Inflamacija u patogenezi aneurizme abdominalne aorte

Janja Raonić; Vesna Lačković; Božina Radević; Nikola Fatić; Nemanja Radojević

doi:10.5937/cma3-9713

Janja Raonić Medicinski fakultet u Podgorici, Katedra za histologiju i embriologiju Klinički centar Crne Gore, Centar za patologiju i sudsku medicinu
Vesna Lačković Medicinski fakultet Univerziteta u Beogradu
Božina Radević Medicinski fakultet Univerziteta u Beogradu
Nikola Fatić Klinički centar Crne Gore
Nemanja Radojević Klinički centar Crne Gore

DOI: https://doi.org/10.5937/cma3-9713

Sažetak

Uvod : Aneurizma abdominalne aorte (AAA) je jedno od najznačajnijih vaskularnih oboljenja. Najviše su zastupljene aterosklerotske AAA. Ateroskleroza se tradicionalno smatrala centralnim procesom u patogenezi ove bolesti. Savremena istraživanja upućuju na nedostatke tradicionalne teorije.

Cilj: Utvrditi prisustvo inflamacije i evaluirati njen značaj u patogenezi AAA.

Materijal i metode : U ovoj retrospektivnoj histopatološkoj studiji, tipa slučaj-kontrola, ispitivano je 30 uzoraka aterosklerotskih AAA, a kao kontrola korišćeno je 30 uzoraka tkiva aterosklerotski izmijenjene abdominalne aorte. Pored rutinskog H/E bojenja primijenjena su imunohistohemijska (CD45 i CD68) bojenja. Morfometrijska analiza vršena je na 10 vidnih polja na uveličanju od 400 puta, a rezultat je izražen kao gustina ćelija (broj ćelija/mm²).

Rezulati: Ekstenzivan inflamatorni infiltrat prisutan je u cijelom zidu AAA. Upalni infiltrat dominantno čine CD45 imunoreaktivne ćelije. Inflamatorne ćelije nekada teže formiranju tercijernog limfnog organa. Gustina upalnih značajno je veća u uzorcima AAA u odnosu na kontrolne.

Diskusija: Nalaz daleko ekstenzivnijeg zapaljenja u zidu AAA i činjenica da svega 9-16% osoba sa aterosklerozom aorte razvije AAA neki su od argumenata koji potvrđuju da tradicionalna teorija o pategenezi AAA u nije tačna. Ćelijsku populaciju inflamatornog infiltrata AAA čine T i B limfociti, ali i plazmociti, dendritske i NK ćelije. Jednom aktiviran, inflamatorni infiltrat, produkuje različite leukotriene, citokine, imunoglobline i proteaze, uslovljavajući, degradaciju vaskularnog zida i apoptozu glatkih mišićnih ćelija. Okidač inflamacije nije jasan.

Zkaljučak: Značajno veća gustina upalnog infiltrata kod uzoraka AAA, u odnosu na kontrolne, ukazuje da ateroskleroza nije jedini proces koji oštećuje vaskularni zid i dovodi do formiranja aneurizme.

Ključne riječi: AAA, inflamacija

Biografije autora

Janja Raonić, Medicinski fakultet u Podgorici, Katedra za histologiju i embriologiju Klinički centar Crne Gore, Centar za patologiju i sudsku medicinu

Vesna Lačković, Medicinski fakultet Univerziteta u Beogradu

Božina Radević, Medicinski fakultet Univerziteta u Beogradu

Nikola Fatić, Klinički centar Crne Gore

Nemanja Radojević, Klinički centar Crne Gore

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