title: The role of extracellular and intracellular proteolytic systems in aneurysms of the ascending aorta.
abstract: Aneurysms of the ascending aorta are an outstanding challenge to clinicians as they may persist asymptomatic until they present with dissection or rupture. Intensive research is performed to reveal the molecular mechanisms causing aneurysm formation. Calpains are ubiquitous non-lysosomal cysteine proteases which are classically activated by calcium signaling. The two major forms of the calpain-family are calpain-I and calpain-II. Calpastatin specifically inhibits the proteolytic activity of calpain-I and -II. Recently it has been demonstrated in aneurysm tissues from ascending aortas obtained from Marfan syndrome patients that calpain-II expression is increased and calpastatin expression is decreased. Thus, we were interested in the probable role of calpains in aneurysms of ascending aorta in non-Marfan patients. Therefore, ascending aortic samples of dilated and non-dilated aortas were analyzed according to their calpain-I, -II and calpastatin content as well as the expression levels of MMPs and elastin as well as the infiltration of inflammatory cells. We have found significant differences in calpain-I and calpastatin protein expression and serum levels in patients with aneurysm of the ascending aorta. Furthermore, MMP-1 and MMP-3 expression levels correlate with calpain-I protein levels. Due to our findings we conclude that calpain-1 seems to be related to fibrotic alteration in aortic aneurysm tissue in our experimental group. The change in calpain-1 modulates the structure of aortic tissue causing alteration in elastin structure, thus enabling macrophage infiltration and elevation of MMP levels. Circulating levels of calpain-1 may be used as a prognostic marker in the future if further correlation analyses are done.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery; University Hospital Frankfurt, Goethe University, Frankfurt/Main, Germany. isabella.werner@kgu.de.
authors.forename: Isabella
authors.initials: I
authors.lastname: Werner
authors.affiliation: Department of Thoracic and Cardiovascular Surgery; University Hospital Frankfurt, Goethe University, Frankfurt/Main, Germany.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Schack
authors.affiliation: Department of Cardiac Surgery, Kerckhoff Heart and Thoracic Center, Bad Nauheim, Germany.
authors.forename: Manfred
authors.initials: M
authors.lastname: Richter
authors.affiliation: Department of Thoracic and Cardiovascular Surgery; University Hospital Frankfurt, Goethe University, Frankfurt/Main, Germany.
authors.forename: Ulrich A
authors.initials: UA
authors.lastname: Stock
authors.affiliation: Department of Thoracic and Cardiovascular Surgery; University Hospital Frankfurt, Goethe University, Frankfurt/Main, Germany.
authors.forename: Ali El-Sayed
authors.initials: Ael-S
authors.lastname: Ahmad
authors.affiliation: Department of Thoracic and Cardiovascular Surgery; University Hospital Frankfurt, Goethe University, Frankfurt/Main, Germany.
authors.forename: Anton
authors.initials: A
authors.lastname: Moritz
authors.affiliation: Department of Thoracic and Cardiovascular Surgery; University Hospital Frankfurt, Goethe University, Frankfurt/Main, Germany.
authors.forename: Andres
authors.initials: A
authors.lastname: Beiras-Fernandez
mesh_terms: D000368:Aged; D001011:Aorta / Q000378:metabolism; D001014:Aortic Aneurysm / Q000378:metabolism*; D002135:Calcium-Binding Proteins / Q000032:analysis / Q000378:metabolism*; D002154:Calpain / Q000032:analysis / Q000378:metabolism*; D004549:Elastin / Q000032:analysis / Q000378:metabolism; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D045726:Metalloproteases / Q000032:analysis / Q000378:metabolism; D008875:Middle Aged; D016133:Polymerase Chain Reaction
chemical_list: D002135:Calcium-Binding Proteins; C033668:calpastatin; D004549:Elastin; D045726:Metalloproteases; D002154:Calpain; C484806:CAPN1 protein, human; C569870:CAPN2 protein, human