Transforming growth factor serum concentrations in patients with proven non-syndromic aortopathy

Abstract

BackgroundThe mechanism underlying aortic dilatation is still unknown. Vascular dilatation is thought to be the result of progressive aortic media degeneration caused by defective vascular matrix hemostasis, including TGF-β1 dysregulation. The goal of this study is to draw attention to the potential utility of TGF-β1 as a diagnostic marker in non-syndromic patients with aortic dilatation.MethodsTGF-β1 levels in plasma were measured in 50 patients who had undergone surgery and had a tricuspid or bicuspid aortic valve as well as a normal or dilated ascending aorta. A pathologist also examined thirty resected aorta samples. To specify the reference range of TGF-β1, a control group of 40 volunteers was enrolled in this study.ResultsWe discovered a significant difference in TGF-β1 levels between patients with aortic dilatation and the control group (32.5 vs. 63.92; P < 0.001), as well as between patients with non-dilated aorta but with aortic valve disease, and the control group (27.68 vs. 63.92; P < 0.001). There was no difference between the dilated ascending aorta group and the non-dilated ascending aorta group. We found a poor correlation between TGF-β1 levels and ascending aorta diameter as well as the grade of ascending aorta histopathological abnormalities.ConclusionTGF-β1 concentration does not meet the criteria to be a specific marker of aortic dilatation, but it is sensitive to aortic valvulopathy-aortopathy. A larger patient cohort study is needed to confirm these findings.

Commentary: Transforming growth factor serum concentrations in patients with proven non-syndromic aortopathy

“…This commentary builds on the recently published original paper of Karalko et al (1). The authors presented an interesting study aiming at identifying a potential diagnostic marker in non-syndromic patients with aortic dilatation.…”

“…Furthermore, the active and latent forms of TGF-β1 and plateletderived TGF-β1 are not distinguished in the results (1). Studies which the authors refer to in their discussion also focused on serum levels of TGF-β1 as a potential marker for future aortopathy, however, they had correlated their findings to the local expression of TGF-β1 in the ascending aortic wall (15,16).…”

“…Bicuspid (BAV) and tricuspid (TAV) aortic valve patients, with and without an aortic dilatation were enrolled in the study, a reference group of 40 volunteers was also included. In their study Karalko et al ( 1 ) conclude that the serum TGF-β1 concentration is significantly changed in non- and syndromic thoracic aortic aneurysms, as well as patients with a BAV. This is an interesting paper aiming at identifying potential biomarkers to predict future aortopathy in BAV patients, but there are some limitations which should be considered while interpreting the presented data.…”

“…Biomarkers can be tissue specific, or derivates in blood. Karalko et al ( 1 ) describe in their study the expression of a potential diagnostic marker in blood.…”

“…In the paper of Karalko et al ( 1 ), TGF-β1 levels in plasma were measured in 50 patients who had undergone cardiac surgery. Bicuspid (BAV) and tricuspid (TAV) aortic valve patients, with and without an aortic dilatation were enrolled in the study, a reference group of 40 volunteers was also included.…”