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Nat Rev Cardiol. 2017 Aug;14(8):457-471. doi: 10.1038/nrcardio.2017.52. Epub 2017 Apr 13.

Monocytes and macrophages in abdominal aortic aneurysm.

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Division of Cardiovascular Medicine, Department of Medicine, University of Cambridge, West Forvie Building, Forvie Site, Robinson Way, Cambridge CB2 0SZ, UK.
Institut National de la Santé et de la Recherche Médicale (Inserm), Unit 970, Paris Cardiovascular Research Center, 56 rue Leblanc, 75015 Paris, France.
Clinical Chemistry Laboratory, University Hospital of Nice, Hôpital Pasteur, 30 Voie Romaine, 06006 Nice Cedex 1, France.
Université Côte d'Azur, CHU, CNRS, Inserm, IRCAN, Tour Pasteur, Avenue de Valombrose, 06107 Nice, France.
Department of Vascular Surgery, University Hospital of Nice, Hôpital Pasteur, 30 Voie Romaine, 06006 Nice Cedex 1, France.


Abdominal aortic aneurysm (AAA) is a life-threatening disease associated with high morbidity, and high mortality in the event of aortic rupture. Major advances in open surgical and endovascular repair of AAA have been achieved during the past 2 decades. However, drug-based therapies are still lacking, highlighting a real need for better understanding of the molecular and cellular mechanisms involved in AAA formation and progression. The main pathological features of AAA include extracellular matrix remodelling associated with degeneration and loss of vascular smooth muscle cells and accumulation and activation of inflammatory cells. The inflammatory process has a crucial role in AAA and substantially influences many determinants of aortic wall remodelling. In this Review, we focus specifically on the involvement of monocytes and macrophages, summarizing current knowledge on the roles, origin, and functions of these cells in AAA development and its complications. Furthermore, we show and propose that distinct monocyte and macrophage subsets have critical and differential roles in initiation, progression, and healing of the aneurysmal process. On the basis of experimental and clinical studies, we review potential translational applications to detect, assess, and image macrophage subsets in AAA, and discuss the relevance of these applications for clinical practice.

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