Objective To investigate the expression and significance of C/EBP-Homologous protein (CHOP)
and active transcription factor 4 (ATF4) in aortic dissection. Methods Patients who were diagnosed as Stanford type
I with a parallel thoracic aortic dissection from March 2017 to April 2018 were enrolled in the AD group (n=13),
and 5 patients were admitted for heart transplantation. The patients were treated as donors (these 5 patients had no
macrovascular disease, and the aortic vessels removed during heart transplantation were used as relatively normal
aortic vascular tissue). The aortic vascular structure changes were studied by mason staining and resorcinol staining.
The sharp muscle cells after aortic dissection were confirmed by TUNEL staining. ATF4 was detected by RT-PCR
and Western-blot at mRNA and protein levels, respectively. And changes in CHOP. In animal experiments, 20 SD
rats were randomly divided into control group: control group (n=10) and AD group (n=10). Rats in the control group
were given feed, and rats in the AD group were given a 0.3% beta-isopropylaminoglycolate (B APN)-maintained
feed for aortic dissection animal model establishment. After the animal model was successfully constructed, the rat
aortic tissue was implanted for paraffin embedding, and the post-slice treatment steps and detection indexes were
the same as the human specimens. Results In human specimens, Masson staining and resorcinol staining showed
that the collagen deposition in the aortic vascular specimens of the AD group was significantly higher than that of the
Donor group, and the degree of elastic fiber rupture was also more serious. TUNEL apoptosis staining revealed that
the aorta vessels of the AD group were aortic. The apoptosis of the normal vascular tissue was significantly higher
than that in the Donor group (P<0.01). RT-PCR and Western-blot experiments showed that the expression of ATF4
and CHOP in the aortic vessels of the AD group was at the RNA level and protein. The water level was significantly
higher than that of the normal aorta in the Donor group, and the difference was statistically significant (P<0.05). In
animal experiments, Masson staining showed that the aortic vessels of the AD group were significantly increased
compared with the control group. The resorcinol staining showed that the aortic vessels of the AD group were
significantly more severe than the control group. Basic non-elastic fiber rupture; TUNEL apoptosis staining showed
that the apoptosis of aortic vessels in AD group was significantly higher than that in Control group, the difference
was statistically significant (P<0.05). RT-PCR and Western-blot experiments also found that the expression of
ATF4 and CHOP in the aortic vessels of the AD group was significantly higher than that of the Control group (P<0.05).
Conclusion CHOP and ATF4 are closely related to endoplasmic reticulum stress. CHOP and ATF4 are significantly
elevated in human aortic dissection specimens and aortic dissection animal models, indicating higher endoplasmic
reticulum stress levels in the aortic dissection. It may be one of the important causes of apoptosis of aortic vascular
smooth muscle cells, and to some extent participate in the occurrence and development of aortic dissection.
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 程宝山,王爱玲. 脉压差与急性主动脉夹层院内预后关系的研究
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