Targeting Tyrosine Hydroxylase for Abdominal Aortic Aneurysm: Impact on Inflammation, Oxidative Stress, and Vascular Remodeling.

Pharmacological treatments for preventing abdominal aortic aneurysm (AAA) rupture or slowing aneurysm progression remain a challenge. It is increasingly recognized that sympathetic activity might play a role in the pathogenesis of AAA; however, the impact of this pathway remains unclear. Here, we show that the expression of tyrosine hydroxylase (TH), dopamine β-hydroxylase (DBH), and the norepinephrine transporter SLC6A2 is upregulated in abdominal aorta samples from AAA patients and in the aneurysmal aorta from 2 animal models susceptible to Ang II (angiotensin II)–induced AAA: the apolipoprotein E-deficient (ApoE−/−) model and a transgenic mouse that overexpresses the human nuclear receptor NOR-1 (neuron-derived orphan receptor-1) in the vascular wall (TgNOR-1VSMC). TH localizes to sympathetic nerves innervating the local vasculature, but also to inflammatory cells, and scattered vascular smooth muscle cell in human and mouse AAA. Interestingly, the preventive effect of doxycycline on AAA formation in Ang II–treated TgNOR-1VSMC mice was associated to the normalization of vascular Th expression. Moreover, the TH specific inhibitor α-methyl-p-tyrosine protected against Ang II–induced AAA formation, limiting the progressive increase in aortic diameter without affecting blood pressure. The drug normalized MMP2 (matrix metalloproteinase 2) expression and MMP activity, preserving elastin integrity, attenuated the Ang II–mediated rise in vascular oxidative stress and inflammatory markers and reduced the inflammatory infiltrate. Finally, NOR-1, whose expression correlated with that of TH in human AAA, was able to drive human TH transcriptional activity in transient transfection assays. Therefore, the upregulation of the TH pathway could be critical in the pathophysiology of AAA, supporting the potential of pharmacological strategies targeting TH for AAA management.This work was supported by the Spanish Ministerio de Ciencia e Innovación (RTI2018-094727-B-100 and PID2019-108489RB-100), Instituto de Salud Carlos III (ISCIII) (PI18/0919), the Agència de Gestió d'Ajuts Universitaris i de Recerca (AGAUR) (2017-SGR-00333), and Sociedad Española de Arteriosclerosis (SEA-2019). The study was co-founded by Fondo Europeo de Desarrollo Regional (FEDER), a way to make Europe. L.C. and C.B-S were supported by a FI (AGAUR) and a FPU fellowship (Ministerio de Universidades), respectivelyS