Stuttgart – Aortic aneurysms can lead to dissections with devastating internal hemorrhage and high rates of death. In a review article recently published in AORTA (Thieme Publishers, New York. 2018), researchers describe the key role played by epigenetics in ascending thoracic aortic aneurysm and dissection. Knowledge of these mechanisms may result in new tools for better diagnosis and treatment of these severe conditions.
Progressive widening of the thoracic aorta is known as thoracic aortic aneurysm (TAA). This is a potentially life-threatening condition that puts patients at risk of ascending aortic dissection (AAD) or rupture, which causes internal hemorrhage that can quickly lead to death. However, most aneurysms are painless and do not cause any symptoms, so patients do not know that they are at risk. The condition is usually only diagnosed when aortic dissection occurs.
Several genetic disorders are associated with thoracic aortic aneurysm and dissection, but in many cases, there is no known genetic cause. However, epigenetic modifications, which do not change the DNA sequence itself, may also trigger or contribute to aneurysms and dissections.
Adeline Boileau from the Cardiovascular Research Unit, Luxembourg Institute of Health and her co-authors are convinced, that a better understanding of the epigenetic mechanisms at play could lead to earlier diagnosis of thoracic aortic aneurysms and prevent dissection. They found that several lines of evidence strongly support a causative role of epigenetic regulation of gene expression. Noncoding RNAs from the diseased wall of the aorta, for example, may provide information about its stability or susceptibility to rupture. Since RNAs are present in blood, noncoding RNAs could possibly be used as biomarkers of thoracic aortic aneurysm and dissection.
Since epigenetic changes can be modulated, this may lead to novel tools for identifying patients at risk and targeted treatment of these severe conditions, that cause thousands of deaths annually.
Adeline Boileau et al.:
Epigenetics in Ascending Thoracic Aortic Aneurysm and Dissection
AORTA 2018; 6; Page 1–12.
AORTA – Official Journal of the Aortic Institute at Yale-New Haven Hospital is devoted to diseases of the aorta, both thoracic and abdominal with both occlusive and aneurysm disease being covered.
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