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

Rumin He, Dong Chuan Guo, Wei Sun, Christina L. Papke, Senthil Duraisamy, Anthony L. Estrera, Hazim J. Safi, Chul Ahn, L. Maximilian Buja, Frank C. Arnett, Jingwu Zhang, Yong Jian Geng, Dianna M. Milewicz

Research output: Contribution to journalArticle

61 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)922-929.e1
JournalJournal of Thoracic and Cardiovascular Surgery
Volume136
Issue number4
DOIs
StatePublished - Oct 2008

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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    He, R., Guo, D. C., Sun, W., Papke, C. L., Duraisamy, S., Estrera, A. L., Safi, H. J., Ahn, C., Maximilian Buja, L., Arnett, F. C., Zhang, J., Geng, Y. J., & Milewicz, D. M. (2008). Characterization of the inflammatory cells in ascending thoracic aortic aneurysms in patients with Marfan syndrome, familial thoracic aortic aneurysms, and sporadic aneurysms. Journal of Thoracic and Cardiovascular Surgery, 136(4), 922-929.e1. https://doi.org/10.1016/j.jtcvs.2007.12.063