Abstract
Purpose of Review: Giant cell arteritis (GCA) and Takayasu arteritis (TAK) are auto-inflammatory and autoimmune diseases with a highly selective tissue tropism for medium and large arteries. In both diseases, CD4+ T cells and macrophages form granulomatous lesions within the arterial wall, a tissue site normally protected by immune privilege. Vascular lesions can be accompanied by an extravascular component, typically an intense hepatic acute phase response that produces well-known laboratory abnormalities, e.g., elevated ESR and CRP. It is unclear whether GCA and TAK lie on a spectrum of disease or whether they represent fundamentally different disease processes. Recent Findings: GCA and TAK share many clinical features, but there are substantial differences in genetics, epidemiology, disease mechanisms, response to treatment, and treatment complications that give rise to different disease trajectories. A significant difference lies in the composition of the wall-infiltrating immune cell compartment, which in TAK includes a significant population of CD8+ T cells as well as natural killer cells, specifying disparate disease effector pathways mediating tissue damage and vessel wall remodeling. Summary: Despite the similarities in tissue tropism and histomorphology, GCA and TAK are two distinct vasculitides that rely on separate disease mechanisms and require disease-specific approaches in diagnosis and management.
Original language | English (US) |
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Article number | 68 |
Journal | Current rheumatology reports |
Volume | 22 |
Issue number | 10 |
DOIs | |
State | Published - Oct 1 2020 |
Keywords
- Giant cell arteritis
- Intimal hyperplasia
- Macrophages
- Neoangiogenesis
- T cells
- T regulatory cells
- Takayasu arteritis
- Vascular remodeling
ASJC Scopus subject areas
- Rheumatology