The interleukin-10-1082 'A' allele and abdominal aortic aneurysms.

BACKGROUND: Abdominal aortic aneurysms (AAA) are caused by inflammatory processes in the wall of the aorta resulting in degradation of structural proteins. This inflammatory process is mediated, in part, by cytokines, and interleukin-10 (IL-10) is a predominantly anti-inflammatory cytokine. A single nucleotide polymorphism in the promoter region of the IL-10 gene that affects transcription has been associated with AAA in a small study. The aim of this study was to determine whether this polymorphism is associated with AAA and also examine its effect on the growth of small AAA. METHODS AND RESULTS: A case control study was performed. A total of 389 patients with AAA and 404 healthy controls were recruited. IL-10-1082 polymorphisms were determined by polymerase chain reaction-based methods. In the case of patients with small AAA (<5.5 cm), serial size measurements were recorded to determine mean growth rate. There was a statistically significant difference both in allele and genotype frequencies between the case and control groups with the IL-10-1082 'A' allele being more common in the AAA group (P = .006). In the AAA group, genotype frequencies were as follows: GG 84, GA 201, and AA 104. In the control group, the genotype frequencies were GG 118, GA 205, and AA 81. The odds ratio for the 'A' allele as a risk factor for AAA was 1.50 (95% confidence interval 1.09 to 2.07). Regression modeling revealed that the IL-10-1082 genotype was, however, not independently associated with AAA if age, tobacco use, hypertension, and history of coronary or peripheral artery disease was taken into account. There was a trend towards lower plasma IL-10 level in IL-10 AA carriers, but the IL-10 'A' allele did not have any discernible effect on the growth of small AAA. CONCLUSIONS: This study demonstrates that the IL-10-1082 'A' allele is associated with AAA, although this association is likely to be secondary to an association between IL-10-1082 genotype and other markers of cardiovascular disease rather than AAA per se.

The pro-inflammatory and chemotactic cytokine microenvironment of the abdominal aortic aneurysm wall: a protein array study.

OBJECTIVE: Cytokines are inflammatory mediators implicated in abdominal aortic aneurysm (AAA) pathogenesis. The cytokine expression profile of the AAA is poorly defined and has focused on the expression of pro-inflammatory cytokines, at the expense of chemokines and growth factors. This study aims to investigate the cytokine expression profile of the established AAA wall. METHODS: Cytokine protein expression was measured in homogenized human aortic tissue (10 AAAs and 9 nonaneurysmal controls) using a 42-cytokine antibody-based protein array. Data were quantified using densitometric analysis and statistically analyzed using a Mann-Whitney U test. RESULTS: A significant difference in cytokine expression between AAA and control samples was found in 15 of 42 cytokines. Several pro-inflammatory cytokines were upregulated within the AAA compared with the control: interleukin (IL)-6 (P = .001), IL-1alpha (P = .001), IL-1beta (P < .001), tumor necrosis factor (TNF)-alpha (P = .002), TNF-beta (P = .002), and oncostatin M (P = .007). The anti-inflammatory cytokine IL-10 was also upregulated (P = .002). Members of the chemokine family were also highly expressed within AAA samples: IL-8 (P = .001), epithelial neutrophil-activating peptide-78 (ENA-78; P = .006), growth related oncogene (GRO; P < .001), monocyte chemoattractant protein (MCP)-1 (P = .003), MCP-2 (P < .001), and regulated upon activation, normal T-cell expressed and secreted (RANTES; P = .001). Of the growth factors examined, granulocyte colony-stimulating factor (GCSF; P = .003) and macrophage colony-stimulating factor (MCSF; P = .004) were significantly higher in the AAA. CONCLUSIONS: The established AAA is characterized by a distinct cytokine profile consisting of pro-inflammatory cytokines, chemokines, and specific growth factors. This suggests that these cytokines may contribute to pathologic changes within the established, preruptured aneurysm.

Case of duodenal haematoma treated with ultrasound guided drainage.

Duodenal haematoma usually occurs secondary to blunt abdominal trauma(1), although more recently it has been recognized as a complication of endoscopic duodenal biopsy(2). The two established management strategies are to treat conservatively until resolution of the haematoma occurs or to surgically evacuate the haematoma. We present a case of duodenal haematoma that was successfully treated by ultrasound guided drainage when no improvement occurred with conservative treatment.