- Department of Cardiovascular Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
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Shalhub S, Regalado ES, Guo DC, Milewicz DM. The natural history of type B aortic dissection in patients with PRKG1 mutation c.530G>A (p.Arg177Gln). J Vasc Surg 2019; 70:718-723. [PMID: 30871887 DOI: 10.1016/j.jvs.2018.12.032] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 12/11/2018] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The c.530G>A (p.Arg177Gln) mutation in PRKG1 has been shown to be associated with thoracic aortic aneurysms and dissections. This rare mutation accounts for an estimated 1% of nonsyndromic heritable thoracic aortic disease. We sought to describe the clinical presentation of type B aortic dissection (TBAD), management, and outcomes in patients with this mutation. METHODS This is a descriptive multi-institutional retrospective study of patients from six families with the PRKG1 mutation. Patients with TBAD were selected for analysis. Demographics, family histories, TBAD management, and outcomes were reviewed. RESULTS Of the 29 individuals diagnosed with the PRKG1 mutation, 12 (41.3%) had TBAD (50% male, TBAD median age: 31 years [range, 16-58 years], median follow-up: 6 years [range, 3-15 years] after TBAD). All had a family history of aortic dissections and none had features of Marfan syndrome. The median size of the descending thoracic aorta (DTA) at TBAD was 4.1 cm (range, 3.8-5 cm). Most cases (9 acute TBAD, 1 incidental TBAD diagnosis during screening) were managed medically. One case had open DTA repair the acute phase. Repair for dissection-related aneurysmal degeneration was performed in seven cases (58.3%) in the chronic phase at a median of 2 years (range, 1-8 years) after TBAD. In four cases (33.3%), the DTA remained stable in size over a range of 1 to 7 years after TBAD. Type A aortic dissection subsequent to TBAD occurred in three cases (25%). There were four (33.3%) deaths in the series, all aortic related at a median age of 24 years (range, 19-43 years). CONCLUSIONS The PRKG1 (p.Arg177Gln) mutation although rare is associated with nonsyndromic TBAD in young and middle-aged patients. Workup for this gene mutation should be included as part of the workup for TBAD etiology in relatively young patients and those with familial history of aortic dissections. Once diagnosed, testing of first-degree family members is warranted. In all individuals with a PRKG1 mutation, close follow-up for aortic root dilatation and hypertension control is essential to reduce the risk of type A or type B aortic dissection, and in cases of TBAD, to decrease the risk of dissection-related aneurysmal degeneration.
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Affiliation(s)
- Sherene Shalhub
- Division of Vascular Surgery, Department of Surgery, University of Washington School of Medicine, Seattle, Wash.
| | - Ellen S Regalado
- Division of Medical Genetics, Department of Internal Medicine, The University of Texas Health Science Center at Houston, Houston, Tex
| | - Dong-Chuan Guo
- Division of Medical Genetics, Department of Internal Medicine, The University of Texas Health Science Center at Houston, Houston, Tex
| | - Dianna M Milewicz
- Division of Medical Genetics, Department of Internal Medicine, The University of Texas Health Science Center at Houston, Houston, Tex
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7
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Zhou B, Li W, Zhao G, Yu B, Ma B, Liu Z, Xie N, Fu Y, Gong Z, Dai R, Zhang X, Kong W. Rapamycin prevents thoracic aortic aneurysm and dissection in mice. J Vasc Surg 2018; 69:921-932.e3. [PMID: 30253896 DOI: 10.1016/j.jvs.2018.05.246] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 05/25/2018] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate whether rapamycin inhibits the development of thoracic aortic aneurysm and dissection (TAAD) in mice. METHODS Three-week-old C57BL/6J male mice were fed a normal diet and randomized into a control group (n = 6), β-aminopropionitrile fumarate (BAPN) group (Gp A; n = 15), BAPN plus rapamycin (5 mg) group (Gp B; n = 8), and BAPN plus rapamycin (10 mg) group (Gp C; n = 8). Gp A, Gp B, and Gp C were administered BAPN (1 g/kg/d) for 4 weeks. One week after BAPN administration, Gp B and Gp C were treated with rapamycin (5 mg/kg/d or 10 mg/kg/d) through gavage for 21 days. Thoracic aortas were harvested for Western blot and immunofluorescence staining at day 14 and for morphologic and histologic analyses at day 28. RESULTS BAPN treatment induced TAAD formation in mice. The incidence of TAAD in control, Gp A, Gp B, and Gp C mice was 0%, 80%, 25%, and 37.5%, respectively. Smaller thoracic aortic diameters (ascending aorta and arch) were observed in Gp B and Gp C mice than in Gp A mice (Gp B vs Gp A: ascending aorta, ex vivo, 1.07 ± 0.21 mm vs 1.80 ± 0.67 mm [P < .05]; aortic arch, ex vivo, 1.51 ± 0.40 mm vs 2.70 ± 1.06 mm [P < .05]; Gp C vs Gp A: ascending aortas, ex vivo, 1.10 ± 0.33 mm vs 1.80 ± 0.67 mm [P < .05]; aortic arch, ex vivo, 1.55 ± 0.56 mm vs 2.70 ± 1.06 mm [P < .05]). TAAD mice exhibited elastin fragmentation, abundant inflammatory cell infiltration, and significantly increased matrix metalloproteinase production in the aorta, and rapamycin treatment alleviated these changes. The protein levels of p-S6K and p-S6 in TAAD aortic tissues increased significantly, whereas they were suppressed by rapamycin. CONCLUSIONS Rapamycin suppressed TAAD formation, probably by inhibition of mechanistic target of rapamycin signaling and reduction of inflammatory cell infiltration and matrix metalloproteinase 9 production. Targeting of the mechanistic target of rapamycin signaling pathway using rapamycin may be a favorable modulation for the clinical treatment of TAAD.
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MESH Headings
- Aminopropionitrile
- Aortic Dissection/chemically induced
- Aortic Dissection/enzymology
- Aortic Dissection/pathology
- Aortic Dissection/prevention & control
- Animals
- Anti-Inflammatory Agents/pharmacology
- Aorta, Thoracic/drug effects
- Aorta, Thoracic/enzymology
- Aorta, Thoracic/pathology
- Aortic Aneurysm, Thoracic/chemically induced
- Aortic Aneurysm, Thoracic/enzymology
- Aortic Aneurysm, Thoracic/pathology
- Aortic Aneurysm, Thoracic/prevention & control
- Dilatation, Pathologic
- Disease Models, Animal
- Male
- Matrix Metalloproteinase 9/metabolism
- Mice, Inbred C57BL
- Phosphorylation
- Protein Kinase Inhibitors/pharmacology
- Ribosomal Protein S6 Kinases/metabolism
- Signal Transduction/drug effects
- Sirolimus/pharmacology
- TOR Serine-Threonine Kinases/antagonists & inhibitors
- TOR Serine-Threonine Kinases/metabolism
- Vascular Remodeling/drug effects
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Affiliation(s)
- Biao Zhou
- Department of Vascular Surgery, Peking University People's Hospital, Peking University, Beijing, China
| | - Wei Li
- Department of Vascular Surgery, Peking University People's Hospital, Peking University, Beijing, China
| | - Guizhen Zhao
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Peking University, Beijing, China; Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing, China
| | - Bing Yu
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Peking University, Beijing, China; Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing, China
| | - Baihui Ma
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Peking University, Beijing, China; Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing, China
| | - Zhujiang Liu
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Peking University, Beijing, China; Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing, China
| | - Nan Xie
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Peking University, Beijing, China; Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing, China
| | - Yi Fu
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Peking University, Beijing, China; Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing, China
| | - Ze Gong
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Peking University, Beijing, China; Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing, China
| | - Rongbo Dai
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Peking University, Beijing, China; Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing, China
| | - Xiaoming Zhang
- Department of Vascular Surgery, Peking University People's Hospital, Peking University, Beijing, China.
| | - Wei Kong
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Peking University, Beijing, China; Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing, China
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8
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Fava M, Barallobre-Barreiro J, Mayr U, Lu R, Didangelos A, Baig F, Lynch M, Catibog N, Joshi A, Barwari T, Yin X, Jahangiri M, Mayr M. Role of ADAMTS-5 in Aortic Dilatation and Extracellular Matrix Remodeling. Arterioscler Thromb Vasc Biol 2018; 38:1537-1548. [PMID: 29622560 PMCID: PMC6026471 DOI: 10.1161/atvbaha.117.310562] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2017] [Accepted: 03/19/2018] [Indexed: 11/16/2022]
Abstract
Supplemental Digital Content is available in the text. Objective— Thoracic aortic aneurysm (TAA), a degenerative disease of the aortic wall, is accompanied by changes in the structure and composition of the aortic ECM (extracellular matrix). The ADAMTS (a disintegrin and metalloproteinase with thrombospondin motifs) family of proteases has recently been implicated in TAA formation. This study aimed to investigate the contribution of ADAMTS-5 to TAA development. Approach and Results— A model of aortic dilatation by AngII (angiotensin II) infusion was adopted in mice lacking the catalytic domain of ADAMTS-5 (Adamts5Δcat). Adamts5Δcat mice showed an attenuated rise in blood pressure while displaying increased dilatation of the ascending aorta (AsAo). Interestingly, a proteomic comparison of the aortic ECM from AngII-treated wild-type and Adamts5Δcat mice revealed versican as the most upregulated ECM protein in Adamts5Δcat mice. This was accompanied by a marked reduction of ADAMTS-specific versican cleavage products (versikine) and a decrease of LRP1 (low-density lipoprotein-related protein 1). Silencing LRP1 expression in human aortic smooth muscle cells reduced the expression of ADAMTS5, attenuated the generation of versikine, but increased soluble ADAMTS-1. A similar increase in ADAMTS-1 was observed in aortas of AngII-treated Adamts5Δcat mice but was not sufficient to maintain versican processing and prevent aortic dilatation. Conclusions— Our results support the emerging role of ADAMTS proteases in TAA. ADAMTS-5 rather than ADAMTS-1 is the key protease for versican regulation in murine aortas. Further studies are needed to define the ECM substrates of the different ADAMTS proteases and their contribution to TAA formation.
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MESH Headings
- ADAMTS1 Protein/metabolism
- ADAMTS5 Protein/deficiency
- ADAMTS5 Protein/genetics
- ADAMTS5 Protein/metabolism
- Angiotensin II
- Animals
- Aorta, Thoracic/enzymology
- Aorta, Thoracic/pathology
- Aortic Aneurysm, Thoracic/chemically induced
- Aortic Aneurysm, Thoracic/enzymology
- Aortic Aneurysm, Thoracic/genetics
- Aortic Aneurysm, Thoracic/pathology
- Cells, Cultured
- Dilatation, Pathologic
- Disease Models, Animal
- Extracellular Matrix/enzymology
- Extracellular Matrix/pathology
- Humans
- Low Density Lipoprotein Receptor-Related Protein-1/genetics
- Low Density Lipoprotein Receptor-Related Protein-1/metabolism
- Male
- Mice, Knockout
- Muscle, Smooth, Vascular/enzymology
- Myocytes, Smooth Muscle
- Receptors, LDL/metabolism
- Tumor Suppressor Proteins/metabolism
- Vascular Remodeling
- Versicans/metabolism
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Affiliation(s)
- Marika Fava
- From the King's British Heart Foundation Centre, King's College London, United Kingdom (M.F., J.B.-B., U.M., R.L., A.D., F.B., M.L., N.C., A.J., T.B., X.Y., M.M.)
- St George's University of London, NHS Trust, United Kingdom (M.F., M.J.)
- Cardiovascular Institute, Cardiovascular Research Center, Icahn School of Medicine at Mount Sinai, New York (M.F., M.M.)
| | - Javier Barallobre-Barreiro
- From the King's British Heart Foundation Centre, King's College London, United Kingdom (M.F., J.B.-B., U.M., R.L., A.D., F.B., M.L., N.C., A.J., T.B., X.Y., M.M.)
| | - Ursula Mayr
- From the King's British Heart Foundation Centre, King's College London, United Kingdom (M.F., J.B.-B., U.M., R.L., A.D., F.B., M.L., N.C., A.J., T.B., X.Y., M.M.)
| | - Ruifang Lu
- From the King's British Heart Foundation Centre, King's College London, United Kingdom (M.F., J.B.-B., U.M., R.L., A.D., F.B., M.L., N.C., A.J., T.B., X.Y., M.M.)
| | - Athanasios Didangelos
- From the King's British Heart Foundation Centre, King's College London, United Kingdom (M.F., J.B.-B., U.M., R.L., A.D., F.B., M.L., N.C., A.J., T.B., X.Y., M.M.)
| | - Ferheen Baig
- From the King's British Heart Foundation Centre, King's College London, United Kingdom (M.F., J.B.-B., U.M., R.L., A.D., F.B., M.L., N.C., A.J., T.B., X.Y., M.M.)
| | - Marc Lynch
- From the King's British Heart Foundation Centre, King's College London, United Kingdom (M.F., J.B.-B., U.M., R.L., A.D., F.B., M.L., N.C., A.J., T.B., X.Y., M.M.)
| | - Norman Catibog
- From the King's British Heart Foundation Centre, King's College London, United Kingdom (M.F., J.B.-B., U.M., R.L., A.D., F.B., M.L., N.C., A.J., T.B., X.Y., M.M.)
| | - Abhishek Joshi
- From the King's British Heart Foundation Centre, King's College London, United Kingdom (M.F., J.B.-B., U.M., R.L., A.D., F.B., M.L., N.C., A.J., T.B., X.Y., M.M.)
| | - Temo Barwari
- From the King's British Heart Foundation Centre, King's College London, United Kingdom (M.F., J.B.-B., U.M., R.L., A.D., F.B., M.L., N.C., A.J., T.B., X.Y., M.M.)
| | - Xiaoke Yin
- From the King's British Heart Foundation Centre, King's College London, United Kingdom (M.F., J.B.-B., U.M., R.L., A.D., F.B., M.L., N.C., A.J., T.B., X.Y., M.M.)
| | - Marjan Jahangiri
- St George's University of London, NHS Trust, United Kingdom (M.F., M.J.)
| | - Manuel Mayr
- From the King's British Heart Foundation Centre, King's College London, United Kingdom (M.F., J.B.-B., U.M., R.L., A.D., F.B., M.L., N.C., A.J., T.B., X.Y., M.M.)
- Cardiovascular Institute, Cardiovascular Research Center, Icahn School of Medicine at Mount Sinai, New York (M.F., M.M.)
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9
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Fiotti N, Calvagna C, Sgorlon G, Altamura N, Pitacco P, Zamolo F, Di Girolamo FG, Chiarandini S, Biolo G, Adovasio R. Multiple sites of vascular dilation or aneurysmal disease and matrix metalloproteinase genetic variants in patients with abdominal aortic aneurysm. J Vasc Surg 2017; 67:1727-1735. [PMID: 29291905 DOI: 10.1016/j.jvs.2017.09.047] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Accepted: 09/25/2017] [Indexed: 01/01/2023]
Abstract
OBJECTIVE The objective of this study was to assess whether functional genetic polymorphisms of matrix metalloproteinases (MMPs) 1, 3, 9, and 12 are associated with arterial enlargements or aneurysms of the thoracic aorta or popliteal arteries in patients with abdominal aortic aneurysm (AAA). METHODS The associations between MMP1 (-1607 G in/del, rs1799750), MMP3 (-1171 A in/del rs35068180), MMP9 (13-26 CA repeats around -90, rs2234681, rs917576, rs917577), and MMP12 (G/T missense variation, rs652438) polymorphisms and enlargements or aneurysms of the thoracic aorta and popliteal arteries were tested in 169 consecutive AAA patients. RESULTS Thoracic aorta enlargement or aneurysm (TE/A; maximum diameter, >35 mm) was detected in 34 patients (20.1% prevalence). MMP9 rs2234681 microsatellite was the only genetic determinant of TE/A in AAA patients (P = .003), followed by hypercholesterolemia and antiplatelet use. Carriers of both alleles with ≥22 CA repeats had a 5.9 (95% confidence interval, 1.9-18.6; P < .0001) increased odds of TE/A, and a score considering all three variables showed 98% negative predictive value and 30% positive predictive value for thoracic aortic aneurysm detection. Eighty-two popliteal artery enlargements or aneurysms (diameter >10 mm) occurred in 55 patients (33.1% prevalence). Carriers of MMP12 rs652438 C allele showed an 18% (P = .006) increased diameter in popliteal arteries and a 2.8 (95% confidence interval, 1.3-6; P = .008) increased odds of popliteal artery enlargement or aneurysm compared with TT genotype. CONCLUSIONS Among patients with AAA, carriers of homozygous ≥22 CA repeats in MMP9 rs12234681 and of C allele in MMP12 rs652438 have a substantial risk of carrying thoracic and popliteal enlargements, respectively.
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MESH Headings
- Aged
- Aged, 80 and over
- Alleles
- Aortic Aneurysm, Abdominal/diagnosis
- Aortic Aneurysm, Abdominal/enzymology
- Aortic Aneurysm, Abdominal/genetics
- Aortic Aneurysm, Thoracic/diagnosis
- Aortic Aneurysm, Thoracic/enzymology
- Aortic Aneurysm, Thoracic/genetics
- Computed Tomography Angiography
- DNA/genetics
- Dilatation, Pathologic/diagnosis
- Dilatation, Pathologic/enzymology
- Dilatation, Pathologic/genetics
- Female
- Genetic Predisposition to Disease
- Genetic Variation
- Genotype
- Humans
- Male
- Matrix Metalloproteinases/genetics
- Matrix Metalloproteinases/metabolism
- Polymorphism, Genetic
- Popliteal Artery
- Risk Factors
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Affiliation(s)
- Nicola Fiotti
- Unit of Clinica Medica, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy.
| | - Cristiano Calvagna
- Unit of Vascular Surgery, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Giada Sgorlon
- Unit of Vascular Surgery, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Nicola Altamura
- Unit of Clinica Medica, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Paola Pitacco
- Unit of Clinica Medica, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Francesca Zamolo
- Unit of Vascular Surgery, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Filippo Giorgio Di Girolamo
- Unit of Clinica Medica, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Stefano Chiarandini
- Unit of Vascular Surgery, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Gianni Biolo
- Unit of Clinica Medica, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Roberto Adovasio
- Unit of Vascular Surgery, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
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10
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Starke RM, Komotar RJ, Connolly ES. Molecular mechanisms behind aneurysm and dissection formation. Neurosurgery 2013; 73:N10-1. [PMID: 24257335 DOI: 10.1227/01.neu.0000438330.64943.51] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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11
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Lesauskaite V, Sinkunaite-Marsalkiene G, Tamosiunas A, Benetis R. Protective effects of angiotensin-converting enzyme I/I and matrix metalloproteinase-3 6A/6A polymorphisms on dilatative pathology within the ascending thoracic aorta. Eur J Cardiothorac Surg 2010; 40:23-7. [PMID: 21111627 DOI: 10.1016/j.ejcts.2010.10.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2010] [Revised: 10/05/2010] [Accepted: 10/07/2010] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Activation of matrix metalloproteinases and the renin/angiotensin signaling pathways is under investigation with regard to their potential pathogenesis in dilatative pathology of the aorta. The purpose of this study was to explore matrix metalloproteinase-3 5A/6A and angiotensin-converting enzyme I/D polymorphisms as predisposing factors to dilatative pathology of the aorta. METHODS We studied 107 patients who underwent aortic reconstruction surgery due to dilatative pathology of ascending thoracic aorta and a random sample of the population (n = 773), all from Lithuania. The insertion/deletion (-1171 5A/6A) polymorphism in the promoter region of matrix metalloproteinase-3 studied by real-time polymerase-chain-reaction amplification and the D and I alleles were identified on the basis of standard polymerase-chain-reaction amplification of the respective fragments from intron 16 of the angiotensin-converting enzyme gene. RESULTS The frequency of the angiotensin-converting enzyme D allele was significantly higher in dilatative pathology of ascending thoracic aorta patients than in the reference group subjects (0.55 vs 0.48, respectively). The latter group had a significantly higher frequency of the angiotensin-converting enzyme I/I genotype than in dilatative pathology of ascending thoracic aorta patients (27.4% vs 16.5%, respectively). In the reference group, the frequency of combined angiotensin-converting enzyme I/I and matrix metalloproteinase-3 6A/6A genotypes was 7.5%, while in the dilatative pathology of ascending thoracic aorta patient group, there was no one carrying that combined genotype (p = 0.001). CONCLUSIONS The present study showing a role of angiotensin-converting enzyme and matrix metalloproteinase-3 in the development of dilatative pathology of ascending thoracic aorta permits us to entertain a possible protective mechanism for the combined effects of the angiotensin-converting enzyme I/I and the matrix metalloproteinase-3 6A/6A genotypes.
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Affiliation(s)
- Vaiva Lesauskaite
- Laboratory of Molecular Cardiology, Institute of Cardiology, Kaunas University of Medicine, Kaunas, Lithuania.
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12
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Xiong W, Knispel RA, Dietz HC, Ramirez F, Baxter BT. Doxycycline delays aneurysm rupture in a mouse model of Marfan syndrome. J Vasc Surg 2008; 47:166-72; discussion 172. [PMID: 18178469 DOI: 10.1016/j.jvs.2007.09.016] [Citation(s) in RCA: 110] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2007] [Revised: 09/06/2007] [Accepted: 09/07/2007] [Indexed: 01/15/2023]
Abstract
OBJECTIVES Thoracic aneurysms are the main cardiovascular complication of Marfan syndrome (MFS) resulting in premature death. MFS has been associated with mutations of the gene encoding fibrillin-1 (FBN1), a major constituent of the elastic fibers. Matrix metalloproteinases (MMPs) are important in the pathogenesis of abdominal aortic aneurysms but their precise role in MFS is not clear. Doxycycline is a nonspecific MMP inhibitor. The objective of the study was to determine whether docycycline can attenuate matrix degradation and prolong the survival of mice with MFS. METHODS The study employed a well-characterized animal model of MFS, namely fibrillin-1 under-expressing mice (mgR/mgR mice) that die spontaneously from rupture of the thoracic aorta between 2 to 4 months of age. Mutant and wild type mice were given doxycycline in their drinking water at a concentration designed to provide 100 mg/kg/day beginning at postnatal day (PD) 1, whereas control mice were given water. Treated mice were divided into two groups. One group of animals was followed until death or for 7 months to determine lifespan. In the second group of mice, the ascending thoracic aortas were collected for histological analysis (H&E staining, trichrome staining) and zymography for examining MMP-2 and MMP-9 levels at 6 weeks. RESULTS MMP-2 and MMP-9 levels were higher in the thoracic aorta of mgR/mgR mice compared with wild type littermates. Doxycycline-treated mgR/mgR mice lived 132 +/- 14.6 days (n = 16) or significantly longer than untreated mutant mice (79 +/- 6.7 days, n = 30) (P < 0.01). Connective tissue staining showed that doxycycline treatment decreased elastic fiber degradation in mgR/mgR mice. Furthermore, mgR/mgR mice treated with doxycycline had lower MMP-2 and MMP-9 levels compared with untreated mgR/mgR mice. CONCLUSIONS This study demonstrates that doxycycline significantly delays aneurysm rupture in MFS-like mice by inhibiting expression of tissue MMP-2 and MMP-9 and thus, degradation of the elastic matrix. The results suggest that MMPs contribute to the progression of thoracic aneurysm in MFS and that doxycycline has the potential to significantly alter the course of the disease.
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MESH Headings
- Animals
- Aorta, Thoracic/drug effects
- Aorta, Thoracic/enzymology
- Aorta, Thoracic/pathology
- Aortic Aneurysm, Thoracic/complications
- Aortic Aneurysm, Thoracic/drug therapy
- Aortic Aneurysm, Thoracic/enzymology
- Aortic Aneurysm, Thoracic/etiology
- Aortic Aneurysm, Thoracic/pathology
- Aortic Rupture/enzymology
- Aortic Rupture/etiology
- Aortic Rupture/pathology
- Aortic Rupture/prevention & control
- Disease Models, Animal
- Disease Progression
- Doxycycline/pharmacology
- Doxycycline/therapeutic use
- Elastic Tissue/metabolism
- Fibrillin-1
- Fibrillins
- Marfan Syndrome/complications
- Marfan Syndrome/drug therapy
- Marfan Syndrome/enzymology
- Marfan Syndrome/pathology
- Matrix Metalloproteinase 2/metabolism
- Matrix Metalloproteinase 9/metabolism
- Matrix Metalloproteinase Inhibitors
- Mice
- Mice, Inbred C57BL
- Mice, Mutant Strains
- Microfilament Proteins/genetics
- Microfilament Proteins/metabolism
- Protease Inhibitors/pharmacology
- Protease Inhibitors/therapeutic use
- Time Factors
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Affiliation(s)
- Wanfen Xiong
- Department of Surgery, University of Nebraska Medical Center, Omaha, NE 68198, USA
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13
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Sinha I, Bethi S, Cronin P, Williams DM, Roelofs K, Ailawadi G, Henke PK, Eagleton MJ, Deeb GM, Patel HJ, Berguer R, Stanley JC, Upchurch GR. A biologic basis for asymmetric growth in descending thoracic aortic aneurysms: a role for matrix metalloproteinase 9 and 2. J Vasc Surg 2007; 43:342-8. [PMID: 16476613 DOI: 10.1016/j.jvs.2005.10.013] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2005] [Accepted: 10/05/2005] [Indexed: 11/17/2022]
Abstract
OBJECTIVE This study was undertaken to define matrix metalloproteinase (MMP) expression in the anterior and posterior wall of descending thoracic aortic aneurysms (TAAs) and correlate it with specific computed tomography (CT) image sites within the descending thoracic aorta. METHODS Serial CT images of patients with TAAs were compared with age- and gender-matched normal descending thoracic aortas at levels T4-T12. The mean circumference of the TAAs was 153 mm (n = 12) and 148 mm (n = 11) at T8 and T10, respectively, compared with 75 mm (n = 12) and 75 mm (n = 10) in controls (P < .001). Aortic tissue was collected from a separate set of eight patients undergoing descending TAA resection (processed < or =12 hours of excision) and six cadavers (processed < or =24 hours of death). Tissue collected between the intercostals arteries was defined as posterior wall, and directly opposite was the anterior wall. MMP-9 and MMP-2 messenger RNA (mRNA) extracted from aortic tissue was analyzed by quantitative real time polymerase chain reaction (PCR) and normalized to beta-actin. Immunohistochemistry was performed for MMP-9 and MMP-2. CT aortic measurements and MMP expression were compared by t tests and analysis of variance, respectively. RESULTS The ratio of arc distance between the intercostals on the posterior wall to total aortic circumference was 0.14 in healthy controls compared with 0.08 in TAAs at vertebral level T8 (P = .001). At T10, the ratio was 0.15 in healthy controls compared with 0.11 in TAAs (P = .001). MMP-9 expression in TAAs was 4.3-fold higher in the anterior wall compared with the posterior wall (P = .03). Conversely, MMP-2 expression in TAAs was 3.2-fold higher in the posterior wall compared with the anterior wall (P = .008). MMP expression was not detected in control cadaver aortas. CONCLUSION Anterior walls of expanding TAAs grow at a greater rate than the posterior wall, as determined from the lower ratio of intercostal arc distance to total circumference in TAAs. Differential MMP expression appears to be a biologic marker for asymmetric growth in the TAA wall. CLINICAL RELEVANCE The pathogenesis of thoracic aortic aneurysms (TAAs) is poorly understood. Multiple lines of evidence suggest that matrix metalloproteinases (MMPs), a family of enzymes, are important in aneurysm development. Earlier experiments documented a regional variation of MMP-9 in stimulated rodent aortas, with production greater in the abdominal aorta compared with the thoracic aorta. The present study extends that observation and documents asymmetric aneurysm development in the TAA wall, with increased anterior wall growth in correlation to increased MMP-9 production. An improved understanding of the mechanisms by which MMP production is regulated is critical.
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Affiliation(s)
- Indranil Sinha
- Section of Vascular Surgery, University of Michigan, Ann Arbor, MI 48109-0329, USA
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14
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Schmoker JD, McPartland KJ, Fellinger EK, Boyum J, Trombley L, Ittleman FP, Terrien C, Stanley A, Howard A. Matrix metalloproteinase and tissue inhibitor expression in atherosclerotic and nonatherosclerotic thoracic aortic aneurysms. J Thorac Cardiovasc Surg 2007; 133:155-61. [PMID: 17198804 DOI: 10.1016/j.jtcvs.2006.07.036] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2006] [Revised: 06/21/2006] [Accepted: 07/07/2006] [Indexed: 10/23/2022]
Abstract
OBJECTIVES The altered expression of matrix metalloproteinases and their inhibitors influences the formation of atherosclerotic abdominal aortic aneurysms. Their association with thoracic aneurysms is less clear. This study describes the expression of metalloproteinases and their inhibitors in atherosclerotic and nonatherosclerotic thoracic aneurysms, and compares these with age-matched controls. METHODS Matrix metalloproteinase-2 and 9 activity were measured by antibody capture, and tissue inhibitor-1 and 2 levels were measured by enzyme-linked immunosorbent assay in 24 patients with atherosclerotic aneurysms and in 63 patients with nonatherosclerotic aneurysms. Gene expression was assessed with reverse transcriptase polymerase chain reaction. The results were compared with 17 controls. RESULTS Data are in nanograms per milligram of protein. Matrix metalloproteinase-2 activity was greater in controls than in the atherosclerotic and nonatherosclerotic groups (80 +/- 67 vs 49 +/- 50 and 35 +/- 44, P = .002). Matrix metalloproteinase-9 activity was greater in the atherosclerotic group than in the nonatherosclerotic group and controls (11.7 +/- 15.7 vs 2.5 +/- 2.2 and 1.7 +/- 1.9, P = .001). Tissue inhibitor-1 and 2 levels were greater in controls than in either aneurysm group (tissue inhibitor of metalloproteinase-1: 376 +/- 192 vs 234 +/- 233 and 174 +/- 148, P = .003; tissue inhibitor of metalloproteinase-2: 143 +/- 74 vs 14 +/- 13 and 27 +/- 43, P < .001). Atherosclerotic aneurysms expressed more matrix metalloproteinase mRNA than controls. CONCLUSIONS The metalloproteinase/tissue inhibitor phenotype of atherosclerotic thoracic aneurysms is similar to that of abdominal aneurysms. The diminished expression of metalloproteinases and tissue inhibitors in nonatherosclerotic thoracic aneurysms relative to aged controls may represent a loss of smooth muscle cells.
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Affiliation(s)
- Joseph D Schmoker
- Department of Surgery, Division of Cardiothoracic Surgery, Fletcher Allen Health Care, Burlington, Vt 05401, USA.
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15
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Jones JA, Barbour JR, Lowry AS, Bouges S, Beck C, McClister DM, Mukherjee R, Ikonomidis JS. Spatiotemporal expression and localization of matrix metalloproteinas-9 in a murine model of thoracic aortic aneurysm. J Vasc Surg 2007; 44:1314-21. [PMID: 17145436 PMCID: PMC1761919 DOI: 10.1016/j.jvs.2006.07.042] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2006] [Accepted: 07/25/2006] [Indexed: 01/27/2023]
Abstract
OBJECTIVE Matrix metalloproteinase-9 (MMP-9) has been widely described to play a critical role in aneurysm development. The goal of this study was to determine the spatiotemporal changes in MMP-9 expression and abundance in the early stages of aortic dilatation during the course of thoracic aortic aneurysm (TAA) formation in a mouse model. METHODS In this study, TAAs were surgically induced in a transgenic reporter mouse strain expressing the beta-galactosidase (beta-gal) gene under control of the MMP-9 promoter. Terminal studies were performed during the early stages of TAA development at 1 week (n = 6), 2 weeks (n = 6), and 4 weeks (n = 6) post-TAA induction surgery. Changes in aortic outer diameter were determined in vivo by video micrometry. MMP-9 transcriptional activity (beta-gal staining) and protein content (immunohistochemistry) were quantified at each time point and expressed as a percentage of unoperated reference control mice (n = 6). RESULTS Aortic dilatation was evident at 1 week and reached maximal size at 2 weeks (21% +/- 6% increase from baseline, P < .05). MMP-9 transcriptional activity was detected at 1 week post-TAA induction (722% +/- 323%, P = .19), reached a maximum within the adventitia at 2 weeks (1770% +/- 505%, P < .05), and returned to baseline by 4 weeks (167% +/- 47%, P = .21). MMP-9 transcription at 2 weeks colocalized with fibroblasts and smooth muscle cells. MMP-9 protein content within the aortic adventitia was increased at 2 weeks post-TAA induction (413% +/- 124%, P < .05) and remained elevated at 4 weeks (222% +/- 41%, P < .05). MMP-9 staining was most intense at the adventitial-medial border and could be detected throughout the elastic media. CONCLUSIONS These findings demonstrate a unique spatiotemporal pattern of MMP-9 transcriptional activation and protein content in the developing TAA. Colocalization studies suggest that early dilatation may be driven in part by MMP-9 produced by endogenous cells residing within the aortic vascular wall.
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MESH Headings
- Animals
- Aorta, Thoracic/enzymology
- Aorta, Thoracic/pathology
- Aortic Aneurysm, Thoracic/enzymology
- Aortic Aneurysm, Thoracic/pathology
- Disease Models, Animal
- Disease Progression
- Fibroblasts/enzymology
- Gene Expression Regulation, Enzymologic
- Genes, Reporter
- Immunohistochemistry
- Matrix Metalloproteinase 9/genetics
- Matrix Metalloproteinase 9/metabolism
- Mice
- Mice, Transgenic
- Microscopy, Video
- Muscle, Smooth, Vascular/enzymology
- Promoter Regions, Genetic/genetics
- RNA, Messenger/metabolism
- Reverse Transcriptase Polymerase Chain Reaction
- Time Factors
- Transcription, Genetic
- Up-Regulation
- beta-Galactosidase/genetics
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Affiliation(s)
| | | | | | | | | | | | | | - John S. Ikonomidis
- Address for correspondence and requests for reprints: John S. Ikonomidis, MD, PhD., Cardiothoracic Surgery Research, Room 625, Strom Thurmond Research Building, 770 MUSC Complex, Medical University of South Carolina, 114 Doughty Street, Charleston, SC 29425, USA, Phone: (843) 876-5186, FAX: (843) 876-5187, e-mail:
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16
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Barbour JR, Stroud RE, Lowry AS, Clark LL, Leone AM, Jones JA, Spinale FG, Ikonomidis JS. Temporal disparity in the induction of matrix metalloproteinases and tissue inhibitors of metalloproteinases after thoracic aortic aneurysm formation. J Thorac Cardiovasc Surg 2006; 132:788-95. [PMID: 17000289 DOI: 10.1016/j.jtcvs.2006.05.052] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2006] [Revised: 05/11/2006] [Accepted: 05/22/2006] [Indexed: 01/24/2023]
Abstract
BACKGROUND An important component of matrix remodeling during thoracic aortic aneurysm progression is the balance between matrix metalloproteinases and their endogenous inhibitors (tissue inhibitors of metalloproteinases). However, whether and to what degree matrix metalloproteinase/tissue inhibitor of metalloproteinases profiles change over time with an evolving thoracic aortic aneurysm remains unclear. METHODS Descending thoracic aortic aneurysms were induced in mice (FVB strain, 15 minutes of 0.5 mol/L CaCl2 exposure) and followed for 24 hours, 72 hours, 1 week, 2 weeks, 4 weeks, or 8 weeks (each group, n = 13). Thoracic aortic aneurysm size was determined by means of video micrometry, and immunoblotting was used to measure aortic matrix metalloproteinase 2, 8, 9, and 12 and tissue inhibitor of metalloproteinases 1 and 4 levels (expressed as a percentage of control values, n = 13). RESULTS Increased aortic diameter was detected by 72 hours and reached a maximal size at 4 weeks (135% +/- 4% increase from baseline, P < .05), which is consistent with thoracic aortic aneurysm progression. Active matrix metalloproteinase 8 (collagenase) levels increased at 72 hours (178% +/- 49%, P < .05 from control), and active matrix metalloproteinase 12 (elastase) levels increased by 24 hours (138% +/- 11%, P < .05), whereas active matrix metalloproteinase 2 levels increased at 72 hours and 1 week after thoracic aortic aneurysm induction (72 hours: 158% +/- 12%, 1 week: 162% +/- 19%; P < .05). At 1 week after thoracic aortic aneurysm induction, active matrix metalloproteinase 9 and 12 levels decrease (matrix metalloproteinase 9: 55% +/- 5%; matrix metalloproteinase 12: 63% +/- 5%; P < .05); however, matrix metalloproteinase 9 and 12 levels were increased from these values at 4 and 8 weeks (P < .05). Tissue inhibitor of metalloproteinases 1 levels were decreased at 1 week (52% +/- 15%, P < .05) and later returned to control values, whereas tissue inhibitor of metalloproteinases 4 levels increased at the late thoracic aortic aneurysm time points (4 weeks: 278% +/- 46%; 8 weeks: 213% +/- 40%; P < .05). CONCLUSIONS These findings show 2 phases of matrix metalloproteinase abundance during murine thoracic aortic aneurysm formation. The late tissue inhibitor of metalloproteinases 4 increase might explain prevention of further aortic dilation past 4 weeks. Unique matrix metalloproteinase/tissue inhibitor of metalloproteinases temporal relationships occurred during the natural history of thoracic aortic aneurysm progression that might hold both diagnostic and therapeutic relevance.
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Affiliation(s)
- John R Barbour
- Cardiothoracic Surgical Research, Division of Cardiothoracic Surgery, Medical University of South Carolina, Charleston, SC 29425, USA
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17
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Nakajima M, Tsuchiya K, Fukuda S, Morimoto H, Mitsumori Y, Kato K. Aortic operation after previous coronary artery bypass grafting. Gen Thorac Cardiovasc Surg 2006; 54:155-9. [PMID: 16642921 DOI: 10.1007/bf02662470] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Aortic surgery for progressive aortic valve disease or aortic aneurysm after previous coronary artery bypass grafting (CABG) is a challenging procedure. We report the outcome of aortic reoperation after previous CABG and evaluate our management of patent grafts and our methods for obtaining myocardial protection. METHODS From February 2001 to July 2003, 6 patients with progressive aortic valve disease and aneurysm of the thoracic aorta were operated on. The group comprised 3 men and 3 women with a mean age of 67.6 years. There were 4 patients with an aneurysm of the aortic arch, 1 with chronic ascending aortic dissection, and 1 with progressive aortic valve stenosis. The interval between previous CABG and aortic surgery was 74.0 +/- 44.2 months. All reoperations were performed via median resternotomy. Myocardial protection was obtained by hypothermic perfusion of patent in-situ arterial grafts following cold-blood cardioplegia administration via the aortic root under aortic cross clamping. RESULTS The operative procedure was aortic arch replacement in 4 patients, ascending aortic replacement with double CABG in 1, and aortic valve replacement in 1. All patients survived the reoperation. Postoperative maximum creatine kinase-MB was 49.2 +/- 29.8 and no new Q-waves occurred in the electrocardiogram nor were any new wall motion abnormalities recognized on echocardiography. There were no late deaths during a follow-up of 30.7 months. CONCLUSION Reoperative aortic procedures after CABG can be performed safely with myocardial protection via hypothermic perfusion of a patent in-situ arterial graft.
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Affiliation(s)
- Masato Nakajima
- Department of Cardiovascular Surgery, Yamanashi Central Hospital, Yamanashi, Japan
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18
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Abstract
BACKGROUND A chemical-induced, nonlethal, dissecting aortic aneurysm (DAA) is described following in utero exposure to semicarbazide, an inhibitor of the vascular enzyme semicarbazide sensitive amine oxidase (SSAO). METHODS Sprague-Dawley rat dams were given semicarbazide (0.096-49.000 mg/kg/day) by IP injection on gestation days (GDs) 14-20, a period of rapid aortic development. Newborn rats (day 1) were killed and their thoracic organs were removed en bloc for near-serial cross sections and routine histopathology, Movat stain for elastin, and immunohistochemistry to differentiate cells involved in the evolution of the DAA. In subsequent experiments, pups from treated dams (0.096-6.125 mg/kg/day) were allowed to survive for 7 or 28 days. RESULTS DAA occurred in nearly 100% of the rats at all doses except the lowest tested (1.530, 0.096 mg/kg/day). Dissections frequently extended to the carotids and, less frequently, to the abdominal aorta. Remodeling of vascular lesions proceeded by organization of collections of blood in vascular media (the "false lumen"), proliferation of vascular smooth muscle cells, fibrosis, and formation of irregular frayed elastic lamellae in healed vascular media. Biochemical quantitation and Western blot analysis of main extracellular matrix proteins on GD 20 showed no overt difference in expression of collagen type I, fibrillin-1, or elastin. CONCLUSION This developmental model provides investigators an opportunity to explore the pathologic mechanisms of DAA and to examine the potential long-term effects of vascular remodeling of DAA.
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MESH Headings
- Amine Oxidase (Copper-Containing)/antagonists & inhibitors
- Analysis of Variance
- Aortic Dissection/chemically induced
- Aortic Dissection/enzymology
- Aortic Dissection/metabolism
- Aortic Dissection/pathology
- Animals
- Animals, Newborn
- Aorta, Thoracic/drug effects
- Aorta, Thoracic/enzymology
- Aorta, Thoracic/growth & development
- Aorta, Thoracic/metabolism
- Aorta, Thoracic/pathology
- Aortic Aneurysm, Thoracic/chemically induced
- Aortic Aneurysm, Thoracic/enzymology
- Aortic Aneurysm, Thoracic/metabolism
- Aortic Aneurysm, Thoracic/pathology
- Collagen/analysis
- Collagen/metabolism
- Dose-Response Relationship, Drug
- Elastin/analysis
- Elastin/metabolism
- Female
- Gestational Age
- Immunohistochemistry
- Injections, Intraperitoneal
- Models, Biological
- Pregnancy
- Rats
- Rats, Sprague-Dawley
- Semicarbazides/administration & dosage
- Semicarbazides/toxicity
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Affiliation(s)
- Bin Gong
- Department of Pathology, University of Texas Medical Branch, Galveston, Texas 77555, USA
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19
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Ikonomidis JS, Barbour JR, Amani Z, Stroud RE, Herron AR, McClister DM, Camens SE, Lindsey ML, Mukherjee R, Spinale FG. Effects of deletion of the matrix metalloproteinase 9 gene on development of murine thoracic aortic aneurysms. Circulation 2006; 112:I242-8. [PMID: 16159824 DOI: 10.1161/circulationaha.104.526152] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND The matrix metalloproteinases (MMPs) contribute to cardiovascular remodeling, and MMPs, such as the gelatinases (MMP-9 and MMP-2), have been identified in thoracic aortic aneurysmal (TAA) tissue, but a cause-effect relationship has not been clearly established. Accordingly, this study examined TAA progression in mice devoid of the MMP-9 gene. METHODS AND RESULTS The descending thoracic aortas of wild-type (WT) FVB (n =17) and MMP-9 gene knockout (KO, n =11) mice were exposed to 0.5 mol/L of CaCl2 for 15 minutes with terminal studies performed at 4 weeks. Aortic lumen diameter was measured using video micrometry at baseline and at 4 weeks (TAA) followed by aortic tissue analysis. In WT mice, aortic diameter increased by 138+/-5% at 4 weeks (P<0.05), consistent with TAA formation. In the KO mice, aortic diameter increased from baseline by 120+/-4% (P<0.05) but was attenuated from WT TAA values (P<0.05). Gelatin zymography performed on TAA segments confirmed the absence of MMP-9 in the KO mice but a >8-fold relative increase in the active form of MMP-2 compared with WT (P<0.05). Despite this, MMP-2 activity was relatively increased (P<0.05) and colocalized to smooth muscle cell actin in a differential pattern favoring medial distruction in the WT TAA compared with the KO TAA segments. CONCLUSIONS These results demonstrate that MMP-9 gene deletion attenuated TAA formation despite an increase in the zymographic levels of MMP-2. These unique findings suggest that an interaction between these 2 MMPs is necessary to facilitate TAA progression.
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Affiliation(s)
- John S Ikonomidis
- Division of Cardiothoracic Surgery, Medical University of South Carolina, Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, USA.
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20
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Ikonomidis JS, Gibson WC, Butler JE, McClister DM, Sweterlitsch SE, Thompson RP, Mukherjee R, Spinale FG. Effects of deletion of the tissue inhibitor of matrix metalloproteinases-1 gene on the progression of murine thoracic aortic aneurysms. Circulation 2005; 110:II268-73. [PMID: 15364874 DOI: 10.1161/01.cir.0000138384.68947.20] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The cause of thoracic aortic aneurysms (TAAs) is poorly understood. Previous work has suggested an association between development of aortic aneurysms and matrix metalloproteinase (MMP) activity. We hypothesized that removal of the primary endogenous aortic MMP inhibitor (TIMP) through TIMP-1 gene deletion will increase TAA progression. METHODS AND RESULTS The descending thoracic aortas of wild-type 129 SvE and TIMP-1 gene knockout (TIMP-1-/-) mice were exposed to 0.5 mol/L CaCl2 for 15 minutes, with terminal studies performed at 4 or 8 weeks. TAA lumen diameter was measured using confocal microscopy and normalized to the ascending aorta. In addition, sections were studied with in situ zymography and immunohistochemistry staining for MMP-9. Both wild-type [TAA/ascending ratio (mean+/-SEM): control, 0.85+/-0.02 (n=14); 4 weeks, 1.00+/-0.03 (n=13); 8 weeks, 1.05+/-0.10 (n=9)] and TIMP-1-/- [control, 0.98+/-0.04 (n=11); 4 weeks, 1.10+/-0.03 (n =21); 8 weeks, 1.22+/-0.09 (n=10)] groups developed aneurysms at 4 and 8 weeks compared with their respective controls (P<0.05). TIMP-1-/- animals developed larger aneurysms than the corresponding wild-type group (P<0.05). Aneurysms in the TIMP-1-/- group were larger at 8 weeks than at 4 weeks (P<0.05), which was not seen in the wild-type aneurysm groups. Both groups showed presence of MMP-9 in 4 and 8 weeks, most prominently in the adventitia and outer media. In situ zymographic activity was increased in the 8-week TIMP-1-/- group compared with wild-type. CONCLUSIONS Deletion of the TIMP-1 gene results in increased and continued progression of aneurysm formation compared with wild-type mice in a unique TAA model caused at least in part by an alteration in the balance between gelatinase activity and its endogenous inhibition. Therapeutic strategies aimed at modifying MMP activity may reduce or prevent the progression of TAAs.
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Affiliation(s)
- John S Ikonomidis
- Assistant Professor of Surgery, Division of Cardiothoracic Surgery, Medical University of South Carolina, Suite 409 CSB, 96 Jonathan Lucas Street, Charleston, SC 29425, USA.
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21
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Abstract
BACKGROUND Aortic aneurysms represent a serious and common condition. Current therapies are based on mechanical treatment. With increased knowledge of the biochemical mechanisms responsible for aneurysm expansion, it may be possible to prevent the growth of small aneurysms. METHODS A series of experiments performed in the investigator's laboratory during the past decade is outlined to show the evolution of our concepts of the processes underlying aneurysm formation and progression. RESULTS Our understanding of aortic aneurysms has changed dramatically. Once thought to represent a simple degenerative process, aneurysm tissue is highly active metabolically with ongoing synthesis and degradation of matrix proteins. Several members of a family of matrix-degrading enzymes play an important role in this process. These enzymes can be inhibited by the antibiotic doxycycline. CONCLUSIONS With a better understanding of aneurysm pathology, it may be possible in the future to inhibit the growth of small aortic aneurysms before they reach a size at which the risk of rupture is significant.
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Affiliation(s)
- B Timothy Baxter
- Department of Surgery, University of Nebraska Medical Center and Methodist Hospital, 8111 Dodge St., Suite 220, Omaha, NE 68114, USA.
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22
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Sibon I, Larrieu D, el Hadri K, Mercier N, Fève B, Lacolley P, Labat C, Daret D, Bonnet J, Lamazière JMD. Semicarbazide-sensitive amine oxidase in annulo-aortic ectasia disease: relation to elastic lamellae-associated proteins. J Histochem Cytochem 2004; 52:1459-66. [PMID: 15505340 PMCID: PMC3957813 DOI: 10.1369/jhc.4a6252.2004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Lysyl oxidases (Lox), which are members of the amine oxidase family, are involved in the maturation of elastic lamellae and collagen fibers. Modifications of amine oxidases in idiopathic annulo-aortic ectasia disease (IAAED) have never been investigated. Our aim was to examine the expression of several proteins that might interfere with elastic fiber organization in control (n=10) and IAAED (n=18) aortic tissues obtained at surgery. Expression of amine oxidases and semicarbazide-sensitive amine oxidase (SSAO), and cellular phenotypic markers were examined by immunohistopathology and confocal microscopy. The expression of these proteins was assessed in relation to clinical and histomorphological features of the arterial wall. In control aorta, SSAO staining was expressed along elastic lamellae, whereas in aneurysmal areas of IAAED, SSAO was markedly decreased, in association with severe disorganization of elastic lamellae. Smooth muscle myosin heavy chain was also decreased in IAAED compared with controls, indicating smooth muscle cell dedifferentiation. Multiple regression analysis showed that elastic lamellar thickness (ELT) was correlated positively with the SSAO:elastin ratio and negatively with the Lox:elastin ratio, and that the clinical features of IAAED (aneurysm, thoracic aorta diameter, and aortic insufficiency) were positively correlated with ELT but not with SSAO. The relationship between SSAO expression and ELT suggests that this amine oxidase may be involved in elastic fiber organization. However, in advanced IAAED, the deficit in SSAO expression could be secondary to the decrease and fragmentation of elastic fibers and/or to vascular smooth muscle cell dedifferentiation.
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MESH Headings
- Amine Oxidase (Copper-Containing)/biosynthesis
- Aorta, Thoracic/enzymology
- Aorta, Thoracic/metabolism
- Aorta, Thoracic/ultrastructure
- Aortic Aneurysm, Thoracic/complications
- Aortic Aneurysm, Thoracic/enzymology
- Aortic Aneurysm, Thoracic/metabolism
- Aortic Valve Insufficiency/complications
- Aortic Valve Insufficiency/enzymology
- Aortic Valve Insufficiency/metabolism
- Cell Differentiation
- Elastin/biosynthesis
- Extracellular Matrix/enzymology
- Extracellular Matrix/metabolism
- Extracellular Matrix/ultrastructure
- Female
- Humans
- Immunohistochemistry
- Male
- Microscopy, Confocal
- Middle Aged
- Muscle, Smooth, Vascular/enzymology
- Muscle, Smooth, Vascular/metabolism
- Muscle, Smooth, Vascular/ultrastructure
- Myosin Heavy Chains/biosynthesis
- Protein-Lysine 6-Oxidase/biosynthesis
- Regression Analysis
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Affiliation(s)
| | | | | | | | - Bruno Fève
- Pessac, France, and CNRS UMR 7079, Paris, France
| | | | | | | | | | - Jean-Marie Daniel Lamazière
- Inserm U441, Paris, France
- Correspondence to: Jean-Marie Daniel Lamazière, Inserm U441, Université Victor Segalen Bordeaux 2, avenue du Haut Lévěque, 33600 Pessac, France. E-mail:
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Boyum J, Fellinger EK, Schmoker JD, Trombley L, McPartland K, Ittleman FP, Howard AB. Matrix metalloproteinase activity in thoracic aortic aneurysms associated with bicuspid and tricuspid aortic valves. J Thorac Cardiovasc Surg 2004; 127:686-91. [PMID: 15001896 DOI: 10.1016/j.jtcvs.2003.11.049] [Citation(s) in RCA: 81] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Matrix metalloproteinases are endopeptidases that function in cell matrix turnover. Abnormal matrix metalloproteinase activity has been implicated in the formation of atherosclerotic abdominal aortic aneurysms. Recent studies suggest that abnormal matrix metalloproteinase activity may also be associated with the formation of atherosclerotic and nonatherosclerotic thoracic aortic aneurysms. Bicuspid aortic valves are associated with an intrinsic aortic pathology that predisposes to formation of proximal thoracic aneurysms while tricuspid aortic valves are not. The objective of this study was to compare the activities of matrix metalloproteinases and levels of their inhibitors in thoracic aneurysms of patients with bicuspid and tricuspid aortic valves. METHODS Endogenous and total activity of matrix metalloproteinase-2 and matrix metalloproteinase-9 were measured in proximal nonatherosclerotic thoracic aortic aneurysms of 16 patients with bicuspid aortic valves and 12 patients with tricuspid aortic valves. Levels of tissue inhibitor metalloproteinase-1 and -2 were also measured. Results were standardized to total protein (mg). RESULTS Total matrix metalloproteinase-2 activity was greater in aneurysms associated with bicuspid valves when compared with those from tricuspid valves (43 +/- 11 ng/mg vs 14 +/- 2 ng/mg, P =.02). Total matrix metalloproteinase-9 activity was also greater in aneurysms associated with bicuspid aortic valves (4.0 +/- 0.9 vs 1.5 +/- 0.3, P =.02). There was no meaningful difference between groups in levels of tissue inhibitor-1 and -2. CONCLUSION The increased activity of matrix metalloproteinases in the walls of aneurysms associated with bicuspid aortic valves may partly explain the predilection to aneurysm formation in these patients.
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Affiliation(s)
- Jon Boyum
- Department of Surgery, Division of Cardiothoracic Surgery, Fletcher Allen Health Care, Fletcher 454, 111 Colchester Avenue, Burlington, VT 05401, USA
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24
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Lesauskaite V, Tanganelli P. [Morphogenesis of thoracic aorta aneurysms: investigation of matrix metalloproteinases and their tissue inhibitors]. Medicina (Kaunas) 2002; 38:31-5. [PMID: 12474714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
The matrix metalloproteinases are a large group of proteases with a central role of the degradation of all types of extracellular matrix. The present study investigated expression of matrix metalloproteinases (MMP-1, -2, -9) and their inhibitors (TIMP-1, -2) in chronic Aneurysm of the Thoracic Aorta (ATA) and Post-Stenotic Dilatation of the ascending aorta due to valvular aortic stenosis (PSD). Fragments of the ascending aorta that had been taken from the patients during coronary by-pass surgery were used as controls. Immunohistochemical investigation showed that medical SMC in the samples taken from aortas with ATA and PDS expressed a stronger immunoreactivity for MMP-1, -2, -9 and TIMP-1, -2 as compared to controls. It can be suggested that during formation of ATA and PSD, production of MMPs and TIMPS by medial smooth muscle cells is of great importance.
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25
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Segura AM, Luna RE, Horiba K, Stetler-Stevenson WG, McAllister HA, Willerson JT, Ferrans VJ. Immunohistochemistry of matrix metalloproteinases and their inhibitors in thoracic aortic aneurysms and aortic valves of patients with Marfan's syndrome. Circulation 1998; 98:II331-7; discussion II337-8. [PMID: 9852923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
BACKGROUND Thoracic aortic aneurysms (TAAs) and valvular insufficiency, the main cardiovascular lesions in Marfan's syndrome, are associated with destruction of connective tissue; however, their pathogenesis remains unclear. METHODS AND RESULTS To test the hypothesis that changes in the activity of the matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) are responsible for the damage to connective tissue in these lesions, histochemical studies of the immunoreactivity (IR) for MMPs and their tissue TIMPs (MMP-1, MMP-2, MMP-3, MMP-9, TIMP-1, and TIMP-2) were made in TAAs (n = 7) and aortic valves (n = 5) from 7 patients with Marfan's syndrome. All TAAs showed cystic medial necrosis (CMN), with loss of elastic fibers and smooth muscle cells. Extensive areas of myxoid change were found in all aortic valves. Areas of CMN showed no IR for any MMPs or TIMPs. The IR of smooth muscle cells at the borders of areas of CMN was stronger for all MMPs, especially MMP-2 and MMP-9, than in other regions. The surfaces of disrupted elastic fibers showed IR for MMP-2 and MMP-9. Areas of myxoid change showed similar but less pronounced alterations. CONCLUSIONS We hypothesize that the defect in fibrillin-1 in Marfan's syndrome leads to (1) formation of elastin that is abnormally aggregated and more easily degraded by MMPs than is normal elastin, (2) upregulation of the synthesis of MMPs, (3) progressive destruction of connective tissue by these enzymes, and (4) development of TAAs and valvular lesions.
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Affiliation(s)
- A M Segura
- St Luke's Episcopal Hospital, Houston, Tex., USA
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26
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Carmeliet P, Moons L, Lijnen R, Baes M, Lemaître V, Tipping P, Drew A, Eeckhout Y, Shapiro S, Lupu F, Collen D. Urokinase-generated plasmin activates matrix metalloproteinases during aneurysm formation. Nat Genet 1997; 17:439-44. [PMID: 9398846 DOI: 10.1038/ng1297-439] [Citation(s) in RCA: 511] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The molecular mechanisms predisposing to atherosclerotic aneurysm formation remain undefined. Nevertheless, rupture of aortic aneurysms is a major cause of death in Western societies, with few available treatments and poor long-term prognosis. Indirect evidence suggests that matrix metalloproteinases (MMPs) and plasminogen activators (PAs) are involved in its pathogenesis. MMPs are secreted as inactive zymogens (pro-MMPs), requiring activation in the extracellular compartment. Plasmin, generated from the zymogen plasminogen by tissue-type plasminogen activator (t-PA) or urokinase-type plasminogen activator (u-PA; refs 14,15), has been proposed as a possible activator in vitro, but evidence for such a role in vivo is lacking. Analysis of atherosclerotic aorta in mice with a deficiency of apoliprotein E (Apoe-/-; ref. 18), singly or combined with a deficiency of t-PA (Apoe-/-:Plat-/-) or of u-PA (Apoe-/-:Plau-/-; ref. 19), indicated that deficiency of u-PA protected against media destruction and aneurysm formation, probably by means of reduced plasmin-dependent activation of pro-MMPs. This genetic evidence suggests that plasmin is a pathophysiologically significant activator of pro-MMPs in vivo and may have implications for the design of therapeutic strategies to prevent aortic-wall destruction by controlling Plau gene function.
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Affiliation(s)
- P Carmeliet
- Centre for Transgene Technology and Gene Therapy, Flanders Interuniversity Institute for Biotechnology, University of Leuven, Belgium
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Yotsumoto G, Toyohira H, Moriyama Y, Watanabe S, Iguro Y, Masuda H, Hisatomi K, Shimokawa S, Taira A. [Cerebral cytochrome oxidase monitoring by near infrared spectroscopy during selective cerebral perfusion]. Nihon Kyobu Geka Gakkai Zasshi 1997; 45:970-3. [PMID: 9256633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
To evaluate selective cerebral perfusion (SCP) for brain protection, the redox state of cytochrome oxidase (Cyt. aa3) in brain tissue were studied in 27 patients with thoracic aortic repair. The redox state of Cyt. aa3 was monitored by near infrared spectroscopy (NIRS) (OM-110, Shimazu). There were no significant changes in the Cyt. aa3 redox state in 13 (Group I), the oxidation state of Cyt. aa3 decreased then recovered to control levels in 12 (Group II), and the oxidation state decreased but did not recover in 2 patients (Group III). Postoperative cerebral damage was observed in 5 patients; blindness occurred in one patient in Group I (8.3%), 2 patients developed hemiplegia in Group II (15.4%), and the 2 patients in Group III failed to reawaken (100%). The incidence of cerebral damage was significantly higher in Group III than in Groups I and II (p < 0.05). We conclude that monitoring the redox state of Cyt. aa3 using NIRS is useful in predicting postoperative cerebral damage. However, it is necessary to increase the number of measurement sites since NIRS can reflect the state in only a small area of the brain.
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Affiliation(s)
- G Yotsumoto
- Second Department of Surgery, Kagoshima University Faculty of Medicine, Japan
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Kotoh K, Ueyama T, Yasuda M. [Study on the change in serum enzyme activity during acute aortic dissection]. Rinsho Kyobu Geka 1989; 9:567-72. [PMID: 9308662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Cases of acute aortic dissection presenting to the First Department of Surgery at Toyama Medical and Pharmaceutical University Hospital were divided into 2 groups according to the presence or absence of complications such as electrocardiographic abnormalities, hepatic or renal dysfunction, intestinal necrosis, and leg ischemia. After hospitalization such complications were completely absent in the "complication-free group", but were present in the "complication group". Fluctuations in serum enzyme activity (CK, LDH, GOT, GPT) were measured, and the 2 groups compared. In the complication-free group, serum CK activity was significantly elevated at 273.3 +/- 154.5 IU/l, reaching a peak on the first day, after which it decreased to normal by the fourth day. In the complication group, fluctuations in the serum enzyme activity levels corresponded to the type of complication, with the fluctuations paralleling changes in the clinical course. Also, CK activity was measured in aortic wall specimens obtained at autopsy, and the CK activity of 585.0 +/- 35.3 IU/g protein demonstrated. From the above it was thought the transient elevation of serum CK activity found in uncomplicated aortic dissection is due to the CK released from the dissected aortic wall into blood.
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