The role of vascular smooth muscle cells in the development of aortic aneurysms and dissections. (21st November 2021)

• Record Type: Journal Article
• Authors: Rombouts, Karlijn B.; van Merrienboer, Tara A. R.; Ket, Johannes C. F.; Bogunovic, Natalija; van der Velden, Jolanda; Yeung, Kak Khee
• Is Part Of: European journal of clinical investigation. Volume 52:Number 4(2022)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2021-11-21
• Subjects: aortic aneurysm -- aortic dissection -- pathophysiology -- vascular biology -- vascular smooth muscle cell; Pathology -- Periodicals; Medical research -- Periodicals; 616.075
• DOI: 10.1111/eci.13697
• Languages: English
• ISSNs: 0014-2972

Abstract

Abstract: Background: Aortic aneurysms (AA) are pathological dilations of the aorta, associated with an overall mortality rate up to 90% in case of rupture. In addition to dilation, the aortic layers can separate by a tear within the layers, defined as aortic dissections (AD). Vascular smooth muscle cells (vSMC) are the predominant cell type within the aortic wall and dysregulation of vSMC functions contributes to AA and AD development and progression. However, since the exact underlying mechanism is poorly understood, finding potential therapeutic targets for AA and AD is challenging and surgery remains the only treatment option. Methods: In this review, we summarize current knowledge about vSMC functions within the aortic wall and give an overview of how vSMC functions are altered in AA and AD pathogenesis, organized per anatomical location (abdominal or thoracic aorta). Results: Important functions of vSMC in healthy or diseased conditions are apoptosis, phenotypic switch, extracellular matrix regeneration and degradation, proliferation and contractility. Stressors within the aortic wall, including inflammatory cell infiltration and (epi)genetic changes, modulate vSMC functions and cause disturbance of processes within vSMC, such as changes in TGF‐β signalling and regulatory RNA expression. Conclusion: This review underscores a central role of vSMC dysfunction in abdominal and thoracic AA and AD development and progression. Further research focused on vSMC dysfunction in the aortic wall is necessary to find potential targets for noninvasive AA and AD treatment options.