Editors' ChoiceAORTIC DISEASE

An Aneurysm Model to Help Predict the Unpredictable.

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Science Translational Medicine  30 Oct 2013:
Vol. 5, Issue 209, pp. 209ec176
DOI: 10.1126/scitranslmed.3007771

Aneurysms are like soap bubbles or balloons in that they may burst at any given time. Yet, whereas a child will probably cry as a consequence of losing a balloon, an adult may die in a matter of seconds when an aneurysm bursts. The biggest problem is that most thoracic aortic aneurysms (TAAs) are asymptomatic and are only diagnosed by accident on imaging studies prescribed for entirely different reasons. If left untreated, approximately one-third of patients with a TAA larger than 5 cm in diameter will die within 5 years from a rupture or dissection. The severity of this condition warrants a search for new methods of cost-effective and accurate diagnosis and new therapeutic approaches linked to a better understanding of the mechanisms of this disease.

Eckhouse et al. have now described a porcine model that holds the potential to satisfy both needs. To induce TAA formation, the authors combined collagenase 2 digestion of the adventitial layer of the descending thoracic aorta with local delivery of calcium chloride to the extraluminal space. After 3 weeks, the area of the aortic lumen in the treated region doubled compared with that of control animals. All the key architectural, cellular, and molecular components of the aortic wall—meticulously analyzed by means of histological, immunohistochemical, and immunoblotting techniques—closely matched the characteristics of clinical TAA disease.

This model may serve to further elucidate the mechanisms mediating aneurysm formation and progression, to reduce the uncertainty revolving around aneurysmal rupture, and to accelerate translation of novel diagnostic and therapeutic alternatives. With additional work in this model, thoracic aortic aneurysms may not need to be compared to bursting balloons or ticking time bombs for much longer.

S. R. Eckhouse et al., Reproducible porcine model of thoracic aortic aneurysm. Circulation 128, S186–S193 (2013). [Abstract]

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