Department of Vascular Surgery, Amsterdam University Medical Centres, location VUmc, Amsterdam, the Netherlands; Department of Physiology, Amsterdam University Medical Centres, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands; Department of Surgery, Zaans Medisch Centrum, Zaandam, the Netherlands.
Department of Angiology and Vascular Surgery, São João University Hospital Centre, Porto, Portugal; Department of Surgery and Physiology, Cardiovascular Research Unit, Faculty of Medicine, University of Porto, Portugal.
Eur J Vasc Endovasc Surg. 2021 Jun;61(6):1008-1016. doi: 10.1016/j.ejvs.2021.02.034. Epub 2021 Apr 12.
Perivascular adipose tissue (PVAT) contributes to vascular homeostasis and is increasingly linked to vascular pathology. PVAT density and volume were associated with abdominal aortic aneurysm (AAA) presence and dimensions on imaging. However, mechanisms underlying the role of PVAT in AAA have not been clarified. This study aimed to explore differences in PVAT from AAA using gene expression and functional tests.
Human aortic PVAT and control subcutaneous adipose tissue were collected during open AAA surgery. Gene analyses and functional tests were performed. The control group consisted of healthy aorta from non-living renal transplant donors. Gene expression tests were performed to study genes potentially involved in various inflammatory processes and AAA related genes. Live PVAT and subcutaneous adipose tissue (SAT) from AAA were used for ex vivo co-culture with smooth muscle cells (SMCs) retrieved from non-pathological aortas.
Adipose tissue was harvested from 27 AAA patients (n [gene expression] = 22, n [functional tests] = 5) and five control patients. An increased inflammatory gene expression of PTPRC (p = .008), CXCL8 (p = .033), LCK (p = .003), CCL5 (p = .004) and an increase in extracellular matrix breakdown marker MMP9 (p = .016) were found in AAA compared with controls. Also, there was a decreased anti-inflammatory gene expression of PPARG in AAA compared with controls (p = .040). SMC co-cultures from non-pathological aortas with PVAT from AAA showed increased MMP9 (p = .033) and SMTN (p = .008) expression and SAT increased SMTN expression in these SMC.
The data revealed that PVAT from AAA shows an increased pro-inflammatory and matrix metallopeptidase gene expression and decreased anti-inflammatory gene expression. Furthermore, increased expression of genes involved in aneurysm formation was found in healthy SMC co-culture with PVAT of AAA patients. Therefore, PVAT from AAA might contribute to inflammation of the adjacent aortic wall and thereby plays a possible role in AAA pathophysiology. These proposed pathways of inflammatory induction could reveal new therapeutic targets in AAA treatment.
血管周围脂肪组织 (PVAT) 有助于血管稳态,并且与血管病理学的关系日益密切。PVAT 密度和体积与影像学上的腹主动脉瘤 (AAA) 存在和尺寸相关。然而,PVAT 在 AAA 中的作用的机制尚未阐明。本研究旨在使用基因表达和功能测试来探索 AAA 中 PVAT 的差异。
在开放 AAA 手术期间从腹主动脉瘤患者中采集人主动脉 PVAT 和对照皮下脂肪组织。进行基因分析和功能测试。对照组由来自非活体肾移植供体的健康主动脉组成。进行基因表达测试以研究可能涉及各种炎症过程和 AAA 相关基因的基因。从非病理性主动脉中提取平滑肌细胞 (SMC) 并与来自 AAA 的活 PVAT 和皮下脂肪组织 (SAT) 进行体外共培养。
从 27 名 AAA 患者 (n [基因表达] = 22,n [功能测试] = 5) 和 5 名对照患者中采集了脂肪组织。与对照组相比,AAA 中发现炎症基因表达增加,包括 PTPRC(p=.008)、CXCL8(p=.033)、LCK(p=.003)、CCL5(p=.004)和细胞外基质分解标志物 MMP9(p=.016)。此外,与对照组相比,AAA 中的抗炎基因表达 PPARG 减少 (p=.040)。与 AAA 的 PVAT 共培养非病理性主动脉的 SMC 显示 MMP9(p=.033)和 SMTN(p=.008)表达增加,并且 SAT 增加了这些 SMC 中的 SMTN 表达。
数据显示,AAA 的 PVAT 显示出增加的促炎和基质金属蛋白酶基因表达以及减少的抗炎基因表达。此外,在与 AAA 患者的 PVAT 共培养的健康 SMC 中发现了参与动脉瘤形成的基因表达增加。因此,AAA 的 PVAT 可能导致邻近主动脉壁的炎症,并因此在 AAA 病理生理学中发挥可能的作用。这些炎症诱导的途径可能为 AAA 治疗揭示新的治疗靶点。