Circulation:胞质DNA及其传感适配器STING在主动脉瘤/夹层发生发展中具有至关重要的作用

2020-01-03 QQY MedSci原创

散发性腹主动脉瘤夹层(AAD),由进行性主动脉平滑肌细胞(SMC)丢失和细胞外基质退化导致的,是一种高度致死性性疾病。解析驱动主动脉退化的机制是开发有限预防该疾病进展的药物治疗的关键步骤。近期,有研究表明胞质DNA和异常激活的胞质DNA传感适配器STING(干扰素基因刺激因子)在血管炎症和破坏中发挥重要作用。现研究人员对这一机制在主动脉退行性变和散发性AAD形成中的作用进行研究。在散发性升主动脉A

散发性腹主动脉瘤夹层(AAD),由进行性主动脉平滑肌细胞(SMC)丢失和细胞外基质退化导致的,是一种高度致死性性疾病。解析驱动主动脉退化的机制是开发有限预防该疾病进展的药物治疗的关键步骤。近期,有研究表明胞质DNA和异常激活的胞质DNA传感适配器STING(干扰素基因刺激因子)在血管炎症和破坏中发挥重要作用。现研究人员对这一机制在主动脉退行性变和散发性AAD形成中的作用进行研究。

在散发性升主动脉AAD患者来源的主动脉组织中检测动脉细胞中胞质DNA的出现和STING通路的激活。在Sting-缺陷(Stinggt/gt,一种散发性AAD模型)小鼠中评估STING在AAD发展中的作用。此外,还在体外系统检测了STING对SMC死亡和巨噬细胞激活的直接效应。

在人类散发性AAD组织中,研究人员SMCs和巨噬细胞中观察到胞质DNA出现和STING信号通路明显激活。在散发性AAD模型中,无论是在胸主动脉段还是腹主动脉段,Stinggt/gt小鼠应激诱导的动脉扩张、分层和破裂均明显减轻。单细胞转录本分析显示,在野生型小鼠中,主动脉应激可引起的SMC DNA损伤反应、炎症反应、去分化和细胞死亡,以及巨噬细胞基质金属蛋白酶表达。但这些变化在应激的Stinggt/gt小鼠中减弱。

在机制上,SMCs细胞核和线粒体DNA损伤以及随后的DNA渗漏至细胞质激活STING信号,进而通过凋亡和坏死性凋亡诱导细胞死亡。此外,损伤SMCs来源的DNA被巨噬细胞吞噬,进而激活吞噬细胞的STING及其靶基因干扰素调控因子3,而该因子可直接诱导基质金属蛋白酶-9表达。此外,药物抑制STING激活可部分预防AAD进展。

本研究提示胞质DNA的出现和随后的胞质DNA传感适配器STING信号的激活是主动脉退化的关键机制,靶向STING或可预防散发性AAD进展。

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    2020-01-05 lxg955

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既往研究显示氟喹诺酮治疗可能会增加胶原疾病、主动脉瘤与夹层(AA/AD)的发病风险。本研究的目的旨在通过一个大型国家行政数据库的案例交叉分析来评估这种相关性。本研究共纳入了2001-2011年1213例住院的AA/AD病人,分析结果发现,暴露于氟喹诺酮的概率在危险期(AA/AD事件发生前60天)比对照期(AA/AD事件发生前60-180天中的任意60天)要更高(1.6% vs. 0.6%; [OR

Int J Cardiol:主动脉瘤外科修复与降低的痴呆发生率

由此可见,与NST相比,OSR与降低主动脉瘤患者痴呆发生率有关。