University of Groningen and University Medical Center Groningen, Groningen, The Netherlands.
Arthritis Rheumatol. 2018 Sep;70(9):1366-1376. doi: 10.1002/art.40520. Epub 2018 Jul 30.
Giant cell arteritis (GCA) is an autoimmune vasculitis affecting large and medium-sized arteries. Ample evidence indicates that GCA is a heterogeneous disease in terms of symptoms, immune pathology, and response to treatment. In the current review, we discuss the evidence for disease subsets in GCA. We describe clinical and immunologic characteristics that may impact the risk of cranial ischemic symptoms, relapse rates, and long-term glucocorticoid requirements in patients with GCA. In addition, we discuss both proven and putative immunologic targets for therapy in patients with GCA who have an unfavorable prognosis. Finally, we provide recommendations for further research on disease subsets in GCA.
巨细胞动脉炎（GCA）是一种影响大动脉和中动脉的自身免疫性血管炎。大量证据表明，GCA 在症状、免疫病理学和治疗反应方面存在异质性。在本次综述中，我们讨论了 GCA 疾病亚组的证据。我们描述了可能影响 GCA 患者颅缺血症状风险、复发率和长期糖皮质激素需求的临床和免疫特征。此外，我们还讨论了 GCA 预后不良患者的治疗中已证实和潜在的免疫靶点。最后，我们为 GCA 疾病亚组的进一步研究提供了建议。
