在多发性肌痛性风湿症中患上亚临床巨细胞动脉炎:并发性疾病或共同的炎症性疾病谱?
Carlo Salvarani1, Roberto Padoan2, Luca Iorio2
1Rheumatology Unit, Azienda USL-IRCCS di Reggio Emilia and Università di Modena and Reggio Emilia, Reggio Emilia, Italy.
Autoimmunity reviews
|August 25, 2023
概括
巨细胞动脉炎 (GCA) 和多肌痛性类风湿 (PMR) 分享炎症途径,影响老年人. 在PMR患者中早期检测亚临床GCA对于预防血管损伤至关重要.
科学领域:
- 类风湿病学 类风湿病学
- 免疫学 免疫学 免疫学
- 血管医学 血管医学
背景情况:
- 巨细胞动脉炎 (GCA) 和多肌痛性类风湿 (PMR) 是老年人常见的炎症状况.
- 存在显著的临床联系,患者同时或顺序地经历了这两种情况.
- 在PMR患者中识别亚临床GCA具有挑战性,因为例行查不是标准实践.
研究的目的:
- 探索GCA和PMR之间的复杂关系.
- 突出诊断挑战和PMR患者中亚临床GCA的患病率.
- 讨论共享和独特的病原遗传机制和治疗考虑.
主要方法:
- 对流行病学数据,遗传学研究和病变发生学研究的审查.
- 分析炎症机制,包括细胞透物和细胞因子概况.
- 对治疗反应和患者结果的比较.
主要成果:
- 在新的PMR患者中,亚临床GCA患病率在23%至29%之间,可以通过血管壁成像或动脉活检检测到.
- 共享的炎症途径涉及树突细胞,巨细胞和IL-6,但GCA显示了广泛的T细胞透,与PMR不同.
- 葡萄糖皮质类药物对两者都有效,但类固醇需求不同;GCA与大动脉动脉瘤携带更高的死亡风险.
结论:
- GCA与PMR的关联是重要的,需要进一步调查.
- 拟议的术语"GCA-PMR谱系疾病" (GPSD) 反映了它们的密切关系.
- 需要进一步的研究,以了解和有效管理这种疾病的频谱.
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