Irqsusi M, Rodepeter FR, Günther M, Kirschbaum A, Vogt S. Matrix metalloproteinases and their tissue inhibitors as indicators of aortic aneurysm and dissection development in extracellular matrix remodeling. World J Exp Med 2025; 15(2): 100166 [DOI: 10.5493/wjem.v15.i2.100166]
Corresponding Author of This Article
Sebastian Vogt, MD, MSc, Associate Professor, Senior Researcher, Department of Heart Surgery, Philipps-University Marburg, Baldinger Street 1, Marburg 35043, Hesse, Germany. vogts@med.uni-marburg.de
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Exp Med. Jun 20, 2025; 15(2): 100166 Published online Jun 20, 2025. doi: 10.5493/wjem.v15.i2.100166
Matrix metalloproteinases and their tissue inhibitors as indicators of aortic aneurysm and dissection development in extracellular matrix remodeling
Marc Irqsusi, Fiona R Rodepeter, Madeline Günther, Andreas Kirschbaum, Sebastian Vogt
Marc Irqsusi, Department of Heart Surgery, Universitätsklinikum Marburg and Gießen GmbH, Marburg 35043, Hesse, Germany
Fiona R Rodepeter, Institute of Pathology, Philipps-University Marburg, Marburg 35043, Hesse, Germany
Madeline Günther, Department of Heart Surgery, Cardiovascular Research Laboratory, Philipps-University Marburg, Marburg 35043, Hesse, Germany
Andreas Kirschbaum, Department of Visceral Surgery, University Hospital Giessen and Marburg GmbH, Marburg 35043, Hesse, Germany
Sebastian Vogt, Department of Heart Surgery, Philipps-University Marburg, Marburg 35043, Hesse, Germany
Author contributions: Irqsusi M and Vogt S were responsible for hypothesis and designed the manuscript; Irqsusi M, Rodepeter FR and Vogt S were responsible for original and revised draft preparation and visualization; Günther M and Kirschbaum A were responsible for review and revised draft preparation; all authors substantially contributed to the preparation of this article, have read and agreed to the published version of the manuscript.
Conflict-of-interest statement: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sebastian Vogt, MD, MSc, Associate Professor, Senior Researcher, Department of Heart Surgery, Philipps-University Marburg, Baldinger Street 1, Marburg 35043, Hesse, Germany. vogts@med.uni-marburg.de
Received: August 8, 2024 Revised: January 4, 2025 Accepted: January 15, 2025 Published online: June 20, 2025 Processing time: 249 Days and 18.8 Hours
Abstract
Aneurysms and dissections represent some of the most serious cardiovascular diseases. The prevailing theory posits that mechanical overloading of the vessel wall is the underlying cause. Inspired by Barkhordarian et al, the authors present matrix metalloproteinases (MMPs) and their inhibitors in immunohistological analyses as contributing factors in the pathophysiology of aortic aneurysms (AA). Data analysis of MMP-1, MMP-9, tissue inhibitors of metalloproteinases (TIMPs), including TIMP-1 and TIMP-2 expression reveals a varied distribution between the adventitia and media and a non-uniform expression of the investigated markers. These elements, as key components of the extracellular matrix (ECM), indicate that the formation of AA is not solely driven by endoluminal pressure loading of the aortic wall. Instead, degenerative processes within ECM elements contribute significantly. Importantly, AA do not necessarily imply dissection. Tissue destruction, allowing blood flow entry, arises from reduced oxygen supply to the media, primarily due to incomplete capillarization or neocapillarization.
Core Tip: Immunohistological examinations of the aortic wall reveal a different distribution of matrix metalloproteinases (MMPs) and their inhibitors in the aortic wall of aneurysms and dissections. While degenerative changes tend to play a role in aneurysmal changes, dissections are caused by impaired tissue nutrition and oxygenation due to dysfunctional capillarization. The tissue layers of the aorta are subject to specific stresses that lead to different expressions of MMPs and tissue inhibitor of metalloproteinases.
