Download PDF
CC BY 4.0 · Aorta (Stamford) 2014; 02(05): 179-185
DOI: 10.12945/j.aorta.2014.14-017
Original Research Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Differences in Elastin and Elastolytic Enzymes between Men and Women with Abdominal Aortic Aneurysm

Christina Villard
1   Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
2   Department of Vascular Surgery, Karolinska University Hospital, Stockholm, Sweden
,
Per Eriksson
3   Atherosclerosis Research Unit, Center for Molecular Medicine, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
,
Jesper Swedenborg
1   Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
,
Rebecka Hultgren
1   Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
2   Department of Vascular Surgery, Karolinska University Hospital, Stockholm, Sweden
› Author Affiliations
Further Information

Publication History

04 March 2014

04 September 2014

Publication Date:
24 September 2018 (online)

Also available at
   Permissions and Reprints

Abstract

Background: Abdominal aortic aneurysms (AAAs) in women differ in some important aspects from those in men. The lower prevalence rate, higher rupture rate and potentially increased growth rate in women with AAA suggest gender to be of importance for aneurysm development and progression. The aim of the study was to analyze wall properties with respect to synthesis and destruction of elastin in men and women with AAA, with and without an intraluminal thrombus.

Methods: Patient characteristics and aneurysm wall biopsies were collected from all women (n = 14) treated with open repair for AAA, 2008-2012, and men with similar aneurysm diameter and similar age (n = 23) treated during the same time period. The expressions of elastin, matrix metalloproteinase (MMP)-2 and -9, and cathepsin K were quantified by immunohistochemistry, Western blot, and gene expression analysis on the aneurysm wall.

Results: The protein expression of elastin was less in women than in men in the non-thrombus-covered aneurysm wall. In addition, the protein and mRNA expressions of MMP-9 were higher in women (−0.83 versus 0.09, P = 0.041). There was no difference in elastin and elastolytic enzymes between men and women in the thrombus-covered aneurysm wall.

Conclusion: Less elastin in the non-thrombus-covered aneurysm wall in women than that in men, and the simultaneous higher level of MMP-9, suggest differences in the elastolytic process in AAA between the sexes.

Key Words

Abdominal aortic aneurysm - Gender - Women - Elastin - MMP-9 - Progression - Rupture
 

  • References

  • 1 Pleumeekers HJ, Hoes AW, van der Does E, van Urk H, Hofman A, de Jong PT. , et al. Aneurysms of the abdominal aorta in older adults. The Rotterdam Study. Am J Epidemiol 1995; 142: 1291-1299
    CrossrefPubMedGoogle Scholar
  • 2 Mofidi R, Goldie VJ, Kelman J, Dawson ARW, Murie JA, Chalmers RTA. Influence of sex on expansion rate of abdominal aortic aneurysms. Br J Surg 2007; 94: 310-314 . 10.1002/bjs.5573
    CrossrefPubMedGoogle Scholar
  • 3 Sweeting MJ, Thompson SG, Brown LC, Powell JT. Meta-analysis of individual patient data to examine factors affecting growth and rupture of small abdominal aortic aneurysms. Br J Surg 2012; 99: 655-665 . 10.1002/bjs.8707
    CrossrefPubMedGoogle Scholar
  • 4 Carmo M, Colombo L, Bruno A, Corsi F, Roncoroni L, Cuttin MS. , et al. Alteration of elastin, collagen and their cross-links in abdominal aortic aneurysms. Eur J Vasc Endovasc Surg 2002; 23: 543-549 . 10.1053/ejvs.2002.1620
    CrossrefPubMedGoogle Scholar
  • 5 Dobrin PB, Baker WH, Gley WC. Elastolytic and collagenolytic studies of arteries. Implications for the mechanical properties of aneurysms. Arch Surg 1984; 119: 405-409 . 10.1001/archsurg.1984.01390160041009
    CrossrefPubMedGoogle Scholar
  • 6 Dobrin PB, Mrkvicka R. Failure of elastin or collagen as possible critical connective tissue alterations underlying aneurysmal dilatation. Cardiovasc Surg 1994; 2: 484-488
    PubMedGoogle Scholar
  • 7 Kielty CM, Sherratt MJ, Shuttleworth CA. Elastic fibres. J Cell Sci 2002; 115: 2817-2828
    PubMedGoogle Scholar
  • 8 Shapiro SD, Endicott SK, Province MA, Pierce JA, Campbell EJ. Marked longevity of human lung parenchymal elastic fibers deduced from prevalence of D-aspartate and nuclear weapons-related radiocarbon. J Clin Invest 1991; 87: 1828-1834 . 10.1172/JCI115204
    CrossrefPubMedGoogle Scholar
  • 9 Sakalihasan N, Limet R, Defawe O. Abdominal aortic aneurysm. Lancet 2005; 365: 1577-1589 . 10.1016/S0140-6736(05)66459-8
    CrossrefPubMedGoogle Scholar
  • 10 Thompson RW, Parks WC. Role of matrix metalloproteinases in abdominal aortic aneurysms. Ann NY Acad Sci 1996; 800: 157-174 . 10.1111/j.1749-6632.1996.tb33307.x
    CrossrefPubMedGoogle Scholar
  • 11 Petersen E, Wågberg F, Angquist KA. Proteolysis of the abdominal aortic aneurysm wall and the association with rupture. Eur J Vasc Endovasc Surg 2002; 23: 153-157 . 10.1053/ejvs.2001.1572
    CrossrefPubMedGoogle Scholar
  • 12 McMillan WD, Tamarina NA, Cipollone M, Johnson DA, Parker MA, Pearce WH. Size matters: the relationship between MMP-9 expression and aortic diameter. Circulation 1997; 96: 2228-2232 . 10.1161/01.CIR.96.7.2228
    CrossrefPubMedGoogle Scholar
  • 13 Abdul-Hussien H, Soekhoe RG, Weber E, von der Thüsen JH, Kleemann R, Mulder A. , et al. Collagen degradation in the abdominal aneurysm: a conspiracy of matrix metalloproteinase and cysteine collagenases. Am J Pathol 2007; 170: 809-817 . 10.2353/ajpath.2007.060522
    CrossrefPubMedGoogle Scholar
  • 14 Koole D, Zandvoort HJ, Schoneveld A, Vink A, Vos JA, van den Hoogen LL. , et al. Intraluminal abdominal aortic aneurysm thrombus is associated with disruption of wall integrity. J Vasc Surg 2013; 57: 77-83 . 10.1016/j.jvs.2012.07.003
    CrossrefPubMedGoogle Scholar
  • 15 Kazi M, Thyberg J, Religa P, Roy J, Eriksson P, Hedin U. , et al. Influence of intraluminal thrombus on structural and cellular composition of abdominal aortic aneurysm wall. J Vasc Surg 2003; 38: 1283-1292 . 10.1016/S0741-5214(03)00791-2
    CrossrefPubMedGoogle Scholar
  • 16 Wiernicki I, Stachowska E, Safranow K, Cnotliwy M, Rybicka M, Kaczmarczyk M. , et al. Enhanced matrix-degrading proteolytic activity within the thin thrombus-covered wall of human abdominal aortic aneurysms. Atherosclerosis 2010; 212: 161-165 . 10.1016/j.atherosclerosis.2010.04.033
    CrossrefPubMedGoogle Scholar
  • 17 Vorp DA, Lee PC, Wang DH, Makaroun MS, Nemoto EM, Ogawa S. , et al. Association of intraluminal thrombus in abdominal aortic aneurysm with local hypoxia and wall weakening. J Vasc Surg 2001; 34: 291-299 . 10.1067/mva.2001.114813
    CrossrefPubMedGoogle Scholar
  • 18 Forbes TL, Lawlor DK, DeRose G, Harris KA. Gender differences in relative dilatation of abdominal aortic aneurysms. Ann Vasc Surg 2006; 20: 564-568 . 10.1007/S10016-006-9079-y
    CrossrefPubMedGoogle Scholar
  • 19 Tong J, Schriefl AJ, Cohnert T, Holzapfel GA. Gender differences in biomechanical properties, thrombus age, mass fraction and clinical factors of abdominal aortic aneurysms. Eur J Vasc Endovasc Surg 2013; 45: 364-372 . 10.1016/j.ejvs.2013.01.003
    CrossrefPubMedGoogle Scholar
  • 20 Lo RC, Lu B, Fokkema MT, Conrad M, Patel VI, Fillinger M. , et al. Relative importance of aneurysm diameter and body size for predicting abdominal aortic aneurysm rupture in men and women. J Vasc Surg 2014; 59: 1209-1216 . 10.1016/j.jvs.2013.10.104
    CrossrefPubMedGoogle Scholar
  • 21 Mendelsohn ME, Karas RH. Molecular and cellular basis of cardiovascular gender differences. Science 2005; 308: 1583-1587 . 10.1126/science.1112062
    CrossrefPubMedGoogle Scholar
  • 22 Astrand H, Stalhand J, Karlsson J, Karlsson M, Sonesson B, Länne T. In vivo estimation of the contribution of elastin and collagen to the mechanical properties in the human abdominal aorta: effect of age and sex. J Appl Physiol 2011; 110: 176-187 . 10.1152/japplphysiol.00579.2010
    CrossrefPubMedGoogle Scholar
  • 23 Natoli AK, Medley TL, Ahimastos AA, Drew BG, Thearle DJ, Dilley RJ. , et al. Sex steroids modulate human aortic smooth muscle cell matrix protein deposition and matrix metalloproteinase expression. Hypertension 2005; 46: 1129-1134 . 10.1161/01.HYP.0000187016.06549.96
    CrossrefPubMedGoogle Scholar
  • 24 Wang Y, Moss J, Thisted R. Predictors of body surface area. J Clin Anesth 1992; 4: 4-10 . 10.1016/0952-8180(92)90111-D
    CrossrefPubMedGoogle Scholar
  • 25 Kälsch H, Lehmann N, Möhlenkamp S, Becker A, Moebus S, Schmermund A. , et al. Body-surface adjusted aortic reference diameters for improved identification of patients with thoracic aortic aneurysms: results from the population-based Heinz Nixdorf Recall study. Int J Cardiol 2013; 163: 72-78 . 10.1016/j.ijcard.2011.05.039
    CrossrefPubMedGoogle Scholar