Tamoxifen up-regulates catalase production, inhibits vessel wall neutrophil infiltration, and attenuates development of experimental abdominal aortic aneurysms

Background: Selective estrogen receptor modulators (SERMs), similar to estrogens, possess vasoprotective effects by reducing release of reactive oxygen species. Little is known about the potential effects of SERMs on the pathogenesis of abdominal aortic aneurysms (AAAs). This study's objective was to investigate the growth of experimental AAAs in the setting of the SERM tamoxifen. Methods: In the first set of experiments, adult male rats underwent subcutaneous tamoxifen pellet (delivering 10 mg/kg/day) implantation (n = 14) or sham operation (n = 16). Seven days later, all animals underwent pancreatic elastase perfusion of the abdominal aorta. Aortic diameters were determined at that time, and aortas were harvested 7 and 14 days after elastase perfusion for immunohistochemistry, real-time polymerase chain reaction, Western blot analysis, and zymography. In the second set of experiments, a direct irreversible catalase inhibitor, 3-amino-1,2,4-triazole (AT), was administered intraperitoneally (1 mg/kg) daily to tamoxifien-treated (n = 6) and control rats (n = 6), starting on day 7 after elastase perfusion. Aortic diameters were measured on day 14. In a third set of experiments, rats were perfused with catalase (150 mg/kg) after the elastase (n = 5), followed by daily intravenous injections of catalase (150 mg/kg/day) administered for 10 days. A control group of rats (n = 7) received 0.9% NaCl instead of catalase. Results. Mean AAA diameters were approximately 50% smaller in tamoxifen-treated rats compared with sham rats 14 days after elastase perfusion (P =.002). The tamoxifen-treated group's aortas had a five-fold increase in catalase mRNA expression (P =.02) on day 7 and an eight-fold increase in catalase protein on day 14 (P =.04). Matrix metalloprotroteinase-9 activity was 2.4-fold higher (P =.01) on day 7 in the aortas of the controls compared to the tamoxifen-treated group's aortas. Tamoxifen-treated rats had approximately 40% fewer aortic polymorphonuclear neutrophils compared to controls on day 7 (P =.05). Administration of the direct catalase inhibitor AT to tamoxifen-treated rats partially reversed the aneurysm inhibitory effect of tamoxifen by nearly 30% (P =.02). In contrast, catalase administration inhibited AAA formation by 44% (P =.002). Conclusions: The selective estrogen receptor modulator tamoxifen inhibits the development of AAAs in male rats in association with an up-regulation of catalase and inhibition of aortic wall neutrophil infiltration. (J Vasc Surg 2005;41:108-14.) Clinical relevance: A group of medications with estrogen-like properties, the SERMs, act as either an estrogen receptor agonist or antagonist in a tissue-selective manner. SERM use has increased rapidly because they have been found to be beneficial in treatment of breast cancer, prevention of osteoporosis, and treatment of desmoid tumors and retroperitoneal fibrosis. The effects of SERMs on the formation of experimental AAAs have not been studied to date. This study was designed to determine the effect of tamoxifen on the experimental development of AAAs in a rodent model.