title: Preoperative treatment with doxycycline reduces aortic wall expression and activation of matrix metalloproteinases in patients with abdominal aortic aneurysms.
abstract: OBJECTIVE
  Matrix metalloproteinases (MMPs) are considered to play a central role in the pathogenesis of abdominal aortic aneurysms (AAAs). Doxycycline (Dox) has direct MMP-inhibiting properties in vitro, and it effectively suppresses the development of elastase-induced AAAs in rodents. The purpose of this study was to determine if treatment with Dox suppresses MMPs within human aneurysm tissue and to elucidate the molecular mechanisms underlying this effect.
  
  
  METHODS
  Aneurysm tissues were obtained from 15 patients with an AAA, eight of whom had been treated with Dox before surgery (100 mg orally twice a day for 7 days). Protein extracts were examined by means of gelatin zymography and immunoblot analysis, and RNA was examined by means of reverse transcription-polymerase chain reaction (RT-PCR). The effects of Dox on MMP production were further examined in human THP-1 mononuclear phagocytes in vitro.
  
  
  RESULTS
  No detectable difference was found between groups by using substrate zymography as a means of assessing total MMP activity, but Dox treatment was associated with a slight (24.4%) reduction in the activated fraction of 72-kDa gelatinase (MMP-2; P <.05). In contrast, a 2.5-fold reduction in the amount of extractable 92-kDa gelatinase (MMP-9) protein in Dox-treated patients was revealed by means of immunoblot analysis (P <.05). Also, a 5.5-fold (81.9%) reduction in MMP-9 messenger RNA (mRNA) in Dox-treated patients was demonstrated by means of quantitative competitive RT-PCR (mean +/- SE, mol MMP-9/mol beta-actin: 1.3 +/- 0.5 vs 7.2 +/- 3.1; P <.04). There was no significant difference between groups in the relative expression of MMP-2 protein or mRNA. In cultured THP-1 monocytes stimulated with phorbol ester, the expression of MMP-9 protein and mRNA were both decreased after exposure to relevant concentrations of Dox in vitro.
  
  
  CONCLUSIONS
  In addition to its recognized effects as a direct MMP antagonist, Dox may influence connective tissue degradation within human aneurysm tissue by reducing monocyte/macrophage expression of MMP-9 mRNA and by suppressing the post-translational processing (activation) of proMMP-2. Through this complementary combination of mechanisms, treatment with Dox may be a particularly effective strategy for achieving MMP inhibition in patients with an AAA.
authors.affiliation: Department of Surgery (Section of Vascular Surgery), Washington University School of Medicine, St Louis, MO 63110, USA.
authors.forename: J A
authors.initials: JA
authors.lastname: Curci
authors.forename: D
authors.initials: D
authors.lastname: Mao
authors.forename: D G
authors.initials: DG
authors.lastname: Bohner
authors.forename: B T
authors.initials: BT
authors.lastname: Allen
authors.forename: B G
authors.initials: BG
authors.lastname: Rubin
authors.forename: J M
authors.initials: JM
authors.lastname: Reilly
authors.forename: G A
authors.initials: GA
authors.lastname: Sicard
authors.forename: R W
authors.initials: RW
authors.lastname: Thompson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D001011:Aorta / Q000737:chemistry / Q000187:drug effects* / Q000201:enzymology*; D017544:Aortic Aneurysm, Abdominal / Q000201:enzymology* / Q000601:surgery; D001483:Base Sequence; D004318:Doxycycline / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D015971:Gene Expression Regulation, Enzymologic / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D015151:Immunoblotting / Q000379:methods / Q000706:statistics & numerical data; D008297:Male; D061965:Matrix Metalloproteinase Inhibitors; D020782:Matrix Metalloproteinases / Q000032:analysis / Q000187:drug effects / Q000235:genetics* / Q000378:metabolism; D008875:Middle Aged; D008969:Molecular Sequence Data; D015345:Oligonucleotide Probes; D011499:Protein Processing, Post-Translational / Q000187:drug effects; D020133:Reverse Transcriptase Polymerase Chain Reaction / Q000379:methods / Q000706:statistics & numerical data
chemical_list: D000900:Anti-Bacterial Agents; D061965:Matrix Metalloproteinase Inhibitors; D015345:Oligonucleotide Probes; D020782:Matrix Metalloproteinases; D004318:Doxycycline