ABSTRACT

Background: The primary objective of this review was to explore the contribution of oxidative stress to the pathogenesis of genetically-triggered thoracic aortic aneurysm (TAA). Genetically-triggered TAAs manifest substantial variability in onset, progression, and risk of aortic dissection, posing a significant clinical management challenge. There is a need for non-invasive biomarkers that predict the natural course of TAA and therapeutics that prevent aneurysm progression.

Methods: An online systematic search was conducted within PubMed, MEDLINE, Scopus and ScienceDirect databases using keywords including: oxidative stress, ROS, nitrosative stress, genetically triggered thoracic aortic aneurysm, aortic dilatation, aortic dissection, Marfan syndrome, Bicuspid Aortic Valve, familial TAAD, Loeys Dietz syndrome, and Ehlers Danlos syndrome.

Results: There is extensive evidence of oxidative stress and ROS imbalance in genetically triggered TAA. Sources of ROS imbalance are variable but include dysregulation of redox mediators leading to either insufficient ROS removal or increased ROS production. Therapeutic exploitation of redox mediators is being explored in other cardiovascular conditions, with potential application to TAA warranting further investigation.

Conclusion: Oxidative stress occurs in genetically triggered TAA, but the precise contribution of ROS to pathogenesis remains incompletely understood. Further research is required to define causative pathological relationships in order to develop therapeutic options.

摘要

背景：本综述的主要目的是探讨氧化应激对基因触发的胸主动脉瘤 (TAA) 发病机制的影响。遗传触发的 TAA 在主动脉夹层的发病、进展和风险方面表现出很大的差异，对临床管理提出了重大挑战。需要预测 TAA 的自然过程的非侵入性生物标志物和预防动脉瘤进展的治疗方法。

方法：在 PubMed、MEDLINE、Scopus 和 ScienceDirect 数据库中进行在线系统搜索，使用的关键字包括：氧化应激、ROS、亚硝化应激、基因触发的胸主动脉瘤、主动脉扩张、主动脉夹层、马凡综合征、二尖瓣主动脉瓣、家族性 TAAD 、Loeys Dietz 综合征和 Ehlers Danlos 综合征。

结果：有大量证据表明遗传触发的 TAA 中存在氧化应激和 ROS 失衡。ROS 失衡的来源是可变的，但包括氧化还原介质的失调导致 ROS 去除不足或 ROS 产生增加。氧化还原介质的治疗性开发正在其他心血管疾病中进行探索，TAA 的潜在应用值得进一步研究。

结论：氧化应激发生在基因触发的 TAA 中，但 ROS 对发病机制的确切贡献仍不完全清楚。需要进一步的研究来定义致病的病理关系，以便开发治疗方案。