Tomasson Gunnar, Monach Paul A, Merkel Peter A
The Vasculitis Center, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts 02118, USA.
Curr Opin Rheumatol. 2009 Jan;21(1):41-6. doi: 10.1097/BOR.0b013e32831de4e7.
To give an overview of recent clinical findings of thromboembolic disease in vasculitis and provide insight into possible explanations of the association between thrombosis and inflammation.
A high incidence of venous thrombotic events has recently been described in four distinct cohorts of patients with antineutrophil cytoplasmic antibody-associated vasculitis (AAV), especially during periods of active disease. No factors other than the vasculitis itself have been identified that explain this high occurrence of thrombosis. Several studies have shown an increased rate of thrombosis in Behçet's disease, with a different clinical presentation from that observed in AAV. Recent laboratory findings provide exciting insights into a bidirectional feedback loop between coagulation and inflammation that may be applicable to vasculitis.
Thrombosis is an important clinical manifestation of some types of vasculitis. Better understanding of the association of thrombosis with inflammation in vasculitis might lead to development of clinically useful biomarkers and new approaches to therapy. Additionally, study of the specific factors involved in thrombosis in systemic vasculitis could help explain the role of inflammation in more common settings of venous thrombotic events.
概述血管炎中血栓栓塞性疾病的近期临床研究结果,并深入探讨血栓形成与炎症之间关联的可能解释。
最近在四个不同队列的抗中性粒细胞胞浆抗体相关性血管炎(AAV)患者中发现静脉血栓事件的发生率很高,尤其是在疾病活动期。除血管炎本身外,尚未发现其他因素可解释这种高血栓发生率。多项研究表明,白塞病的血栓形成率增加,其临床表现与AAV不同。近期的实验室研究结果为凝血与炎症之间的双向反馈回路提供了令人兴奋的见解,这可能适用于血管炎。
血栓形成是某些类型血管炎的重要临床表现。更好地理解血管炎中血栓形成与炎症的关联可能会导致开发出临床有用的生物标志物和新的治疗方法。此外,对系统性血管炎中血栓形成所涉及的特定因素的研究有助于解释炎症在更常见的静脉血栓事件中的作用。