Aortic aneurysms: current pathogenesis and therapeutic targets

Abstract

Aortic aneurysm is a chronic disease characterized by localized expansion of the aorta, including the ascending aorta, arch, descending aorta, and abdominal aorta. Although aortic aneurysms are generally asymptomatic, they can threaten human health by sudden death due to aortic rupture. Aortic aneurysms are estimated to lead to 150,000 ~ 200,000 deaths per year worldwide. Currently, there are no effective drugs to prevent the growth or rupture of aortic aneurysms; surgical repair or endovascular repair is the only option for treating this condition. The pathogenic mechanisms and therapeutic targets for aortic aneurysms have been examined over the past decade; however, there are unknown pathogenic mechanisms involved in cellular heterogeneity and plasticity, the complexity of the transforming growth factor-β signaling pathway, inflammation, cell death, intramural neovascularization, and intercellular communication. This review summarizes the latest research findings and current pathogenic mechanisms of aortic aneurysms, which may enhance our understanding of aortic aneurysms.

New Insights into Complex Pathologies of Aortic Aneurysms

Aortic aneurysms, a chronic aortic disease, can lead to life-threatening consequences. Recent advancements in understanding the pathophysiological mechanisms of aortic aneurysms have focused on the source of therapeutic targets. The heterogeneity of aortic cells during the progress of an aortic aneurysm is augmented by the alteration of gene expression that changes the phenotype and function of the aortic cells. Inflammatory cells, cytokines production, matrix metalloproteinases, smooth muscle cells phenotypic switching, SMCs death, neovascularization, and thrombosis contribute to the development and progression of aortic aneurysms. Neutralization of transforming growth factor-β in mouse aortic aneurysm models exhibits different consequences in the progress of aortic aneurysms depending on experimental designs. Extracellular vesicles contain various contents with biological activity and are released from donor cells to target cells or organs, potentially promoting or preventing the progress of aortic aneurysms.

This summary was initially drafted using artificial intelligence, then revised and fact-checked by the author.