JVS - Vascular Science (Jan 2022)

Proteomic analysis of descending thoracic aorta identifies unique and universal signatures of aneurysm and dissection

  • Louis Saddic, MD, PhD,
  • Amanda Orosco, BS,
  • Dongchuan Guo, PhD,
  • Dianna M. Milewicz, MD, PhD,
  • Dana Troxlair, MD,
  • Richard Vander Heide, MD,
  • David Herrington, MD,
  • Yue Wang, PhD,
  • Ali Azizzadeh, MD,
  • Sarah J. Parker, PhD

Journal volume & issue
Vol. 3
pp. 85 – 181

Abstract

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Objective: Very few clinical predictors of descending thoracic aorta dissection have been determined. Although aneurysms can dissect in a size-dependent process, most descending dissections will occur without prior enlargement. We compared the proteomic profiles of normal, dissected, aneurysm, and both aneurysm and dissected descending thoracic aortas to identify novel biomarkers and further understand the molecular pathways that lead to tissue at risk of dissection. Methods: We performed proteomic profiling of descending thoracic aortas with four phenotypes: normal (n = 46), aneurysm (n = 22), dissected (n = 12), and combined aneurysm and dissection (n = 8). Pairwise differential protein expression analyses using a Bayesian approach were then performed to identify common proteins that were dysregulated between each diseased tissue type and control aorta and to uncover unique proteins between aneurysmal and dissected aortas. Network and Markov cluster algorithms of differentially expressed proteins were used to find enriched ontology processes. A convex analysis of mixtures was also performed to identify the molecular subtypes within the different tissue types. Results: The diseased aortas had 71 common differentially expressed proteins compared with the control, including higher amounts of the protein thrombospondin 1. We found 42 differentially expressed proteins between the aneurysm and dissected tissue, with an abundance of apolipoproteins in the former and higher quantities of extracellular matrix proteins in the latter. The convex analysis of mixtures showed enhancement of a molecular subtype enriched in contractile proteins within the control tissue compared with the diseased tissue, in addition to increased proportions of molecular subtypes enriched in inflammation and red blood cell expression in the aneurysmal compared with the dissected tissue. Conclusions: We found some overlapping differentially expressed proteins in aneurysmal and nonaneurysmal descending thoracic aortas at risk of dissection compared with normal aortas. However, we also found uniquely altered molecular pathways that might uncover mechanisms for dissection. : Clinical Relevance: Diseases of the descending thoracic aorta such as aneurysms and dissections carry a high degree of morbidity and mortality. At present, a complete understanding is still lacking of the genetics that drive these diseases and why some aortic segments dissect in the presence or absence of an aneurysm. We compared and contrasted the whole proteome expression of descending aortas from patients with normal, dissected, aneurysmal, and aneurysmal with dissected pathology aortic tissue. We uncovered potential tissue markers that might serve as future targets for therapy or predictors of disease progression.

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