Yang Clinical Research
From UWSMPH - Department of Anesthesiology
Jay Yang, MD, PHD
"Membrane Metaloproteinase-9 Genotype and Aortic Aneurysm"
The incidence of aortic aneurysm, an abnormal ballooning of the vascular wall of the aorta, has been increasing over recent years and is now thought to affect 8% of men over age 60 and is largely a disease of the elderly disproportionately impacting the aging population. The diseased patients are mostly asymptomatic with acute rupture and death often being the presenting symptom. Significant progress has been made in caring for patients undergoing surgical interventions but significant mortality approaching 20% in high-risk patients and morbidity including stroke and spinal cord paralysis remain major clinical problems. Identification of a specific and sensitive biomarker that can identity patients likely to develop a severe aortic aneurysm will allow a more rational use of healthcare resources, early surgical intervention while the operation is safer before the dilation involves more aorta, and also could provide insight on the pathophysiology of this disease. The plasma level of membrane metalloproteinase (MMP)-9, a member of the MMP family of Zn++-dependent endopeptidases, has been suggested as a biomarker for aortic aneurysm, however, there are reports of no association between the MMP-9 serum level and aortic aneurysm as well.
This study will test the working hypothesis that a statistically-optimized combination of MMP-9 genetic polymorphisms will serve as a biomarker for patients that require intervention (surgical or endovascular) for severe thoraco-abdominal aneurysm (TAA). We will genotype all known MMP-9 SNPs from 40 subjects with TAA and 40 age-, sex-, and race-matched controls to obtain a complete picture of the MMP-9 genetic polymorphism. The results should allow formulation of a statistical model predictive of severe TAA presenting for surgical intervention.