Transforming growth factor-beta signaling in thoracic aortic aneurysm development: a paradox in pathogenesis

J Vasc Res. 2009;46(2):119-37. doi: 10.1159/000151766. Epub 2008 Sep 2.


Thoracic aortic aneurysms (TAAs) are potentially devastating, and due to their asymptomatic behavior, pose a serious health risk characterized by the lack of medical treatment options and high rates of surgical morbidity and mortality. Independent of the inciting stimuli (biochemical/mechanical), TAA development proceeds by a multifactorial process influenced by both cellular and extracellular mechanisms, resulting in alterations of the structure and composition of the vascular extracellular matrix (ECM). While the role of enhanced ECM proteolysis in TAA formation remains undisputed, little attention has been focused on the upstream signaling events that drive the remodeling process. Recent evidence highlighting the dysregulation of transforming growth factor-beta (TGF-beta) signaling in ascending TAAs from Marfan syndrome patients has stimulated an interest in this intracellular signaling pathway. However, paradoxical discoveries have implicated both enhanced TGF-beta signaling and loss of function TGF-beta receptor mutations, in aneurysm formation; obfuscating a clear functional role for TGF-beta in aneurysm development. In an effort to elucidate this subject, TGF-beta signaling and its role in vascular remodeling and pathology will be reviewed, with the aim of identifying potential mechanisms of how TGF-beta signaling may contribute to the formation and progression of TAA.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Aneurysm, Dissecting / metabolism
  • Animals
  • Aorta, Thoracic / metabolism*
  • Aorta, Thoracic / pathology
  • Aortic Aneurysm, Thoracic / genetics
  • Aortic Aneurysm, Thoracic / metabolism*
  • Aortic Aneurysm, Thoracic / pathology
  • Disease Progression
  • Ehlers-Danlos Syndrome / metabolism
  • Extracellular Matrix / genetics
  • Extracellular Matrix / metabolism*
  • Genetic Predisposition to Disease
  • Humans
  • Marfan Syndrome / metabolism
  • Mutation
  • Peptide Hydrolases / metabolism
  • Receptors, Transforming Growth Factor beta / metabolism
  • Signal Transduction* / genetics
  • Smad Proteins / metabolism
  • Telangiectasia, Hereditary Hemorrhagic / metabolism
  • Transforming Growth Factor beta / genetics
  • Transforming Growth Factor beta / metabolism*


  • Receptors, Transforming Growth Factor beta
  • Smad Proteins
  • Transforming Growth Factor beta
  • Peptide Hydrolases