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Publication : Phospholipid membranes drive abdominal aortic aneurysm development through stimulating coagulation factor activity.

First Author  Allen-Redpath K Year  2019
Journal  Proc Natl Acad Sci U S A Volume  116
Issue  16 Pages  8038-8047
PubMed ID  30944221 Mgi Jnum  J:273825
Mgi Id  MGI:6294549 Doi  10.1073/pnas.1814409116
Citation  Allen-Redpath K, et al. (2019) Phospholipid membranes drive abdominal aortic aneurysm development through stimulating coagulation factor activity. Proc Natl Acad Sci U S A 116(16):8038-8047
abstractText  Abdominal aortic aneurysm (AAA) is an inflammatory vascular disease with high mortality and limited treatment options. How blood lipids regulate AAA development is unknown. Here lipidomics and genetic models demonstrate a central role for procoagulant enzymatically oxidized phospholipids (eoxPL) in regulating AAA. Specifically, through activating coagulation, eoxPL either promoted or inhibited AAA depending on tissue localization. Ang II administration to ApoE (-/-) mice increased intravascular coagulation during AAA development. Lipidomics revealed large numbers of eoxPL formed within mouse and human AAA lesions. Deletion of eoxPL-generating enzymes (Alox12 or Alox15) or administration of the factor Xa inhibitor rivaroxaban significantly reduced AAA. Alox-deficient mice displayed constitutively dysregulated hemostasis, including a consumptive coagulopathy, characterized by compensatory increase in prothrombotic aminophospholipids (aPL) in circulating cell membranes. Intravenously administered procoagulant PL caused clotting factor activation and depletion, induced a bleeding defect, and significantly reduced AAA development. These data suggest that Alox deletion reduces AAA through diverting coagulation away from the vessel wall due to eoxPL deficiency, instead activating clotting factor consumption and depletion in the circulation. In mouse whole blood, approximately 44 eoxPL molecular species formed within minutes of clot initiation. These were significantly elevated with ApoE (-/-) deletion, and many were absent in Alox (-/-) mice, identifying specific eoxPL that modulate AAA. Correlation networks demonstrated eoxPL belonged to subfamilies defined by oxylipin composition. Thus, procoagulant PL regulate AAA development through complex interactions with clotting factors. Modulation of the delicate balance between bleeding and thrombosis within either the vessel wall or circulation was revealed that can either drive or prevent disease development.
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