<p>Assessment of T helper 17-associated cytokines in thromboangiitis obliterans</p>

Abstract

BackgroundThe management of thromboangiitis obliterans (TAO) remains a medical challenge because of its unknown etiology. It is also not known whether it is a systemic or localized disease or a type of autoimmune vasculitis.MethodsIn this study, we evaluated the serum level of IL-17 and IL-23 which increase in both systemic inflammation and autoimmunity, in 60 TAO patients and 30 age- and smoking habit-matched controls. Also, IL-22, which has reported high level during infection but not in autoimmunity, was evaluated.ResultsThe serum levels of IL-17, IL-22 and IL-23 were significantly higher in the TAO patients in comparison with the controls (P<0.001). Notably, the serum levels of IL-17, IL-22 and IL-23 were highest in the patients with the chief complaint of chronic ulcer and lowest in the patients with gangrene (P<0.05). Also, the serum level of IL-22 was significantly higher in the anemic patients in comparison with the non-anemic patients (P=0.03).ConclusionOwing to our findings, TAO appears more likely to be a systemic disorder rather than a localized vasculopathy. Therefore, treatment protocols based on systemic treatment of TAO patients may be more helpful than localized treatment, such as bypass surgery and endovascular procedures. Also, according to our findings regarding the high level of IL-22, the trigger of TAO development may be an infectious pathogen. However, additional research is highly recommended to investigate whether TAO is an infectious disease or an infectious-induced autoimmunity.

<p>The IL-33/sST2 Axis in Thromboangiitis Obliterans</p>

“…Notably, according to previous studies regarding the evaluation of IL-17, toll-like receptor 4 (TLR4), neopterin and high sensitivity C-reactive protein (hsCRP) on the same TAO samples, 9,10 there was a significant negative correlation between IL-33 and IL-17 (p = 0.041, CC = −0.42). Also, the IL-33 level was 459 ± 125.5ng/mL in CRP-negative patients and 222.6 ± 11.26ng/mL in CRP-positive patients (p = 0.017, Z = −2.38).…”

The Imbalance among Oxidative Biomarkers and Antioxidant Defense Systems in Thromboangiitis Obliterans (Winiwarter-Buerger Disease)

“…Despite the studies on pathophysiology (reviewed in [29,51], actually, the detailed etiopathogenesis and molecular mechanisms are still unknown. Among the possible biomolecular hypotheses [10,12,14,18,[20][21][22][23]27,50,[54][55][56], oxidative stress has been crucially indicated as an important factor for both the initiation and progression of WBD [30,31,51,54].…”

“…Among the immunologic and inflammatory biomolecular hypotheses for the WBD disease, some biomarkers and biochemical mechanisms have been identified. Among them, crucial roles are played by cytokines and chemokines [10][11][12], adhesion molecules [13][14][15], Rickettsia rickettsii and Porphyromonas gingivalis (through toll-like receptors) [16][17][18][19], angiogenic factors [20], catecholamines [21], inflammation on sympathetic ganglia [22], T cells/macrophages/dendritic cells (intima infiltration of vessels) [23], accumulation of immunoglobulins, immune complexes and complement factors on sub-endothelial elastic lamina [24], urinary cotinine [25], circulating auto-antibodies [26], heme oxygenase 1 and the inducible isozyme of nitric oxide synthase [27], and matrix metalloproteinases [28] (as reviewed in [29]).…”

Recent Updates and Advances in Winiwarter-Buerger Disease (Thromboangiitis Obliterans): Biomolecular Mechanisms, Diagnostics and Clinical Consequences

“…In contrast to atherosclerosis or vasculitis, low mean platelet volume (MPV) has been observed in TAO patients [14]. MPV is an indicator of platelet activation, and there is strong evidence indicating that MPV is an important variable and that larger platelets have a higher thrombogenicity.…”

“…MPV is an indicator of platelet activation, and there is strong evidence indicating that MPV is an important variable and that larger platelets have a higher thrombogenicity. It is implicated that the severe inflammatory condition has been associated with low MPV, which increases with anti-inflammatory therapy [14]. Interestingly, it has been reported that other metabolic disorders, such as high cholesterol and diabetes, have an association with increased MPV, and this could indicate a link between increased MPV and atherosclerosis [15].…”