Insulin Resistance Promotes the Formation of Aortic Dissection by Inducing the Phenotypic Switch of Vascular Smooth Muscle Cells

Zheng, Hui; Qiu, Zhihuang; Chai, Tianci; He, Jian; Zhang, Yuling; Wang, Chaoyun; Ye, Jianqiang; Wu, Xiaohui; Li, Yumei; Zhang, Li

doi:10.3389/fcvm.2021.732122

Cited by 5 publications

(5 citation statements)

References 51 publications

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“…Insulin resistance (IR) or type 2 diabetes mellitus (T2DM) have previously been proven to be independent predictors for a variety of cardiovascular illnesses, but there have been few studies on the link between IR and aortic dissection (AD). Hui Zheng et al found that IR induced a phenotypic shift in VSMCs from contractual to synthetic phenotypes, thereby promoting AD [ 78 ].…”

Section: Cardiovascular Diseases Associated With Vsmcs Phenotypic Swi...mentioning

confidence: 99%

Vascular Smooth Muscle Cells Phenotypic Switching in Cardiovascular Diseases

Tang

Chen

Zhang

et al. 2022

Cells

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Vascular smooth muscle cells (VSMCs), the major cell type in the arterial vessel wall, have a contractile phenotype that maintains the normal vessel structure and function under physiological conditions. In response to stress or vascular injury, contractile VSMCs can switch to a less differentiated state (synthetic phenotype) to acquire the proliferative, migratory, and synthetic capabilities for tissue reparation. Imbalances in VSMCs phenotypic switching can result in a variety of cardiovascular diseases, including atherosclerosis, in-stent restenosis, aortic aneurysms, and vascular calcification. It is very important to identify the molecular mechanisms regulating VSMCs phenotypic switching to prevent and treat cardiovascular diseases with high morbidity and mortality. However, the key molecular mechanisms and signaling pathways participating in VSMCs phenotypic switching have still not been fully elucidated despite long-term efforts by cardiovascular researchers. In this review, we provide an updated summary of the recent studies and systematic knowledge of VSMCs phenotypic switching in atherosclerosis, in-stent restenosis, aortic aneurysms, and vascular calcification, which may help guide future research and provide novel insights into the prevention and treatment of related diseases.

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Section: Cardiovascular Diseases Associated With Vsmcs Phenotypic Swi...mentioning

confidence: 99%

Vascular Smooth Muscle Cells Phenotypic Switching in Cardiovascular Diseases

Tang

Chen

Zhang

et al. 2022

Cells

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“…The enhanced insulin resistance in turn promotes the occurrence of AAD through the induction of phenotypic switch in vascular smooth muscle cells (Zheng et al, 2022), which may explain the increase in the abundance of Prevotella in patient with AAD observed in this study. We calculated the Gini index values for bacterial genera with significant differences between the two groups and adopted the random forest machine learning algorithm to calculate the accuracy of AAD prediction by differential microbiome.…”

Section: Discussionmentioning

confidence: 55%

Changes in the gut microbiome of patients with type a aortic dissection

Jiang

Cai²,

Peng³

et al. 2023

Front. Microbiol.

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ObjectiveTo investigate the characteristic changes in the gut microbiota of patients with type A aortic dissection (AAD) and provide a theoretical basis for future microbiome-oriented interventional studies.MethodsHigh-throughput 16S rDNA sequencing was performed on the stool samples of patients with and without (healthy control subjects) AAD. Using alpha and beta diversity analysis, we compared the gut microbiota composition of 20 patients with AAD and 20 healthy controls matched for gender, age, BMI, and geographical region. The accuracy of AAD prediction by differential microbiome was calculated using the random forest machine learning model. Targeted measurement of the plasma concentration of short-chain fatty acids (SCFAs), which are the main metabolites of the gut microbiome, was performed using gas chromatography–mass spectrometry (GC–MS). Spearman’s correlation analysis was conducted to determine the relationships of gut microbiome and SCFAs with the clinical characteristics of subjects.ResultsThe differences in gut microbiota alpha diversity between patients with AAD and the healthy controls were not statistically significant (Shannon index: p = 0.19; Chao1: p = 0.4); however, the microbiota composition (beta diversity) was significantly different between the two groups (Anosim, p = 0.001). Bacteroidota was enriched at the phylum level, and the SCFA-producing genera Prevotella, Porphyromonas, Lachnospiraceae, and Ruminococcus and inflammation-related genera Fenollaria and Sutterella were enriched at the genus level in the AAD group compared with those in the control group. The random forest model could predict AAD from gut microbiota composition with an accuracy of 87.5% and the area-under-curve (AUC) of the receiver operating characteristic curve was 0.833. The SCFA content of patients with AAD was higher than that of the control group, with the difference being statistically significant (p < 0.05). The different microflora and SCFAs were positively correlated with inflammatory cytokines.ConclusionTo the best of our knowledge, this is the first demonstration of the presence of significant differences in the gut microbiome of patients with AAD and healthy controls. The differential microbiome exhibited high predictive potential toward AAD and was positively correlated with inflammatory cytokines. Our results will assist in the development of preventive and therapeutic treatment methods for patients with AAD.

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“…A recent study by Zheng et al [ 7 ] showed that insulin resistance induces the phenotypic switching of vascular smooth muscle cells from contractile to synthetic, which contributes to the occurrence of TAAD.…”

Section: Discussionmentioning

confidence: 99%

“…However, it seems to be inversely related to the aortic aneurysm’s rupture. For some authors, insulin resistance plays a causal factor in dissection by affecting nutrient metabolism and the release of inflammatory cytokines [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Diabetes is not a negative prognostic factor for 30-days mortality after surgery for acute type A aortic dissection

Lorenz,

Muzzi,

Neri

2024

Cardiovascular Endocrinology &Amp; Metabolism

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Background The correlation between diabetes and aortic dissection is not fully understood yet, although in literature many studies have suggested that there may be an association between the two conditions. The purpose of this study is to evaluate whether diabetes represents a short- and long-term risk factor for mortality from type A acute aortic dissection. Materials and methods A total of 340 patients with the diagnosis of type A acute aortic dissection underwent aortic surgery between January 2002 and March 2023. The sample was divided into 2 cohorts according to the presence of diabetes (n = 34) or not (n = 306). Results The mean age was 66 (±12.4) years and 60.9% were male. The primary endpoint was 30-day mortality. Hospital mortality was 12 (35.3%) for the diabetes group and 70 (22.9%) for nondiabetes group (P = 0.098). Overall survival at 10 years was 48.3% [95% confidence interval (CI): 41.6–54.7%], while the 10-year survival for people with diabetes was 29.5% (95% CI: 13.2–47.9%) and for nondiabetes group 50.6% (95% CI: 43.4–57.3%) (Log-rank, P = 0.024). Conclusion Diabetes was not found to be a risk factor associated with 30-day mortality in patients undergoing surgery for type A acute aortic dissection. It was a risk factor for long-term survival, but this may be related to diabetes complications.

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Insulin Resistance Promotes the Formation of Aortic Dissection by Inducing the Phenotypic Switch of Vascular Smooth Muscle Cells

Cited by 5 publications

References 51 publications

Vascular Smooth Muscle Cells Phenotypic Switching in Cardiovascular Diseases

Vascular Smooth Muscle Cells Phenotypic Switching in Cardiovascular Diseases

Changes in the gut microbiome of patients with type a aortic dissection

Diabetes is not a negative prognostic factor for 30-days mortality after surgery for acute type A aortic dissection

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