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J Thorac Cardiovasc Surg 2007;133:155-161
© 2007 The American Association for Thoracic Surgery

Cardiopulmonary Support and Phyisiology

Matrix metalloproteinase and tissue inhibitor expression in atherosclerotic and nonatherosclerotic thoracic aortic aneurysms

^a Department of Surgery, Division of Cardiothoracic Surgery, Fletcher Allen Health Care, Burlington, Vt
^b University of Vermont College of Medicine, Burlington, Vt.

Received for publication April 5, 2006; revisions received June 21, 2006; accepted for publication July 7, 2006.

^_* Address for reprints: Joseph D. Schmoker, MD, Division of Cardiothoracic Surgery, Fletcher Allen Health Care, Fletcher 454, 111 Colchester Avenue, Burlington, VT 05401. (Email: joseph.schmoker{at}vtmednet.org).

OBJECTIVES: The altered expression of matrix metalloproteinases and their inhibitors influences the formation of atherosclerotic abdominal aortic aneurysms. Their association with thoracic aneurysms is less clear. This study describes the expression of metalloproteinases and their inhibitors in atherosclerotic and nonatherosclerotic thoracic aneurysms, and compares these with age-matched controls.

METHODS: Matrix metalloproteinase-2 and 9 activity were measured by antibody capture, and tissue inhibitor-1 and 2 levels were measured by enzyme-linked immunosorbent assay in 24 patients with atherosclerotic aneurysms and in 63 patients with nonatherosclerotic aneurysms. Gene expression was assessed with reverse transcriptase polymerase chain reaction. The results were compared with 17 controls.

RESULTS: Data are in nanograms per milligram of protein. Matrix metalloproteinase-2 activity was greater in controls than in the atherosclerotic and nonatherosclerotic groups (80 ± 67 vs 49 ± 50 and 35 ± 44, P = .002). Matrix metalloproteinase-9 activity was greater in the atherosclerotic group than in the nonatherosclerotic group and controls (11.7 ± 15.7 vs 2.5 ± 2.2 and 1.7 ± 1.9, P = .001). Tissue inhibitor-1 and 2 levels were greater in controls than in either aneurysm group (tissue inhibitor of metalloproteinase-1: 376 ± 192 vs 234 ± 233 and 174 ± 148, P = .003; tissue inhibitor of metalloproteinase-2: 143 ± 74 vs 14 ± 13 and 27 ± 43, P < .001). Atherosclerotic aneurysms expressed more matrix metalloproteinase mRNA than controls.

CONCLUSIONS: The metalloproteinase/tissue inhibitor phenotype of atherosclerotic thoracic aneurysms is similar to that of abdominal aneurysms. The diminished expression of metalloproteinases and tissue inhibitors in nonatherosclerotic thoracic aneurysms relative to aged controls may represent a loss of smooth muscle cells.

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