The role of autoimmunity and autoinflammation in giant cell arteritis: A systematic literature review

Valentin S. Schäfer, Peter Brossart, Kenneth J. Warrington, Christian Kurts, Georg W. Sendtner, Clemens A. Aden

Research output: Contribution to journalReview articlepeer-review


Giant cell arteritis is the most common form of large vessel vasculitis and preferentially involves large and medium-sized arteries in patients over the age of 50. Aggressive wall inflammation, neoangiogenesis and consecutive remodeling processes are the hallmark of the disease. Though etiology is unknown, cellular and humoral immunopathological processes are well understood. Matrix metalloproteinase-9 mediated tissue infiltration occurs through lysis of basal membranes in adventitial vessels. CD4+ cells attain residency in immunoprotected niches, differentiate into vasculitogenic effector cells and enforce further leukotaxis. Signaling pathways involve the NOTCH1-Jagged1 pathway opening vessel infiltration, CD28 mediated T-cell overstimulation, lost PD-1/PD-L1 co-inhibition and JAK/STAT signaling in interferon dependent responses. From a humoral perspective, IL-6 represents a classical cytokine and potential Th-cell differentiator whereas interferon-γ (IFN- γ) has been shown to induce chemokine ligands. Current therapies involve glucocorticoids, tocilizumab and methotrexate application. However, new agents, most notably JAK/STAT inhibitors, PD-1 agonists and MMP-9 blocking substances, are being evaluated in ongoing clinical trials.

Original languageEnglish (US)
Article number103328
JournalAutoimmunity Reviews
Issue number6
StatePublished - Jun 2023


  • Adaptive immunity
  • Autoimmunity
  • Autoinflammation
  • Giant cell arteritis
  • Humoral immunity
  • Innate immunity

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology


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