1 Department of Vascular Surgery, Countess of Chester Hospital, Chester, UK.
2 Department of General Surgery, Peterborough City Hospital, Peterborough, UK.
Vasc Med. 2019 Feb;24(1):79-88. doi: 10.1177/1358863X18802989. Epub 2018 Oct 24.
Despite being recognised over a century ago, the aetiology and pathogenesis of large vessel vasculitis (LVV) still remains elusive. Takayasu's arteritis (TA) and giant cell arteritis (GCA) represent the two major categories of LVV, each with distinctive clinical features. Over the last 10 years an increased understanding of the immunopathogenesis of the inflammatory cascade within the aortic wall has revived the view that LVVs may represent subtypes of the same pathological process, with implications in the treatment of this disease. In this review, the histological, genetic and immunopathological features of TA and GCA will be discussed and the evidence for a common underlying disease mechanism examined. Novel markers of disease activity and therapies based on advances in our understanding of the immunopathogenesis of these conditions will also be discussed.
尽管大动脉血管炎 (LVV) 早在一个多世纪前就已被认识，但它的病因和发病机制仍然难以捉摸。Takayasu 动脉炎 (TA) 和巨细胞动脉炎 (GCA) 代表了 LVV 的两个主要类别，它们各自具有独特的临床特征。在过去的 10 年中，人们对主动脉壁内炎症级联反应的免疫发病机制的认识不断加深，重新认为 LVVs 可能代表同一病理过程的亚型，这对该疾病的治疗具有重要意义。在这篇综述中，将讨论 TA 和 GCA 的组织学、遗传学和免疫病理学特征，并探讨其潜在的共同疾病机制。此外，还将讨论基于对这些疾病免疫发病机制的理解而取得的新的疾病活动标志物和治疗方法。
