New insight in aetiopathogenesis of aortic diseases

E Allaire1, F Schneider, F Saucy

  • 1Surgical Research Center, Paris 12 University, CNRS EAC 7054, 8 rue du Général Sarrail, 94010 Créteil Cedex, France.

Insights

Aortic diseases like aneurysms and dissections involve complex genetic and cellular factors. Understanding these mechanisms is key to better characterizing lesions and developing effective therapeutic strategies.

Area of Science:

  • Cardiovascular Biology
  • Vascular Medicine
  • Atherosclerosis Research

Background:

  • Aortic diseases, including aneurysms and dissections, are significant health concerns.
  • Understanding their aetiopathogeny is crucial for improved characterization, risk assessment, and treatment.
  • This review specifically excludes infectious, inflammatory, and traumatic causes.

Purpose of the Study:

  • To review recent biomedical literature on the aetiopathogeny of aortic aneurysms and dissections.
  • To synthesize current knowledge on the heterogeneous factors contributing to aortic diseases.
  • To highlight areas for future research in understanding disease mechanisms.

Main Methods:

  • Comprehensive review of biomedical literature from the past 10 years.
  • Focus on genetic determinants, cellular contributions (smooth muscle cells, macrophages, neutrophils, mesenchymal, endothelial cells), inflammation, and thrombus formation.
  • Analysis of extracellular matrix degradation and aortic wall reconstruction failure.

Main Results:

  • Aortic diseases exhibit heterogeneity in genetic factors, smooth muscle cell roles, inflammation, and thrombus formation.
  • Extracellular matrix degradation by proteases is a critical event modulated by genetics, hemodynamics, cellular activity, and thrombus.
  • New genetic determinants have been identified, and proteases originate from diverse cell types.
  • Smooth muscle cells play a role in maintaining aortic wall homeostasis against inflammation and proteolysis.

Conclusions:

  • Aortic diseases are diverse, involving multiple biological systems within the vascular wall and blood interface.
  • Further research is needed to elucidate specific cellular and molecular mechanisms underlying clinical events like dissection, aneurysm expansion, and rupture.
Abstract

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