Pathogenesis of #GiantCellArteritis with focus on cellular populations
Immune+Stromal cell dynamics
Cytokine signature
IL6-IL17
IL12-IFNΞ³
Immune Checkpoint
Immunosenescence
This is a very friendly review for a non-immunologist (meπ)
Dr. Pavlos Stamatis lab Front Medicine 2022
https://www.frontiersin.org/articles/10.3389/fmed.2022.1058600/full
Giant cell arteritis (GCA), the most common non-infectious vasculitis, mainly affects elderly individuals. The disease usually affects the aorta and its main supra-aortic branches causing both general symptoms of inflammation and specific ischemic symptoms because of the limited blood flow due to arterial structural changes in the inflamed arteries. The pathogenesis of the GCA is complex and includes a dysregulated immune response that affects both the innate and the adaptive immunity. During the last two decades several studies have investigated interactions among antigen-presenting cells and lymphocytes, which contribute to the formation of the inflammatory infiltrate in the affected arteries. Toll-like receptor signaling and interactions through the VEGF-Notch-Jagged1 pathway are emerging as crucial events of the aberrant inflammatory response, facilitating among others the migration of inflammatory cells to the inflamed arteries and their interactions with the local stromal milieu. The increased use of checkpoint inhibitors in cancer immunotherapy and their immune-related adverse events has fed interest in the role of checkpoint dysfunction in GCA, and recent studies suggest a dysregulated check point system which is unable to suppress the inflammation in the previously immune-privileged arteries, leading to vasculitis. The role of B-cells is currently reevaluated because of new reports of considerable numbers of plasma cells in inflamed arteries as well as the formati...
My continued biomedical education
Multimodality imaging of large-vessel #Vasculitis
#GiantCellArteritis #TakayasuArteritis
Aorta/Coronary artery/Pulmonary artery
Echo
CT
MRI
18F-FDG PET
Dr. Jason Tarkin & Deepa Gopalan @Heart_BMJ 2022 @Jmtarkin
https://heart.bmj.com/content/early/2022/11/29/heartjnl-2022-321113
Multimodality cardiovascular imaging is an essential component of the clinical management of patients with large-vessel vasculitis (LVV), a chronic, relapsing and remitting inflammatory disease of the aorta and its major branches. Imaging is needed to confirm the initial diagnosis, to survey the extent and severity of arterial involvement, to screen for cardiovascular complications and for subsequent long-term disease monitoring. Indeed, diagnosing LVV can be challenging due to the non-specific nature of the presenting symptoms, which often evoke a broad differential. Identification of disease flares and persistent residual arteritis following conventional treatments for LVV present additional clinical challenges. However, by identifying and tracking arterial inflammation and injury, multimodality imaging can help direct the use of disease-modifying treatments that suppress inflammation and prevent or slow disease progression. Each of the non-invasive imaging modalities can provide unique and complementary information, contributing to different aspects of the overall clinical assessment. This article provides a focused review of the many roles of multimodality imaging in LVV.
Wisdom4theblind
Hao Yin
slmrheum