Johnston William F, Salmon Morgan, Pope Nicolas H, Meher Akshaya, Su Gang, Stone Matthew L, Lu Guanyi, Owens Gary K, Upchurch Gilbert R, Ailawadi Gorav
From the Division of Thoracic and Cardiovascular Surgery (W.F.J., M.S., N.H.P., A.M., M.L.S., G.A.), Division of Vascular and Endovascular Surgery (G.S., G.L., G.R.U.), Department of Molecular Physiology and Biological Physics, Robert M. Berne Cardiovascular Research Center (G.K.O., G.R.U.), and Department of Biomedical Engineering (G.A.), University of Virginia, Charlottesville, VA.
Circulation. 2014 Sep 9;130(11 Suppl 1):S51-9. doi: 10.1161/CIRCULATIONAHA.113.006800.
Thoracic aortic aneurysms (TAAs) are common, but experimental TAA models are limited and the role of interleukin-1β (IL-1β) is undetermined.
IL-1β protein was measured in human TAAs and control aortas, and IL-1β protein was increased ≈20-fold in human TAAs. To develop an experimental model of TAAs, 8- to 10-week-old male C57Bl/6 mice (wild type [WT]) underwent thoracotomy with application of periadventitial elastase (WT TAA) or saline (WT control; n=30 per group). Elastase treatment to thoracic aortas resulted in progressive dilation until day 14 with maximal dilation of 99.6±24.7% compared with 14.4±8.2% for WT saline control (P<0.0001). WT TAAs demonstrated elastin fragmentation, smooth muscle cell loss, macrophage infiltration, and increased IL-1β expression. Next, TAAs were induced in mice deficient of IL-1β (IL-1β knockout) or IL-1 receptor (IL-1R knockout; n=10 each). Genetic deletion of IL-1β and IL-1R significantly decreased thoracic aortic dilation (IL-1β knockout=54.2±16.8% and IL-1R knockout=62.6±17.2% versus WT TAA=104.7±23.8%; P<0.001for both). IL-1β knockout and IL-1R knockout aortas demonstrated preserved elastin and smooth muscle cells with fewer inflammatory cells. Correspondingly, IL-1β and IL-1R knockout aortas had decreased inflammatory cytokine and matrix metalloproteinase 9 expression. Separately, WT mice pretreated with either IL-1R antagonist anakinra (100 mg/kg per day) or vehicle alone (control) underwent elastase treatment. Pretreatment of WT mice with anakinra attenuated TAA formation (control: 99.2±15.5% versus anakinra: 68.3±19.2%; P<0.005). Finally, to investigate treatment of small TAAs, WT mice were treated with anakinra 3 days after TAA induction. Anakinra treatment in WT mice with small TAAs reduced aortic dilation on day 14 (control treatment: 89.1±18.6% versus anakinra treatment: 59.7±25.7%; P=0.01).
Periadventitial application of elastase to murine thoracic aortas reproducibly produced aneurysms with molecular and histological features consistent with TAA disease. Genetic and pharmacological inhibition of IL-1β decreased TAA formation and progression, indicating that IL-1β may be a potential target for TAA treatment.
胸主动脉瘤(TAA)很常见,但实验性TAA模型有限,且白细胞介素-1β(IL-1β)的作用尚未确定。
检测人TAA和对照主动脉中的IL-1β蛋白,发现人TAA中的IL-1β蛋白增加了约20倍。为建立TAA实验模型,对8至10周龄雄性C57Bl/6小鼠(野生型[WT])进行开胸手术,在外膜周围应用弹性蛋白酶(WT TAA)或生理盐水(WT对照;每组n = 30)。对胸主动脉进行弹性蛋白酶处理导致主动脉逐渐扩张,直至第14天达到最大扩张,与WT生理盐水对照组的14.4±8.2%相比,最大扩张为99.6±24.7%(P<0.0001)。WT TAA表现出弹性蛋白断裂、平滑肌细胞丢失、巨噬细胞浸润以及IL-1β表达增加。接下来,在缺乏IL-1β(IL-1β基因敲除)或IL-1受体(IL-1R基因敲除)的小鼠中诱导TAA(每组n = 10)。IL-1β和IL-1R的基因缺失显著降低了胸主动脉扩张(IL-1β基因敲除组为54.2±16.8%,IL-1R基因敲除组为62.6±17.2%,而WT TAA组为104.7±23.8%;两者P均<0.001)。IL-1β基因敲除和IL-1R基因敲除的主动脉显示弹性蛋白和平滑肌细胞得以保留,炎症细胞较少。相应地,IL-1β和IL-1R基因敲除的主动脉中炎症细胞因子和基质金属蛋白酶9的表达降低。另外,用IL-1R拮抗剂阿那白滞素(每天100 mg/kg)或单独使用载体(对照)预处理WT小鼠后进行弹性蛋白酶处理。用阿那白滞素预处理WT小鼠可减轻TAA形成(对照:99.2±15.5%,阿那白滞素:68.3±19.2%;P<0.005)。最后,为研究小TAA的治疗,在TAA诱导后3天用阿那白滞素治疗WT小鼠。对患有小TAA的WT小鼠进行阿那白滞素治疗可在第14天减少主动脉扩张(对照治疗:其89.1±18.6%,阿那白滞素治疗:59.7±25.7%;P = 0.01)。
对外膜周围应用弹性蛋白酶于小鼠胸主动脉可重复性地产生具有与TAA疾病一致的分子和组织学特征的动脉瘤。对IL-1β的基因和药理学抑制可减少TAA的形成和进展,表明IL-1β可能是TAA治疗的一个潜在靶点。