Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Elastin Degradation and Collagen III Deficiency in the Superficial Temporal Arteries of Patients with Intracranial Aneurysms

  • Hwang, Chul-Yoon (Department of Neurosurgery, Dong-A University College of Medicine) ;
  • Roh, Mi-Suk (Department of Pathology, Dong-A University College of Medicine) ;
  • Huh, Jae-Taeck (Department of Neurosurgery, Dong-A University College of Medicine)
  • Published : 2007.07.30
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Abstract

Objective : We present the difference of histopathologic changes of the internal elastic lamina (IEL) and collagen III in the superficial temporal artery (STA) between aneurysmal patients and non-aneurysmal patients. Also, the pathologic data with clinical features by comparative methods to validate the risk factor of the intracranial aneurysm are presented. Methods : Samples of the STA were harvested form 38 patients including aneurysmal and non-aneurysmal patients undergoing craniotomy. Paraffin-embedded sections were examined, using hematoxylin and eosin, van Giebson and mouse anti-collagen III staining techniques. Histopathological observations were ana lysed and correlated with clinical features such as presence of aneurysm, hypertension, age, and sex. Results : Twenty-seven patients had the intracranial aneurysm. Of these 24 patients were 50 years old or older. Nineteen patients had a history of hypertension. Twenty patients were female. Histopathological study demostrated the derangement of IEL and the deficiency of type III collagen were prominent in aneurysmal patients (p < 0.05). Fifty years old or older patients did not show correlation with the deficiency of type III collagen, but with the derangement of IEL (p < 0.05). The female sex was not correlated with the derangement of IEL but with the deficiency of type III collagen (p < 0.05). However, Hypertension was not correlated with these pathologic data. Conclusion : Patients with intracranial aneurysms have severe histopathologic changes of the arterial wall showing the derangement of IEL and the deficiency of type III collagen. In the clinico-pathologic study, the advanced age and female sex were considered as risk factors of the intracranial aneurysm.

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References

  1. Brincat M, Moniz CF, Studd JW, Darby AJ, Magos A, Cooper D : Sex hormones and skin collagen content in postmenopausal women. Br Med J 287 : 1337-1338, 1983 https://doi.org/10.1136/bmj.287.6402.1337
  2. Broderick JP, Viscoli CM, Brott T, Kernan WN, Brass LM, Feldmann E, et al : Major risk factors for aneurysmal subarachnoid hemorrhage in the young are modifiable. Stroke 34 : 1375-1381, 2003 https://doi.org/10.1161/01.STR.0000074572.91827.F4
  3. Carmichael R : Gross defects in the muscular and elastic coats of the larger cerebral arteries. J Pathol Bacteriol 57 : 345-351, 1945 https://doi.org/10.1002/path.1700570308
  4. Connolly ES Jr, Fiore AJ, Winfree CJ, Prestigiacoma CJ, Goldman JE, Solomon RA : Elastin degradation in the superficial temporal arteries of patients with intracranial aneurysms reflects changes in plasma elastase. Neurosurgery 40 : 903-909, 1997 https://doi.org/10.1097/00006123-199705000-00003
  5. Dwyer GN, Barlett JR, Nicholls AC, Narcisi P, Pope FM : Collagen deficiency and ruptured cerebral aneurysm : A clinical and biochemical study. J Neurosurg 59 : 16-20, 1983 https://doi.org/10.3171/jns.1983.59.1.0016
  6. Fujimoto K : 'Medial defects' in the prenatal human cerebral arteries : an electron microscopic study. Stroke 27 : 706-708, 1996 https://doi.org/10.1161/01.STR.27.4.706
  7. Gaetani P, Tartara F, Tancioni F, Klersy C, Forlino A, Baena RR : Activity of alpha 1-antitrypsin and cigarette smoking in subarachnoid haemorrhage from ruptured aneurysm. J Neurol Sci 141 : 33-38, 1996 https://doi.org/10.1016/0022-510X(96)00132-3
  8. Graham DI, Lantos PL : Greenfield's neuropathology. London : Arnold, 2002, pp281-819
  9. Gu YX, Chen XC, Song DL, Leng B, Zhao F : Risk factors for intracranial aneurysm in a Chinese ethnic population. Chin Med J 119 : 1359-1364, 2006
  10. Inagawa T : Risk factors for aneurysmal subarachnoid hemorrhage in patients in Izumo City, Japan. J Neurosurg 102 : 60-67, 2005 https://doi.org/10.3171/jns.2005.102.1.0060
  11. Juvela S, Hillbom M, Numminen H, Koskinen P : Cigarette smoking and alcohol consumption as risk factors for aneurysmal subarachnoid hemorrhage. Stroke 24 : 639-646, 1993 https://doi.org/10.1161/01.STR.24.5.639
  12. Juvela S, Poussa K, Porras M : Factors affecting formation and growth of intracranial aneurysms : a long-term follow-up study. Stroke 32 : 485-491, 2001 https://doi.org/10.1161/01.STR.32.2.485
  13. Kassam AB, Horowitz M, Chang YF, Peters D : Altered arterial homeostasis and cerebral aneurysms : a molecular epidemiology study. Neurosurgery 54 : 1450-1462, 2004 https://doi.org/10.1227/01.NEU.0000125005.67850.F8
  14. Kataoka K, Taneda M, Asai T, Kinoshita A, Ito M, Kuroda R : Structural fragility and inflammatory response of ruptured cerebral aneurysms. A comparative study between ruptured and unruptured cerebral aneurysms. Stroke 30 : 1396-1401, 1999 https://doi.org/10.1161/01.STR.30.7.1396
  15. Kongable GL, Lanzino G, Germanson TP, Truskowski LL, Alves WM, Torner JC, et al : Gender-related differences in aneurysmal subarachnoid hemorrhage. J Neurosurg 84 : 43-48, 1996 https://doi.org/10.3171/jns.1996.84.1.0043
  16. Leppala JM, Virtamo J, Fogelholm R, Albanes D, Heinonen OP : Different risk factors for different stroke subtypes : association of blood pressure, cholesterol, and antioxidants. Stroke 30 : 2535- 2540, 1999 https://doi.org/10.1161/01.STR.30.12.2535
  17. Longstreth WT Jr, Nelson LM, Koepsell TD, van Belle G : Cigarette smoking, alcohol use, and subarachnoid hemorrhage. Stroke 23 : 1242- 1249, 1992 https://doi.org/10.1161/01.STR.23.9.1242
  18. Majamaa K, Savolainen ER, Myllyla VV : Synthesis of structurally unstable type III procollagen in patients with cerebral artery aneurysm. Biochim Biophys Acta 1138 : 191-196, 1992 https://doi.org/10.1016/0925-4439(92)90037-N
  19. Mhurchu CN, Anderson C, Jamrozik K, Hankey G, Dunbabin D : Hormonal factors and risk of aneurysmal subarachnoid hemorrhage : an international population-based, case-control study. Stroke 32 : 606-612, 2001 https://doi.org/10.1161/01.STR.32.3.606
  20. Mimata C, Kitaoka M, Nagahiro S, Iyama K, Hori H, Yoshioka H, et al : Differential distribution and expressions of collagens in the cerebral aneurysmal wall. Acta Neuropathol 94 : 197-206, 1997 https://doi.org/10.1007/s004010050694
  21. Miskolczi L, Guterman LR, Flaherty JD, Hopkins LN : Saccular aneurysm induction by elastase digestion of the arterial wall : a new animal model. Neurosurgery 43 : 595-601, 1998 https://doi.org/10.1097/00006123-199809000-00110
  22. Mizutani T, Kojima H, Miki Y : Arterial dissections of penetrating cerebral arteries causing hypertension-induced cerebral hemorrhage. J Neurosurg 5 : 859-862, 2000
  23. Ostergaard JR, Oxlund H : Collagen type III deficiency in patients with rupture of intracranial saccular aneurysms. J Neurosurg 67 : 690-696, 1987 https://doi.org/10.3171/jns.1987.67.5.0690
  24. Pope FM, Nicholls AC, Narcisi P, Bartlett J, Neil-Dwyer G, Doshi B : Some patients with cerebral aneurysms are deficient in type III collagen. Lancet 1 : 973-975, 1981
  25. Qureshi AI, Suarez JI, Parekh PD, Sung G, Geocadin R, Bhardwaj A, et al : Risk factors for multiple intracranial aneurysms. Neurosurgery 43 : 22-27, 1998 https://doi.org/10.1097/00006123-199807000-00013
  26. Qureshi AI, Sung GY, Suri MF, Straw RN, Guterman LR, Hopkins LN : Factors associated with aneurysm size in patients with subarachnoid hemorrhage : effect of smoking and aneurysm location. Neurosurgery 46 : 44-50, 2000 https://doi.org/10.1093/neurosurgery/46.1.44
  27. Ruigrok YM, Rinkel GJ, Wijmenga C : Genetics of intracranial aneurysms : Review. Lancet Neurol 4 : 179-189, 2005 https://doi.org/10.1016/S1474-4422(05)70021-1
  28. Sheffield EA, Weller RO : Age changes at cerebral artery bifurcations and the pathogenesis of berry aneurysms. J Neurol Sci 46 : 341- 352, 1980 https://doi.org/10.1016/0022-510X(80)90059-3
  29. Sukhova GK, Shi GP, Simon DI, Chapman HA, Libby P : Expression of the elastolytic cathepsins S and K in human atheroma and regulation of their production in smooth muscle cells. J Clin Invest 102 : 576- 583, 1998 https://doi.org/10.1172/JCI181
  30. Weller RO : Subarachnoid haemorrhage and myths about saccular aneurysms. J Clin Pathol 48 : 1078-1081, 1995 https://doi.org/10.1136/jcp.48.12.1078
  31. van den Berg JS, Pals G, Arwert F, Hennekam RC, Albrecht KW, Westerveld A, et al : Type III collagen deficiency in saccular intracranial aneurysms. Defect in gene regulation? Stroke 30 : 1628-1631, 1999 https://doi.org/10.1161/01.STR.30.8.1628
  32. Zhang B, Fugleholm K, Day LB, Ye S, Weller RO, Day IN : Molecular pathogenesis of subarachnoid haemorrhage. Int J Biochem Cell Biol 35 : 1341-1360, 2003 https://doi.org/10.1016/S1357-2725(03)00043-8