Vascular Mesenchymal Stromal Cells and Cellular Senescence: A Two-Case Study Investigating the Correlation Between an Inflammatory Microenvironment and Abdominal Aortic Aneurysm Development

An abdominal aortic aneurysm (AAA) is described as a gradual and localized permanent expansion of the aorta resulting from the weakening of the vascular wall. The key aspects of AAA's progression are high proteolysis of the structural elements of the vascular wall, the depletion of vascular smooth muscle cells (VSMCs), and a chronic immunoinflammatory response. The pathological mechanisms underpinning the development of an AAA are complex and still unknown. At present, there are no successful drug treatments available that can slow the progression of an AAA or prevent the rupture of the aneurysmal vascular wall. Recently, it has been suggested that endothelial cellular senescence may be involved in vascular aging and vascular aging diseases, but there is no clear correlation between cellular senescence and AAAs. Therefore, the aim of this study was to identify the presence of senescent cells on the vascular wall of aneurysmatic abdominal aortas and to correlate their distribution with the morphological markers of AAAs. Pathological and healthy segments of abdominal aortas were collected during repair surgery and immediately processed for histological and immunohistochemical analyses. Hematoxylin/eosin, Verhoeff-van Gieson, and Goldner's Masson trichrome staining procedures were carried out to investigate the morphological features related to the pathology. Immunohistochemical investigations for the p21^cip1/waf1, p53, and NFkB markers were carried out to selectively identify positive cells in the vascular wall of the AAA samples related to cellular senescence and an inflammatory microenvironment. The results revealed the presence of a few senescent vascular cells on the aneurysmatic wall of the abdominal aortas, surrounded by a highly inflamed microenvironment that was highly expressed in the tunica media and adventitia of both pathological and healthy segments. Our data demonstrate the presence of senescent vascular cells in AAA samples, which could enhance the promotion of a high inflammatory vascular microenvironment, supporting the evolution of the pathology. Although this study was based on only two cases, the results highlight the importance of targeting cellular senescence to reduce an inflammatory microenvironment, which can support the progression of age-related diseases.