Platelet Dysfunction and Altered Immune Response in Acute Aortic Dissection Type A: Insights from RNA-Seq Analysis

All articles of this category (opens in new window) Background: Acute aortic dissection type A (AADA) is associated with increased bleeding risk, complicating surgical management. While clinical risk factors are established, the underlying molecular mechanisms remain poorly understood. We investigated transcriptional alterations in AADA to identify pathways contributing to bleeding complications and disease pathogenesis. Methods: We performed a comprehensive bioinformatics analysis of publicly available bulk RNA-sequencing data from AADA patients and control samples. Differential gene expression analysis was conducted using established pipelines, followed by functional annotation and pathway enrichment analysis. Single-cell RNA-seq datasets were analyzed to characterize cell-type-specific alterations. Results: We identified 1,655 significantly differentially expressed genes between AADA and controls. Functional enrichment analysis revealed significant overrepresentation of terms related to leukocyte migration and activation, plasma membrane organization, and blood circulation processes. Pathway analysis suggested significant dysregulation of platelet degranulation, platelet activation, and elevated platelet level pathways. Single-cell analysis revealed altered immune cell composition in AADA patients, with increased proportions of T17 cells, macrophages, pericytes, and smooth muscle cells, alongside decreased mast cells, fibroblasts, and plasma cells compared to controls. Conclusion: Our transcriptomic analysis reveals significant alterations in platelet-related pathways and immune cell composition in AADA patients, providing molecular evidence for observed bleeding complications. The identified dysregulation of haemostatic processes and altered vascular microenvironment offer potential mechanistic insights into AADA pathophysiology and suggest novel therapeutic targets for managing bleeding disorders in this patient population. Publication History Article published online: 17 February 2026 © 2026. Thieme. All rights reserved. Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany