Patterns of expression of fibrinolytic genes and matrix metalloproteinase-9 in dissecting aortic aneurysms

Jacob Schneiderman, Gerald M. Bordin, Raphael Adar, Aram Smolinsky, Dietmar Seiffert, Isaac Engelberg, Ralph B. Dilley, Terri Thinnes, David J. Loskutoff*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

37 Scopus citations


Although extensive tissue remodeling occurs during the various phases of aortic dissection, the underlying proteinases remain to be identified. Matrix metalloproteinase-9 (MMP-9) and components of the fibrinolytic system have been implicated in numerous tissue remodeling events and were therefore analyzed in surgical specimens of acute (n = 9), subacute (n = 4), and chronic (n = 7) aortic dissection by in situ hybridization. In the acute phase, intense plasminogen activator inhibitor 1 (PAI-l) gene expression was apparent in areas interfacing the dissecting hematoma, but no tissue-type PA (t-PA), urokinase-type PA (u-PA), or MMP-9 mRNAs were detected. Although PAI- 1 mRNA was still present in the subacute phase, t-PA, u-PA, and MMP-9 mRNAs were now obvious, with PA gene expression co-localizing with areas of PAI-1 gene expression. In the chronic phase, PAI-1 mRNA was demonstrated around erythrocyte extravasations and surrounding bands of medial degeneration. However, there was little expression of PAs in these areas, and no MMP-9 was detected. Thus, fibrinolytic genes and MMP-9 are differentially expressed during the progression of aortic dissections. The kinetics of expression are consistent with acute fibrinolytic shutdown in response to the initial injury, a secondary subacute phase with active proteolysis, and finally, a chronic hypofibrinolytic state. Extensive neovascularization in the chronic phase may further reduce the physical stability of the dissected wall.

Original languageEnglish
Pages (from-to)703-710
Number of pages8
JournalAmerican Journal of Pathology
Issue number3
StatePublished - Mar 1998


FundersFunder number
National Heart, Lung, and Blood InstituteP01HL048728


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