Yuan Shi Min, Wu Ning
Department of Cardiothoracic Surgery, The First Hospital of Putian, Teaching Hospital, Fujian Medical University, Putian, Fujian Province-People's Republic of China.
Anatol J Cardiol. 2018 Jan;19(1):11-16. doi: 10.14744/AnatolJCardiol.2017.7839.
The is to report immunohistochemical observations of aortic α-smooth muscle actin (SMA) expressions in patients with aortic aneurysm, acute aortic dissection, and coronary artery disease and to discuss phenotypic switching of smooth muscle cells (SMCs) of these lesions.
Forty-nine consecutive patients scheduled for surgical treatment for acute type A aortic dissection (20 patients), aortic aneurysm (9 patients), and coronary artery disease (20 patients) were included. Surgical specimens of the aorta were obtained and prepared for hematoxylin and eosin and immunohistochemical stainings.
A comparison of aortic structural changes between the three groups showed that patients with coronary artery disease had the least severe aorta degeneration with the most intense α-SMA positivity. Aortic structural impairment was the most severe in patients with aortic dissection, whereas α-SMA positivity was more intense in patients with aortic dissection than in those with aortic aneurysm.
Disparities in α-SMA expressions in the aortic tissues of the three groups represent the extent of SMC degenerations or a phenotypic switching between contractile and synthetic SMCs. The results imply severe SMC degenerations in patients with aortic aneurysm, which may be beneficial because of the production of extracellular matrix necessary for healing of the vascular wall, but severe disruptions in elastic fibers in patients with aortic dissection. Patients with coronary artery disease show slight SMC degeneration and phenotypic switching among the three groups. The possible apoptotic and genetic mechanisms of aortic structural impairments warrant further elaborations.
报告主动脉瘤、急性主动脉夹层和冠状动脉疾病患者主动脉α平滑肌肌动蛋白（SMA）表达的免疫组化观察结果，并探讨这些病变中平滑肌细胞（SMC）的表型转换。
纳入49例计划接受手术治疗的连续患者，其中急性A型主动脉夹层20例、主动脉瘤9例、冠状动脉疾病20例。获取主动脉手术标本，进行苏木精-伊红染色和免疫组化染色。
三组之间主动脉结构变化的比较显示，冠状动脉疾病患者的主动脉退变最轻，α-SMA阳性最强。主动脉夹层患者的主动脉结构损伤最严重，而主动脉夹层患者的α-SMA阳性比主动脉瘤患者更强。
三组主动脉组织中α-SMA表达的差异代表了SMC退变的程度或收缩性和合成性SMC之间的表型转换。结果表明主动脉瘤患者存在严重的SMC退变，这可能是有益的，因为其可产生血管壁愈合所需的细胞外基质，但主动脉夹层患者的弹性纤维严重破坏。冠状动脉疾病患者在三组中表现出轻微的SMC退变和表型转换。主动脉结构损伤可能的凋亡和遗传机制值得进一步阐述。
