JTCS Click here to go to SJM website.
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Wei Sun
Anthony L. Estrera
Hazim J. Safi
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by He, R.
Right arrow Articles by Milewicz, D. M.
Right arrow Search for Related Content
PubMed
Right arrow Articles by He, R.
Right arrow Articles by Milewicz, D. M.
Related Collections
Right arrow Great vessels

J Thorac Cardiovasc Surg 2008;136:922-929
© 2008 The American Association for Thoracic Surgery

Surgery for Acquired Cardiovascular Disease

Characterization of the inflammatory cells in ascending thoracic aortic aneurysms in patients with Marfan syndrome, familial thoracic aortic aneurysms, and sporadic aneurysms

Rumin He, MDa,*, Dong-Chuan Guo, PhDa,*, Wei Sun, PhDd, Christina L. Papke, BSa, Senthil Duraisamy, PhDa, Anthony L. Estrera, MDb, Hazim J. Safi, MDb, Chul Ahn, PhDa, L. Maximilian Buja, MDc, Frank C. Arnett, MDa, Jingwu Zhang, MDd, Yong-Jian Geng, MD, PhDa, Dianna M. Milewicz, MD, PhDa,*

a Department of Internal Medicine, The University of Texas Medical School at Houston, Houston, Texas
b Department of Cardiovascular Surgery, The University of Texas Medical School at Houston, Houston, Texas
c Department of Pathology, The University of Texas Medical School at Houston, Houston, Texas
d Department of Immunology, Baylor College of Medicine, Houston, Texas

Received for publication June 30, 2007; revisions received November 28, 2007; accepted for publication December 18, 2007.

* Address for reprints: Dianna M. Milewicz, MD, PhD, The University of Texas Medical School at Houston, 6431 Fanin St, MSB 6.100, Houston, TX 77030. (Email: Dianna.M.Milewicz{at}uth.tmc.edu).

Objective: This study sought to characterize the inflammatory infiltrate in ascending thoracic aortic aneurysm in patients with Marfan syndrome, familial thoracic aortic aneurysm, or nonfamilial thoracic aortic aneurysm.

Background: Thoracic aortic aneurysms are associated with a pathologic lesion termed "medial degeneration," which is described as a noninflammatory lesion. Thoracic aortic aneurysms are a complication of Marfan syndrome and can be inherited in an autosomal dominant manner of familial thoracic aortic aneurysm.

Methods: Full aortic segments were collected from patients undergoing elective repair with Marfan syndrome (n = 5), familial thoracic aortic aneurysm (n = 6), and thoracic aortic aneurysms (n = 9), along with control aortas (n = 5). Immunohistochemistry staining was performed using antibodies directed against markers of lymphocytes and macrophages. Real-time polymerase chain reaction analysis was performed to quantify the expression level of the T-cell receptor β-chain variable region gene.

Results: Immunohistochemistry of thoracic aortic aneurysm aortas demonstrated that the media and adventitia from Marfan syndrome, familial thoracic aortic aneurysm, and sporadic cases had increased numbers of T lymphocytes and macrophages when compared with control aortas. The number of T cells and macrophages in the aortic media of the aneurysm correlated inversely with the patient's age at the time of prophylactic surgical repair of the aorta. T-cell receptor profiling indicated a similar clonal nature of the T cells in the aortic wall in a majority of aneurysms, whether the patient had Marfan syndrome, familial thoracic aortic aneurysm, or sporadic disease.

Conclusion: These results indicate that the infiltration of inflammatory cells contributes to the pathogenesis of thoracic aortic aneurysms. Superantigen-driven stimulation of T lymphocytes in the aortic tissues of patients with thoracic aortic aneurysms may contribute to the initial immune response.

Abbreviations and Acronyms AAA = abdominal aortic aneurysm; FTAA = familial thoracic aortic aneurysm; ICAM = intercellular adhesion molecule; MD = medial degeneration; MFS = Marfan syndrome; PCR = polymerase chain reaction; TAA = thoracic aortic aneurysm; TCR BV = T-cell receptor β-chain variable region; TGFBR2 = transforming growth factor β receptor type II; Th = T-helper; VCAM = vascular cell adhesion molecule






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2008 by The American Association for Thoracic Surgery.