Inflammatory aneurysm of the ascending thoracic aorta

Roth, Matthias; Lemke, P.; Bohle, Rainer M.; Klövekorn, W. P.; Bauer, Erwin

doi:10.1067/mtc.2002.121291

Cited by 15 publications

(14 citation statements)

References 5 publications

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“…During the pathogenesis of aneurysms, activated immune cells have been proposed to contribute to elimination of SMCs, which are a source of ECM proteins, in both AAAs (Henderson et al, 1999) and TAAs (He et al, 2006). Yet, in contrast to AAAs (Paravastu et al, 2009), inflammation is documented in only a few cases in TAAs (Biddinger et al, 1997;Girardi and Coselli, 1997;Roth et al, 2002).…”

Section: Introductionmentioning

confidence: 99%

Smooth Muscle Cells Isolated from Thoracic Aortic Aneurysms Exhibit Increased Genomic Damage, but Similar Tendency for Apoptosis

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et al. 2012

DNA and Cell Biology

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Aortic aneurysms (AA) are characterized by structural deterioration leading to progressive dilation. During the development of AA, two key structural changes are pronounced, one being degradation of extracellular matrix and the other loss of smooth muscle cells (SMCs) through apoptosis. Reactive oxygen species (ROS) are produced above physiological levels in dilated (aneurismal) part of the aorta compared to the nondilated part and they are known to be associated with both the extracellular matrix degradation and the loss of SMCs. In this study, we hypothesized that aneurismal SMCs are more prone to apoptosis and that at least some cells undergo apoptosis due to elevated ROS in the aortic wall. To test this hypothesis, we first isolated SMCs from thoracic aneurismal tissue and compared their apoptotic tendency with normal SMCs in response to H 2 O 2 , oxidized sterol, or UV treatment. Exposed cells exhibited morphological changes characteristic of apoptosis, such as cell shrinkage, membrane blebbing, chromatin condensation, and DNA fragmentation. Terminal deoxynucleotidyl transferased UTP nick end labeling (TUNEL) further confirmed the fragmentation of nuclear DNA in these cells. Vascular SMCs were analyzed for their micronuclei (MN) and binucleate (BN) frequency as indicators of genomic abnormality. These data were then compared to patient parameters, including age, gender, hypertension, or aortic diameter for existing correlations. While the tendency for apoptosis was not significantly different compared to normal cells, both the %MN and %BN were higher in aneurismal SMCs. The data suggest that there is increased DNA damage in TAA samples, which might play a pivotal role in disease development.

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Section: Introductionmentioning

confidence: 99%

Smooth Muscle Cells Isolated from Thoracic Aortic Aneurysms Exhibit Increased Genomic Damage, but Similar Tendency for Apoptosis

Acılan

Serhatlı

Kaçar

et al. 2012

DNA and Cell Biology

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“…Connery et al 3 published the fi rst report of an isolated infl ammatory aneurysm of the ascending aorta in 1994 and our search of the literature found only seven cases reported to date (Table 1). [3][4][5][6][7][8][9] Seven (88%) of the eight patients, including ours, had symptoms similar to those of an infl ammatory abdominal aortic aneurysm. These symptoms were thoracic pain in six (75%) patients and sudden asystole in one (13%).…”

Section: Discussionmentioning

confidence: 93%

Inflammatory Aneurysm of the Ascending Aorta: Report of a Case

et al. 2007

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Inflammatory aortic aneurysms are found most commonly in the infrarenal abdominal aorta. We report the case of a 78-year-old man with an inflammatory aortic aneurysm of the ascending aorta, which is extremely unusual. Surgery revealed that the ascending aorta was adherent to the superior vena cava and pulmonary artery, but a dissection membrane was not found. The wall of the ascending aorta was up to 20 mm thick with perianeurysmal fibrosis. Pathologic examination revealed an inflammatory aneurysm with adventitia remarkably thickened by fibrotic tissue and infiltrated by lymphocytes and plasma cells. Our search of the literature found only seven other cases of an inflammatory ascending aortic aneurysm. Preoperative diagnosis was very difficult in most of these cases; however, improved scanning techniques using multidetector row computed tomography may allow the differential diagnosis of this clinical entity.

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“…Recent studies have shown that CP may also involve other vascular segments, such as the coronary, renal and mesenteric arteries [6][7][8][9][10] and represent, at least in some patients, a systemic vascular process, rather than a localized inflammatory reaction [6] . The presentation of aortic involvement may range from inflammatory aneurism with or without perianeurysmal fibrosis to isolated periaortic (retroperitoneal and/or mediastinal) fibrosis with compression of the aorta [6][7][8][9] .…”

Section: Discussionmentioning

confidence: 99%

“…The presentation of aortic involvement may range from inflammatory aneurism with or without perianeurysmal fibrosis to isolated periaortic (retroperitoneal and/or mediastinal) fibrosis with compression of the aorta [6][7][8][9] . This patient had an aneurysmal form of CP (PRF) with extensive thoracic and abdominal periaortic involvement, which is extremely uncommon.…”

Section: Discussionmentioning

confidence: 99%

Chronic periaortitis and antiphospholipid syndrome: is there a link?

Carneiro¹,

Ferreira²,

Rios³

2016

Gal. Clin.

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A 64-year-old man was referred to internal medicine consultation with a 6-month history of anorexia, weight loss (22 % of body weight) and progressive pain in the abdomen radiating to the lower back. He had a past strong medical history of cardiovascular disease with systemic hypertension, coronary disease and open surgical repair of a ruptured ascending thoracic aortic aneurysm 4 years before. Relevant medical background also included two episodes of deep venous thrombosis (DVT) in the last year. On physical examination there was an abdominal pulsatile mass. Initial laboratory findings showed microcytic anemia (8.9 g/dL; N 12-13 g/dL), elevated erythrocyte sedimentation rate (133mm 1st hour; N<20mm 1st hour) and C-reactive protein (13 mg/dL; N<5 mg/L), and renal dysfunction (creatinine 2.8 mg/dL; N<1 mg/dL) without proteinuria or red blood cells casts. The serum proteinogram showed polyclonal hypergammaglobulinemia with raised level of IgG (1945 mg/dl) but normal serum IgG4 concentrations. Serological testing for EBV, CMV, HSV, parvovirus B19, HIV, hepatitis B and C, syphilis and tuberculosis skin testing were negative. Immunological studies revealed persistent high levels of IgM anticardiolipin (aCL) antibody (159.5 MPL, positive >11) and IgM β2-glycoprotein (B2G) antibody (168 U/mL, positive >11), with negative lupus anticoagulant, measured on two occasions 4 months apart. Workup for other autoimmune disorders was unremarkable, including negative anti-neutrophil cytoplasmic antibodies and antinuclear antibody panel. A thoracoabdominal computed tomography (CT) scan was made and showed an aneurysm of the infrarenal abdominal aorta with 4.1 cm in diameter and bilateral hydronephrosis ( figure 1 -C). In addition, there was a 'sleeve' of abnormal material of soft tissue density surrounding the right brachiocephalic trunk, aortic arch, descending aorta, abdominal aorta and common iliac arteries (Figure 1 -A and 1-B AbstractChronic periaortitis (CP) is a rare fibro-inflammatory disease characterized by periaortic fibrosis and/or aortic aneurysms formation, mostly localized in retroperitoneum and occasionally in the mediastinum. Recent studies have shown its common association with autoimmune diseases, therefore autoimmunity has been proposed as a contributing factor. Herein, we describe the second case in the literature of CP associated with antiphospholipid syndrome. A 64-year-old man with history of open surgery for inflammatory thoracic aortic aneurysm and recurrent deep vein thrombosis was referred for abdominal pain and weight loss in the last 6 months. Further investigation revealed elevated acute-phase reactant levels, positive antiphospholipid autoantibodies, radiological and histological evidence of periaortic fibrosis and inflammation causing abdominal aortic aneurysm and ureteral obstruction. Diagnosis of CP and antiphospholipid syndrome were made and steroid therapy was implemented with clinical and radiological improvement. The present report further supports the potentially immune-mediated origin of ...

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Inflammatory aneurysm of the ascending thoracic aorta

Cited by 15 publications

References 5 publications

Smooth Muscle Cells Isolated from Thoracic Aortic Aneurysms Exhibit Increased Genomic Damage, but Similar Tendency for Apoptosis

Smooth Muscle Cells Isolated from Thoracic Aortic Aneurysms Exhibit Increased Genomic Damage, but Similar Tendency for Apoptosis

Inflammatory Aneurysm of the Ascending Aorta: Report of a Case

Chronic periaortitis and antiphospholipid syndrome: is there a link?

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