Parodi Federico E, Mao Dongli, Ennis Terri L, Bartoli Michel A, Thompson Robert W
Department of Surgery, Section of Vascular Surgery, Washington University School of Medicine, One Barnes-Jewish Hospital Plaza, St. Louis, MO 63110, USA.
J Vasc Surg. 2005 Mar;41(3):479-89. doi: 10.1016/j.jvs.2004.12.030.
Proinflammatory cytokines and matrix metalloproteinases (MMPs) are prominent mediators of the connective tissue destruction that characterizes abdominal aortic aneurysms (AAAs), and nuclear factor (NF)-kappaB is a cytokine-responsive transcription factor that promotes macrophage MMP expression. The purpose of this study was to determine whether aneurysmal degeneration is influenced by pyrrolidine dithiocarbamate (PDTC), a pharmacologic inhibitor of NF-kappaB.
Adult male C57BL/6 mice underwent transient elastase perfusion of the abdominal aorta to induce the development of AAAs. Animals were treated every 48 hours by intraperitoneal injection with either saline (n = 34) or PDTC 20 mg/kg (n = 49). Aortic diameter (AD) measurements were used to determine the extent of aortic dilatation before and immediately after elastase perfusion and again at day 14.
All saline-treated mice developed AAAs associated with mononuclear inflammation and destruction of medial elastin (overall increase in AD, mean +/- SEM, 169.1% +/- 7.5%). In contrast, the incidence of AAAs was only 63% in PDTC-treated mice, with a reduction in the overall increase in AD to 109.8% +/- 4.2% ( P < .0001 vs saline), decreased inflammation, and structural preservation of aortic wall connective tissue. Although aneurysm development in saline-treated mice was associated with a marked increase in aortic tissue NF-kappaB and activator protein 1 DNA-binding activities, both activities were substantially reduced in PDTC-treated animals. PDTC-treated mice also exhibited significantly lower serum and aortic wall concentrations of interleukin 1beta and interleukin 6, as well as lower amounts of aortic wall MMP-9, as compared with saline-treated controls.
Treatment with PDTC inhibits elastase-induced experimental AAAs in the mouse, along with suppression of aortic wall NF-kappaB and activator protein 1 transcription factor activities, reduced expression of proinflammatory cytokines, and suppression of MMP-9. NF-kappaB is therefore a potentially important therapeutic target for the suppression of aneurysmal degeneration.
Development and progression of human AAAs is associated with inflammation and enzymatic degradation of connective tissue proteins. MMP-9 is one of the enzymes involved in aneurysm disease, and its production may be induced in part by activation of the transcription factor NF-kappaB. In this mouse model, treatment with pyrrolidine dithiocarbamate (a pharmacologic inhibitor of NF-kappaB) acted to suppress MMP-9 and aneurysm development. It is hoped that treatment strategies that target NF-kappaB may eventually be shown to suppress the growth of small aortic aneurysms in patients.
促炎细胞因子和基质金属蛋白酶(MMPs)是腹主动脉瘤(AAAs)特征性结缔组织破坏的主要介质,核因子(NF)-κB是一种细胞因子反应性转录因子,可促进巨噬细胞MMP表达。本研究的目的是确定动脉瘤退变是否受NF-κB的药理抑制剂吡咯烷二硫代氨基甲酸盐(PDTC)影响。
成年雄性C57BL/6小鼠接受腹主动脉短暂弹性蛋白酶灌注以诱导AAAs形成。动物每48小时通过腹腔注射生理盐水(n = 34)或20 mg/kg PDTC(n = 49)进行治疗。使用主动脉直径(AD)测量来确定弹性蛋白酶灌注前、灌注后即刻以及第14天时主动脉扩张的程度。
所有生理盐水处理的小鼠均发生了与单核炎症和中膜弹性蛋白破坏相关的AAAs(AD总体增加,均值±标准误,169.1%±7.5%)。相比之下,PDTC处理的小鼠中AAAs的发生率仅为63%,AD总体增加降至109.8%±4.2%(与生理盐水组相比,P <.0001),炎症减轻,主动脉壁结缔组织结构得以保存。虽然生理盐水处理的小鼠动脉瘤形成与主动脉组织NF-κB和活化蛋白1 DNA结合活性显著增加有关,但在PDTC处理的动物中这两种活性均大幅降低。与生理盐水处理的对照组相比,PDTC处理的小鼠血清和主动脉壁中白细胞介素1β和白细胞介素6的浓度也显著降低,主动脉壁MMP-9的含量也更低。
PDTC治疗可抑制小鼠弹性蛋白酶诱导的实验性AAAs,同时抑制主动脉壁NF-κB和活化蛋白1转录因子活性,减少促炎细胞因子表达,并抑制MMP-9。因此,NF-κB是抑制动脉瘤退变的一个潜在重要治疗靶点。
人类AAAs的发生和发展与结缔组织蛋白的炎症和酶降解有关。MMP-9是参与动脉瘤疾病的酶之一,其产生可能部分由转录因子NF-κB的激活诱导。在这个小鼠模型中,吡咯烷二硫代氨基甲酸盐(NF-κB的药理抑制剂)治疗可抑制MMP-9和动脉瘤形成。希望最终能证明靶向NF-κB的治疗策略可抑制患者小主动脉瘤的生长。