Department of Cardiovascular Surgery, Institute of Health Biosciences, University of Tokushima Graduate School, Tokushima, Japan; Department of Surgery, Yale University School of Medicine, New Haven, Conn.
J Thorac Cardiovasc Surg. 2013 Dec;146(6):1501-8. doi: 10.1016/j.jtcvs.2013.02.073. Epub 2013 Mar 25.
Although systemic hypertension is closely associated with aortic aneurysm (AA) formation, there are many patients with AA without hypertension. In these patients, an inflammation-mediated progression of aneurysmal disease is likely responsible for AA growth and eventual rupture. Unfortunately, there remains no reproducible and durable small animal model of aortic aneurysmal disease, the development of which would enable the investigation of the pathophysiology of this vexing condition. The first aim was to establish a useful wild-type mouse model of AA with low mortality. The second aim was to use this model to assess the protective effect of azelnidipine, a new calcium channel blocker, against the progression of the AA independent of its antihypertensive effect.
Angiotensin II and β-aminopropionitrile (a lysyl oxidase inhibitor) were administrated subcutaneously in 7-week-old C57BL/6J mice using an osmotic minipump for 4 weeks to generate a wild-type mouse model of AA. Concurrently, azelnidipine (a calcium channel blocker) or a placebo was administrated orally for 4 weeks. Mice were humanely killed and assessed at the end of the 4 weeks of pharmacologic manipulation.
The combined infusion of angiotensin II and β-aminopropionitrile induced degenerative aneurysm of the thoracic and/or abdominal aorta (11/12; 92%). The majority of aneurysms were located in the distal aortic arch and suprarenal abdominal aorta. Although there was no difference in systolic blood pressure between the control and azelnidipine-treated groups, azelnidipine significantly reduced the incidence of AA (2/11; 18%). Azelnidipine treatment reduced the pathologic findings normally associated with aneurysm formation within the aortic wall. Azelnidipine also reduced the number of macrophage antigen-3 (MAC-3)-positive cells in the periaortic adipose tissue and reduced the gene expression levels of tumor necrosis factor-alpha and matrix metalloproteinase-2 and -9 within the aortic wall.
This study demonstrates that combined treatment with angiotensin II and β-aminopropionitrile induces degenerative AAs in wild-type mice, and azelnidipine prevents aneurysm progression via its anti-inflammatory effect.
尽管系统性高血压与主动脉瘤(AA)的形成密切相关,但仍有许多患有 AA 但无高血压的患者。在这些患者中,炎症介导的动脉瘤疾病进展可能导致 AA 的生长和最终破裂。不幸的是,目前仍然没有可复制和持久的主动脉瘤疾病的小型动物模型,该模型的发展将能够研究这种令人烦恼的疾病的病理生理学。第一个目标是建立一个死亡率低的有用的野生型 AA 小鼠模型。第二个目标是使用该模型评估新型钙通道阻滞剂 azelnidipine 对 AA 进展的保护作用,而不依赖其降压作用。
使用渗透微型泵,在 7 周龄 C57BL/6J 小鼠的皮下注射血管紧张素 II 和β-氨基丙腈(赖氨酰氧化酶抑制剂)4 周,以建立野生型 AA 小鼠模型。同时,给予 azelnidipine(钙通道阻滞剂)或安慰剂口服 4 周。在 4 周药物处理结束时,将小鼠人道处死并进行评估。
血管紧张素 II 和β-氨基丙腈联合输注导致胸主动脉和/或腹主动脉退行性动脉瘤(11/12;92%)。大多数动脉瘤位于主动脉弓远端和肾上腺腹部主动脉。尽管对照组和 azelnidipine 治疗组的收缩压没有差异,但 azelnidipine 显著降低了 AA 的发生率(2/11;18%)。Azelnidipine 治疗降低了主动脉壁内与动脉瘤形成相关的病理发现。Azelnidipine 还减少了主动脉周围脂肪组织中巨噬细胞抗原-3(MAC-3)阳性细胞的数量,并降低了主动脉壁内肿瘤坏死因子-α和基质金属蛋白酶-2 和 -9 的基因表达水平。
本研究表明,血管紧张素 II 和β-氨基丙腈联合治疗可诱导野生型小鼠发生退行性 AA,azelnidipine 通过其抗炎作用预防动脉瘤进展。