Aortic involvement in giant cell arteritis

Alegria, Guillermo Carvajal; Sleen, Yannick van; Graver, Jacoba Carolien; Sandovici, Maria; Devauchelle‐Pensec, Valérie; Brouwer, Elisabeth; Cornec, Divi

doi:10.1016/j.jbspin.2020.06.018

Cited by 8 publications

(5 citation statements)

References 19 publications

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“…Difficulties in recognising GCA do not only occur among patients presenting with PMR symptoms; also patients presenting with infectious symptoms can in fact have GCA [ 3 , 4 ]. Early recognition of GCA is crucial in order to detect and prevent irreversible damage such as vision loss and aortic aneurysms in time [ 5 , 6 ]. However, this is challenging, as presently no single symptom, physical sign or laboratory test can confirm or exclude the diagnosis of GCA [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Angiopoietin-2/-1 ratios and MMP-3 levels as an early warning sign for the presence of giant cell arteritis in patients with polymyalgia rheumatica

et al. 2022

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Background Diagnosing patients with giant cell arteritis (GCA) remains difficult. Due to its non-specific symptoms, it is challenging to identify GCA in patients presenting with symptoms of polymyalgia rheumatica (PMR), which is a more common disease. Also, commonly used acute-phase markers CRP and ESR fail to discriminate GCA patients from PMR and (infectious) mimicry patients. Therefore, we investigated biomarkers reflecting vessel wall inflammation for their utility in the accurate diagnosis of GCA in two international cohorts. Methods Treatment-naïve GCA patients participated in the Aarhus AGP cohort (N = 52) and the Groningen GPS cohort (N = 48). The AGP and GPS biomarker levels and symptoms were compared to patients presenting phenotypically as isolated PMR, infectious mimicry controls and healthy controls (HCs). Serum/plasma levels of 12 biomarkers were measured by ELISA or Luminex. Results In both the AGP and the GPS cohort, we found that weight loss, elevated erythrocyte sedimentation rate (ESR) and higher angiopoietin-2/-1 ratios but lower matrix metalloproteinase (MMP)-3 levels identify concomitant GCA in PMR patients. In addition, we confirmed that elevated platelet counts are characteristic of GCA but not of GCA mimicry controls and that low MMP-3 and proteinase 3 (PR3) levels may help to discriminate GCA from infections. Conclusion This study, performed in two independent international cohorts, consistently shows the potential of angiopoietin-2/-1 ratios and MMP-3 levels to identify GCA in patients presenting with PMR. These biomarkers may be used to select which PMR patients require further diagnostic workup. Platelet counts may be used to discriminate GCA from GCA look-alike patients.

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Section: Introductionmentioning

confidence: 99%

Angiopoietin-2/-1 ratios and MMP-3 levels as an early warning sign for the presence of giant cell arteritis in patients with polymyalgia rheumatica

et al. 2022

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“…The results at 5 years should determine the subsequent timing of surveillance. Patients with hypertension and cardiovascular risk factors should be monitored more closely (20). A scannographic control was performed in a single patient with an initial stable appearance and partial regression of the thoracoabdominal aortitis at 6 and 18 months respectively.…”

Section: The Differential Diagnosis Of Aortitis Is Essentiallymentioning

confidence: 99%

Inflammatory aorta in Giant Cell Arteritis disease: a case study of 5 patients

Chabchoub

Snoussi

Frikha

et al. 2023

Asian J. Internal Med.

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Inflammatory aorta in Giant Cell Arteritis disease: a case study of 5 patientsIntroduction: Aortitis defined as the inflammation of the aortic wall can be due to various diseases including giant cell arteritis (GCA). Aortic involvement in GCA, reported since 1940, is rarely described. The main objective of this study was to analyse the epidemiological, clinical, radiological and evolutionary characteristics of patients with inflammatory aortitis in a cohort of patients diagnosed with GCA. We conducted a review of the literature to study the clinical and paraclinical aspects of this entity and to describe a diagnostic and therapeutic approach to inflammatory aortitis in GCA. Methods: This is a retrospective descriptive study of 109 patients with giant cell arteritis fulfilling the diagnostic criteria established by the American College of Rheumatology (ACR), conducted over a period of 25 years

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“…It was therefore underlined that GCA should be classified into a cranial form (c-GCA) and an extracranial or large vessel form (LV-GCA). LV-GCA mainly involves the thoracic aorta and its branches and is the main cause of noninfectious aortitis in humans [4].…”

Section: Introductionmentioning

confidence: 99%

“…The most feared complication of c-GCA is transient or permanent blindness Cells 2024, 13, 267 2 of 17 due to the involvement of the ophthalmic artery [9,10]. On the other hand, LV-GCA can cause aortic stenosis due to vascular remodeling secondary to inflammation, as well as thrombosis, limb claudication, mesenteric ischemia, and arterial aneurysms [4,11]. All these conditions contribute to a significant increase in mortality.…”

Section: Introductionmentioning

confidence: 99%

Giant Cell Arteritis: Advances in Understanding Pathogenesis and Implications for Clinical Practice

Paroli,

Caccavale,

Accapezzato

2024

Cells

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Giant cell arteritis (GCA) is a noninfectious granulomatous vasculitis of unknown etiology affecting individuals older than 50 years. Two forms of GCA have been identified: a cranial form involving the medium-caliber temporal artery causing temporal arteritis (TA) and an extracranial form involving the large vessels, mainly the thoracic aorta and its branches. GCA generally affects individuals with a genetic predisposition, but several epigenetic (micro)environmental factors are often critical for the onset of this vasculitis. A key role in the pathogenesis of GCA is played by cells of both the innate and adaptive immune systems, which contribute to the formation of granulomas that may include giant cells, a hallmark of the disease, and arterial tertiary follicular organs. Cells of the vessel wall cells, including vascular smooth muscle cells (VSMCs) and endothelial cells, actively contribute to vascular remodeling responsible for vascular stenosis and ischemic complications. This review will discuss new insights into the molecular and cellular pathogenetic mechanisms of GCA, as well as the implications of these findings for the development of new diagnostic biomarkers and targeted drugs that could hopefully replace glucocorticoids (GCs), still the backbone of therapy for this vasculitis.

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Aortic involvement in giant cell arteritis

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Cited by 8 publications

References 19 publications

Angiopoietin-2/-1 ratios and MMP-3 levels as an early warning sign for the presence of giant cell arteritis in patients with polymyalgia rheumatica

Angiopoietin-2/-1 ratios and MMP-3 levels as an early warning sign for the presence of giant cell arteritis in patients with polymyalgia rheumatica

Inflammatory aorta in Giant Cell Arteritis disease: a case study of 5 patients

Giant Cell Arteritis: Advances in Understanding Pathogenesis and Implications for Clinical Practice

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