The composition of collagen in the aneurysm wall of men and women

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Loss of vessel wall integrity by degradation is essential for the development of abdominal aortic aneurysm (AAA) and ultimately its rupture. The observed greater rupture rate in women with AAA might be related to gender differences in the biomechanical properties of the aneurysm wall. The aim of the study was to compare the biomechanically important structure of collagen between men and women with AAA.


Biopsies of the aneurysm walls were obtained during elective open repair of men (n = 14) and women (n = 14) treated for AAA. High-performance liquid chromatography (HPLC), Western blot, messenger RNA expression, and histochemical analyses were performed to assess the cross-linking and the amount and the composition of collagen.


There was neither a difference in the thickness of the aneurysm wall, nor in the histological evaluation of the collagen composition between the sexes. Relative collagen content in the aneurysm wall was similar in men and women, as assessed by messenger RNA expression and HPLC. Collagen cross-linking differed between the sexes; women had more lysyl pyridinoline (LP) than men (0.140 vs 0.07;P= .005), resulting in a lower hydroxyl pyridinoline (HP):LP ratio (3.28 vs 8.41;P= .003). There was no difference in messenger RNA and protein expressions of lysyl hydroxylase and lysyl oxidase to associate with the lower HP:LP ratio in women.


The composition of collagen in the aneurysm wall of men and women are in several aspects similar, with the exception of collagen cross-linking, suggesting that the difference in rupture rate between the sexes rather depend on the composition of other vessel wall structures.

Clinical Relevance:

The marked differences in prevalence and rupture risk of abdominal aortic aneurysm between men and women suggest gender to be of importance for both aneurysm development and progression. To study the amount and composition of collagen in men and women is of great importance for the understanding of the degenerative process occurring in aneurysms in both sexes and how it potentially differs, in regards to the increased rupture rate observed in women.

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