Yuan S-M, Ma H-H, Zhang R-S, Jing H
Department of Cardiothoracic Surgery, Jinling Hospital, School of Clinical Medicine, Nanjing University, China.
Vasa. 2011 Sep;40(5):369-74. doi: 10.1024/0301-1526/a000133.
Marfan's syndrome is an inherited disorder that affects the connective tissue. It has been proposed that mutations of FBN1 gene or of transforming growth factor (TGF)-beta type II receptor may be responsible for its pathogenesis. However, the role of TGF-beta signaling pathway in the development of Marfan's syndrome has not been comprehensively investigated.
Surgical specimens of the aorta were obtained from two female Marfan patients, and the control aortic tissue was taken from an autopsy of a healthy individual. The aortic specimens were examined with hematoxylin-eosin, Masson's trichrome, von Gieson/victoria blue-van Gieson bichrome, and immunohistochemical stainings of TGF-beta1, TGF-beta type I receptor, Smad2/3, Smad4 and Smad7.
Hematoxylin-eosin staining demonstrated severe elastic lamellar disruption and patchy vascular smooth muscle dissolution in the aortic media of the Marfan patients. Collagen deposition, interlamilar elastic fiber fragmentation, loss or proliferation, and acid mucopolysaccharide accumulation were observed in the disarrayed aortic wall structures of Marfan patients by Masson's trichrome, victoria blue-van Gieson bichrome, and Alcian blue and periodic schiff's (AB-PAS) stainings, respectively. By immunohistochemistry, structural disruptions with enhanced TGF-beta;1 in the cytoplasm, Smad2/3 in the interstices, Smad4 in the cytoplasm, nuclei or interstices, and OOO Smad7, in the nucleus along with attenuated TGF-beta type I receptor in the aortic tissues of Marfan patients in comparison to the healthy control.
Marfan patients may have aberrant TGF-beta signaling pathway associated with increased collagen deposition, interlamilar elastic fiber degenerative changes, and acid mucopolysaccharide accumulation. The signaling dysregulation may play an important role in the pathogenesis of this genetic disorder.
马凡综合征是一种影响结缔组织的遗传性疾病。有人提出,FBN1基因或转化生长因子(TGF)-βII型受体的突变可能是其发病机制的原因。然而,TGF-β信号通路在马凡综合征发展中的作用尚未得到全面研究。
从两名女性马凡患者身上获取主动脉手术标本,对照主动脉组织取自一名健康个体的尸检。对主动脉标本进行苏木精-伊红染色、Masson三色染色、冯·吉森/维多利亚蓝-冯·吉森双色染色,以及TGF-β1、TGF-βI型受体、Smad2/3、Smad4和Smad7的免疫组织化学染色。
苏木精-伊红染色显示马凡患者主动脉中膜有严重的弹性板层破坏和散在的血管平滑肌溶解。Masson三色染色、维多利亚蓝-冯·吉森双色染色以及阿尔辛蓝和过碘酸希夫(AB-PAS)染色分别在马凡患者紊乱的主动脉壁结构中观察到胶原沉积、层间弹性纤维断裂、丢失或增殖以及酸性粘多糖积聚。通过免疫组织化学,与健康对照相比,马凡患者主动脉组织中TGF-β1在细胞质中增强、Smad2/3在间隙中、Smad4在细胞质、细胞核或间隙中以及Smad7在细胞核中结构破坏,同时TGF-βI型受体减弱。
马凡患者可能存在异常的TGF-β信号通路,与胶原沉积增加、层间弹性纤维退行性改变和酸性粘多糖积聚有关。信号失调可能在这种遗传疾病的发病机制中起重要作用。