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Volume 37, Issue 5 , Pages 531-537 , May 2009

New Insight in Aetiopathogenesis of Aortic Diseases

E. Allaire
- Surgical Research Center, Paris 12 University, CNRS EAC 7054, 8 rue du Général Sarrail, 94010 Créteil Cedex, France
- Department of Vascular Surgery, Henri Mondor Hospital, Assistance Publique–Hôpitaux de Paris, 51 Avenue du Maréchal de, Lattre de Tassigny, 94010 Créteil, France
- Corresponding author at: Eric Allaire, Department of Vascular Surgery, Henri Mondor Hospital, 51 avenue du Maréchal de, Lattre de Tassigny, 94010 Créteil, France. Tel.: +33 1 49 81 44 20; fax: +33 1 49 81 24 35.
F. Schneider
- Surgical Research Center, Paris 12 University, CNRS EAC 7054, 8 rue du Général Sarrail, 94010 Créteil Cedex, France
- Department of Vascular Surgery, Henri Mondor Hospital, Assistance Publique–Hôpitaux de Paris, 51 Avenue du Maréchal de, Lattre de Tassigny, 94010 Créteil, France
F. Saucy
- Surgical Research Center, Paris 12 University, CNRS EAC 7054, 8 rue du Général Sarrail, 94010 Créteil Cedex, France
- Department of Vascular and Thoracic Surgery, Centre Hospitalier Universitaire Vaudois, Rue du Bugnon 46, 1011 Lausanne-CHUV, Switzerland
J. Dai
- Surgical Research Center, Paris 12 University, CNRS EAC 7054, 8 rue du Général Sarrail, 94010 Créteil Cedex, France
F. Cochennec
- Surgical Research Center, Paris 12 University, CNRS EAC 7054, 8 rue du Général Sarrail, 94010 Créteil Cedex, France
- Department of Vascular Surgery, Henri Mondor Hospital, Assistance Publique–Hôpitaux de Paris, 51 Avenue du Maréchal de, Lattre de Tassigny, 94010 Créteil, France
S. Michineau
- Surgical Research Center, Paris 12 University, CNRS EAC 7054, 8 rue du Général Sarrail, 94010 Créteil Cedex, France
M. Zidi
- Surgical Research Center, Paris 12 University, CNRS EAC 7054, 8 rue du Général Sarrail, 94010 Créteil Cedex, France
J.-P. Becquemin
- Surgical Research Center, Paris 12 University, CNRS EAC 7054, 8 rue du Général Sarrail, 94010 Créteil Cedex, France
- Department of Vascular Surgery, Henri Mondor Hospital, Assistance Publique–Hôpitaux de Paris, 51 Avenue du Maréchal de, Lattre de Tassigny, 94010 Créteil, France
M. Kirsch
- Surgical Research Center, Paris 12 University, CNRS EAC 7054, 8 rue du Général Sarrail, 94010 Créteil Cedex, France
- Department of Cardiac and Thoracic Surgery, Hôpital Henri Mondor, 51 Avenue du Maréchal de Lattre de Tassigny, Créteil, France
M. Gervais
- Surgical Research Center, Paris 12 University, CNRS EAC 7054, 8 rue du Général Sarrail, 94010 Créteil Cedex, France

Received 4 February 2009 ,Accepted 4 February 2009.

Proposed mechanisms for destruction and reconstruction in the aortic wall. Different sources of proteases. (1) The interplay between lymphocytes and macrophages regulates production of proteases (P).

Proposed mechanisms for destruction and reconstruction in the aortic wall. Different sources of proteases. (1) The interplay between lymphocytes and macrophages regulates production of proteases (P). (2) Neutrophils adsorbed at the surface of the luminal thrombus liberate proteases which diffuse centrifugally to the aneurysmal wall, causing ECM destruction and VSMC death (anoïkis). (3) Angiogenesis in the adventitia, spreading to the media, causes influx of leukocytes and concentrates proteases. Fibroblasts in the adventitia may also produce proteases. The three mechanisms may not be active simultaneously in a same type of lesion at the same time of its evolution. (4) VSMCs in the media produce inhibitors of proteases, and TGF-beta1 which, under particular circumstances, triggers ECM production and down-regulates inflammation. (5) Fibroblasts in the adventitia produce ECM.
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