HISTOLOGY AND HISTOPATHOLOGY

From Cell Biology to Tissue Engineering

 

The role of extracellular and intracellular proteolytic systems in aneurysms of the ascending aorta

Isabella Werner1, Stephanie Schack1, Manfred Richter2, Ulrich A. Stock1, Ali El-Sayed Ahmad1, Anton Moritz1 and Andres Beiras-Fernandez1

1Department of Thoracic and Cardiovascular Surgery, University Hospital Frankfurt, Goethe University, Frankfurt/Main and 2Department of Cardiac Surgery, Kerckhoff Heart and Thoracic Center, Bad Nauheim, Germany

Offprint requests to: Dr. Isabella Werner, Department of Thoracic and Cardiovascular Surgery, University Hospital Frankfurt, Goethe University, Theodor Stern Kai 7, 60590 Frankfurt am Main, Germany. e-mail: Isabella.Werner@kgu.de


Summary. 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. Histol Histopathol 31, 523-534 (2016)

Key words: Calpain, Calpastatin, MMP, Aortic aneurysm, Elastin

DOI: 10.14670/HH-11-691