Elastin metabolism of the infrarenal aorta

Abstract

Aortic tissue elastase and otl-antitrypsin were assayed in 67 patients with different types ofinfrarenal aortic disease; occlusive disease, elective abdominal aortic aneurysms (AAAs), multiple aneurysms, and ruptured aneurysms. Elastase modified by otl-antitrypsin (elastase/otl-antitrypsin) increased significantly as the type of aortic disease changed from occlusive to aneurysmal disease. Aortic elastase was significantly higher in patients with AAAs, multiple aneurysms, and ruptured AAAs compared with occlusive disease. The o~-antitrypsin was significantly lower in patients with multiple aneurysms and ruptured AAAs. These data suggest that the ratio between elastase and its major serum inhibitor, ot~-antitrypsin, is significantly altered in the aortic wall in different types of infrarenal aortic disease. In addition, the ratio between these two enzyme systems changes in favor of more proteolytic activity as the type of infrarenal disease changes from occlusive to aneurysmal.

Protease activity in the multi-layered intra-luminal thrombus of abdominal aortic aneurysms

“…Moreover, EDPs have been shown to recruit inflammatory cells, which in turn produce more proteases that continue the degradation of elastin, leading to a vicious cycle (Satta, Laurila et al 1998;Hance, Tataria et al 2002). The imbalance between protease and inhibitor exacerbates the progression of AAA (Cohen, Mandell et al 1988).…”

Splenic artery aneurysm and orthotopic liver transplantation

“…Ruptured splenic artery aneurysm has also been reported in a patient with cirrhosis secondary to alpha-l-antitrypsin deficiency [17], as well as in a patient with iliac artery dissection [4]. Alpha-1 -antitrypsin content in the aortic wall has been found to be significantly lower in patients with multiple infra-renal aneurysms and ruptured abdominal aortic aneurysms [5]. Alpha-l-antitrypsin deficiency has also been associated with rupture of a middle colic artery aneurysm in a patient with multiple visceral aneurysms [12] and with rupture of an intra-cranial aneurysm and spontaneous dissection of the internal carotid artery [15].…”

The role of alpha-1-antitrypsin protein in the pathogenesis of abdominal aortic aneurysm

“…Increased activity of neutrophil elastase, an imbalance between AAT antiprotease and neutrophil elastase, was observed among patients with abdominal aortic aneurysms. However, initial reports on reduced AAT protein concentrations were not unequivocally confirmed in later studies [21,22].…”