Buerger's disease: autoimmune disease involving multiple hypersensitivity types

Abstract

Buerger’s disease is an autoimmune disease? And what is the immunological pathogenesis？It has not been deeply researched but still attracts the attention of scholars. In our early study we reported that TAO may be an autoimmune disease involving hypersensitivity Type III & Type IV. In this study we further explored the immune pathogenesis of TAO based on initial research. We detected humoral immunity (Ig E) in 28 cases using enzyme-linked immunosorbent assay (ELISA). Antigen-antibody complex depositing on the vessel wall in 18 cases, and anti-vessel antibodies in 28 cases using three kinds of immune-labeling techniques (immunofluorescence labeling, immunoenzymatic staining and immuno-gold-silver staining). The result shows Ig E levels were significantly high (P<0.01). As high as 86% of anti-vessel antibodies in serum were found (P<0.001), and the auto-antibodies against the vessel were combined directly with vascular collagen. Antigen-antibody complexes deposited on the vascular wall. These findings further confirm TAO is an autoimmune disease involving multiple hypersensitivity reactions. This is mainly Type III hypersensitivity and type II in addition to type IV. The elevated Ig E suggest that TAO may a type I hypersensitivity involved.

Intra-Arterial Nitroglycerin Injection in Upper Extremity Buerger's Disease for Faster Ulcer Recovery: A Case Report

“…3,8,9,12 In some cases, the role of history of trauma in the development of TAO has to be better clarified. 13 Histologically, TAO stages are distinguished based on the disease's acute, subacute, and chronic stages. 14,15 Thromboarteritis or a thrombophlebitic process is the initial pathologic process.…”

“…Type III hypersensitivity is mainly present, in addition to other types of hypersensitivity reactions. [13][14][15] Numerous researches suggest that oxidative stress increases endothelial cell dysfunction and can affect vascular tone directly by lowering the bioavailability of nitric oxide (NO). However, it is unclear if the elevated oxidative stress in TAO results from low NO levels or if low NO levels are a contributing factor.…”