Open Access
CC BY 4.0 · Aorta (Stamford) 2017; 05(06): 159-167
DOI: 10.12945/j.aorta.2017.17.693
State-of-the-Art Review
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Autoimmunity in the Abdominal Aortic Aneurysm and its Association with Smoking

M. David Tilson
1   Department of Surgery, College of Physicians and Surgeons, Columbia University, New York, New York, USA
› Author Affiliations
Further Information

Publication History

12 May 2017

05 December 2017

Publication Date:
24 September 2018 (online)

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Abstract

Smoking increases the risk of abdominal aortic aneurysm (AAA) in both humans and mice, although the underlying mechanisms are not completely understood. An adventitial aortic antigen, AAAP-40, has been partially sequenced. It has motifs with similarities to all three fibrinogen chains and appears to be connected in evolution to a large family of proteins called fibrinogen-related proteins. Fibrinogen may undergo non-enzymatic nitration, which may result from exposure to nitric oxide in cigarette smoke. Nitration of proteins renders them more immunogenic. It has recently been reported that anti-fibrinogen antibody promotes AAA development in mice. Also, anti-fibrinogen antibodies are present in patients with AAA. These matters are reviewed in the overall context of autoimmunity in AAA. The evidence suggests that smoking amplifies an auto-immune reaction that is critical to the pathogenesis of AAA.