Apolipoproteins B, (a), and E accumulate in the morphologically early lesion of 'degenerative' valvular aortic stenosis
Apolipoproteins B, (a), and E accumulate in the morphologically early lesion of 'degenerative' valvular aortic stenosis
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DOI：
10.1161/01.atv.16.4.523
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发表时间：
1996-04-01
影响因子：
8.7
通讯作者：
Otto, CM
中科院分区：
文献类型：
--
作者：
OBrien, KD;Reichenbach, DD;Otto, CM
非风湿性三叶主动脉瓣狭窄一直被认为是一种“退行性”过程，但主动脉瓣狭窄的早期病变包含慢性炎症细胞、巨噬细胞和T淋巴细胞。由于脂蛋白沉积在动脉粥样硬化（另一种慢性炎症过程）中很突出，因此本研究检查了脂蛋白是否在主动脉瓣病变中积聚。进行免疫组织化学研究以检测 18 个从正常到狭窄的三叶主动脉瓣上的载脂蛋白 (ape) B、apo(a)、apoE、巨噬细胞和 a-肌动蛋白表达细胞。所有三种载脂蛋白均在主动脉瓣狭窄的早期至终末期病变中检测到，但不在组织学正常区域中检测到。与油红 O 染色的比较表明，这些瓣膜中的大部分细胞外中性脂质与血浆衍生的或局部产生的载脂蛋白相关。因此，在早期至末期主动脉瓣病变中，载脂蛋白积累并与大多数细胞外瓣膜脂质相关。这些结果与主动脉瓣中脂蛋白积累导致主动脉瓣狭窄发病机制的假设一致。
Nonrheumatic aortic stenosis of trileaflet aortic valves has been considered to be a ''degenerative'' process, but the early lesion of aortic stenosis contains the chronic inflammatory cells, macrophages and T lymphocytes. Because lipoprotein deposition is prominent in atherosclerosis, another chronic inflammatory process, this study examined whether lipoproteins accumulate in aortic valve lesions. Immunohistochemical studies were performed to detect apolipoprotein (ape) B, apo(a), apoE, macrophages, and a-actin-expressing cells on 18 trileaflet aortic valves that ranged from normal to stenotic. All three apolipoproteins were detected in early through end-stage lesions of aortic stenosis bur not in histologically normal regions. Comparison with oil red O staining suggested that most of the extracellular neutral lipid in these valves was associated with either plasma-derived or locally produced apolipoproteins. Thus, in early through end-stage aortic valve lesions, apolipoproteins accumulate and are associated with the majority of extracellular valve lipid. These results are consistent with the hypothesis that lipoprotein accumulation in the aortic valve contributes to pathogenesis of aortic stenosis.