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1. Pyo R., et al. Targeted disruption of MMP-9 (gelatinase B)
suppresses the development of experimental AAA. J. Clin. Invest.
2000; 105:1641-1649.
Abstract (abridged from authors): MMP-9 and MMP-12 have been
implicated in AAA, but it is not known if either is necessary in
AAA degeneration. This study approached this question by
performing the well-characterized elastase infusion model in mice
with targeted gene disruption of MMP-9 and MMP-12. AAA
degeneration was suppressed in the MMP-9 knockout mice; but not in
the MMP-12 knockout.
Comment by mdt: *Very nice* work by the Washington University (St.
Louis) group under the leadership of Robert W. Thompson. We
nominated MMP-9 as what I called "The Killer Elastase" many years
ago, and now Thompson et al have proven it.
2. Blanchard JF, Haroutune KA, Friesen PP. Risk factors for AAA:
Results of a case-control study. Am J Epidemiol 2000: 151: 575-83.
Ninety-eight newly diagnosed cases of AAA were compared with 102
non-AAA controls. The authors show that smoking is the highest
ranking risk-odds factor, in a dose-associated manner, rising to
9.9 OR for smokers with 50 or more pack years. Other significant
OR's were 1) male gender, 2.68; 2) family history; 4.77; and
diastolic BP, OR per 10 mmHg = 1.88. Diabetes was inversely
associated with risk. Neither clinical hypercholesterolemia nor
serum levels of total cholesterol, LDL, and HDL cholesterol was
associated with AAA. "The results of this study suggest that the
risk factors for AAA differ from those of atherosclerosis and that
atherosclerosis per se is not an adequate explanation as the cause
of AAAs."
comment by mdt: Thank you, Dr. Blanchard, I couldn't have said it
better myself.
3. Brunelli T, et al. High prevalence of mild hyperhomocysteinemia
in patients with AAA. J Vasc Surg 2000; 32: 531-6.
Summary (brief): The authors present data that is statistically
impressive (p < .0001) that 58 consecutive male patients with AAA
had higher plasma homocysteine levels that 60 age and sex-matched
controls. The authors also showed:
AAA CON
Diabetes mellitus 12% -
Hypercholesterolemia 45% 3%
Hypertriglyceridemia 24% 5%
comment by mdt: Well, maybe atherosclerosis does cause AAA in some
parts of the world. Hey, Dr. Blanchard, do you still have the
blood samples to check homocystein levels in North Americans?