Manabe Takahiro, Imoto Kiyotaka, Uchida Keiji, Doi Chiharu, Takanashi Yoshinori
First Department of Surgery, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004.
Surg Today. 2004;34(3):220-5. doi: 10.1007/s00595-003-2683-3.
Aortic dissection is characterized by fragility of the tunica media, and matrix metalloproteinases (MMPs) are enzymes that degrade the extracellular matrix of the aorta. This study examines MMPs in patients with acute aortic dissection (AAD) in an attempt to elucidate the mechanisms of their actions.
Enzyme-linked immunosorbent assays were used to measure the quantification of MMP-2, MMP-9, and the tissue inhibitor of metalloproteinase (TIMP)-2 in 30 patients with AAD, 12 patients with abdominal aortic aneurysm (AAA), and 16 control (CON) patients who underwent coronary artery bypass grafting.
MMP-2 and TIMP-2 were significantly lower in the AAD group than in the CON group, at 36 +/- 19 vs 58 +/- 30 (P < 0.01) and at 21 +/- 25 vs 216 +/- 130 (P < 0.001), respectively. The TIMP-2/MMP-2 ratio was 3.7 +/- 1.7 in the CON group and 0.9 +/- 0.8 in the AAD group (P < 0.001 vs CON), and the TIMP-2/MMP-9 ratio was 200 +/- 170 in the CON group and 37 +/- 80 in the AAD group (P < 0.001 vs CON).
Low TIMP-2/MMP-2 and TIMP-2/MMP-9 ratios might play an important role in the onset of aortic dissection, when the tunica media becomes fragile with chronic breakage and degradation of the extracellular matrix.
主动脉夹层的特征是中膜脆弱，而基质金属蛋白酶（MMPs）是降解主动脉细胞外基质的酶。本研究检测急性主动脉夹层（AAD）患者的MMPs，以试图阐明其作用机制。
采用酶联免疫吸附测定法测量30例AAD患者、12例腹主动脉瘤（AAA）患者和16例接受冠状动脉旁路移植术的对照（CON）患者的MMP-2、MMP-9和金属蛋白酶组织抑制剂（TIMP）-2的定量。
AAD组的MMP-2和TIMP-2显著低于CON组，分别为36±19 vs 58±30（P<0.01）和21±25 vs 216±130（P<0.001）。CON组的TIMP-2/MMP-2比值为3.7±1.7，AAD组为0.9±0.8（与CON组相比，P<0.001），CON组的TIMP-2/MMP-9比值为200±170，AAD组为37±80（与CON组相比，P<0.001）。
当细胞外基质因慢性断裂和降解而导致中膜变得脆弱时，低TIMP-2/MMP-2和TIMP-2/MMP-9比值可能在主动脉夹层的发病中起重要作用。
