title: The multitasking role of macrophages in Stanford type A acute aortic dissection.
abstract: OBJECTIVE
  The aim of the study was to determine whether the release by macrophages of matrix metalloproteinase (MMP)-12 and vascular endothelial growth factor (VEGF) - leading to inflammation, matrix degradation and neoangiogenesis - represents an effective pathway that underlies aortic wall remodeling in Stanford type A acute aortic dissection (AAD).
  
  
  METHODS
  Twenty-one consecutive patients with no genetic predisposition, with Stanford type A AAD were selected. In each patient, the levels of serum VEGF, MMP-12, serum interleukin (IL)-6, IL-8 and monocyte chemoattractant protein (MCP)-1 were evaluated using enzyme-linked immunosorbent assay. Ascending aortic specimens were collected for immunohistochemical identification of any presence of inflammatory infiltrate, VEGF and CD31 expression.
  
  
  RESULTS
  A significant increase in serum VEGF (p = 0.044), MMP-12 (p = 0.007), IL-6 (p = 0.0001), IL-8 (p = 0.0001) and MCP-1 (p = 0.0001) levels was observed in the AAD group compared to the control group. Furthermore, all AAD samples were positive for VEGF in the tunica media and showed vessel growth and immune-inflammatory infiltrate. A large number of cases (62.79%) showed inflammation at the edge of the dissection and approximately half (51.42%) showed neovessels growing at the edge of the dissection.
  
  
  CONCLUSIONS
  The results suggest that VEGF-mediated angiogenesis and matrix degradation play a role in AAD. Finally, we believe that MMP-12 should be considered a marker of AAD.
authors: Dipartimento di Medicina Clinica e Molecolare, Facoltà di Medicina e Psicologia, Ospedale Sant'Andrea, Rome, Italy.
authors: Flavia
authors: F
authors: Del Porto
authors: Cira
authors: C
authors: di Gioia
authors: Luigi
authors: L
authors: Tritapepe
authors: Livia
authors: L
authors: Ferri
authors: Martina
authors: M
authors: Leopizzi
authors: Italo
authors: I
authors: Nofroni
authors: Vincenzo
authors: V
authors: De Santis
authors: Carlo
authors: C
authors: Della Rocca
authors: Anna Paola
authors: AP
authors: Mitterhofer
authors: Guglielmo
authors: G
authors: Bruno
authors: Maurizio
authors: M
authors: Taurino
authors: Maria
authors: M
authors: Proietta
mesh_terms: D000208:Acute Disease; D000784:Aortic Dissection / Q000209:etiology*; D017545:Aortic Aneurysm, Thoracic / Q000209:etiology*; D016207:Cytokines / Q000378:metabolism; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008264:Macrophages / Q000378:metabolism / Q000502:physiology*; D008297:Male; D053508:Matrix Metalloproteinase 12 / Q000378:metabolism; D008875:Middle Aged; D019408:Platelet Endothelial Cell Adhesion Molecule-1 / Q000378:metabolism; D017540:Tunica Media / Q000378:metabolism; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism
chemical_list: D016207:Cytokines; D019408:Platelet Endothelial Cell Adhesion Molecule-1; D042461:Vascular Endothelial Growth Factor A; D053508:Matrix Metalloproteinase 12