Current understanding and management of giant cell arteritis and polymyalgia rheumatica

Ghosh, Parasar; Borg, Frances; Dasgupta, Bhaskar

doi:10.1586/eci.10.59

Cited by 24 publications

(10 citation statements)

References 87 publications

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“…The pathogenesis of GCA remains unclear but CD4 + T cell is the key cell involved and the key cytokines are IFN-c (essential for granuloma formation) and IL-6 (for systemic response) [86,87].…”

Section: Gaint Cell Arteritis and Takayasu Arteritismentioning

confidence: 99%

Anti‐interleukin‐6 receptor antibody, tocilizumab, for the treatment of autoimmune diseases

2011

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Interleukin (IL)‐6 is a cytokine with multiple biological activities. It contributes to host defense against pathogens, whereas accelerated production of IL‐6 plays a significant pathological role in various diseases. Clinical trials have demonstrated the efficacy of tocilizumab, a humanized anti‐IL‐6 receptor antibody, for patients with rheumatoid arthritis, Castleman's disease or juvenile idiopathic arthritis, leading to approval of this innovative drug for the treatment of these diseases. Since IL‐6 has been demonstrated to play a significant role in the development of various other autoimmune and inflammatory diseases, tocilizumab can be expected to become a novel drug for such diseases as well.

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Section: Gaint Cell Arteritis and Takayasu Arteritismentioning

confidence: 99%

Anti‐interleukin‐6 receptor antibody, tocilizumab, for the treatment of autoimmune diseases

2011

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“…What do I need to do? Why is it important for me to do this?” [22]. Furthermore, the use of “teach-back” has been documented to improve care in diabetes [23], although this has not been tested in musculoskeletal conditions.…”

Section: Discussionmentioning

confidence: 99%

Role of Health Literacy in Self-Reported Musculoskeletal Disorders

et al. 2015

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Self-report of musculoskeletal conditions is often used to estimate population prevalence and to determine disease burden and influence policy. However, self-report of certain musculoskeletal conditions is frequently inaccurate, suggesting inadequate communication to the patient of their diagnosis. The aim of this study is to determine the association between functional health literacy (FHL) and self-reported musculoskeletal conditions in a representative population survey. FHL was measured using Newest Vital Sign in 2824 randomly selected adults. Participants also self-reported medically diagnosed arthritis, gout, and osteoporosis. Multiple logistic regression was adjusted for age and sex. The prevalence of self-reported arthritis, gout, and osteoporosis was 25.2%, 4.9%, and 5.6%, respectively. The prevalence of those at risk for inadequate FHL was 24.0% and high likelihood of inadequate FHL was 21.0%. However, over 50% of respondents with arthritis or gout had at risk/inadequate FHL, increasing to 70% of those self-reporting osteoporosis. After adjustment for age and sex, respondents in the arthritis subgroup of “don't know” and self-reported osteoporosis were significantly more likely to have inadequate FHL than the general population. This study indicates a substantial burden of low health literacy amongst people with musculoskeletal disease. This has implications for provider-patient communication, individual healthcare, population estimates of musculoskeletal disease, and impact of public health messages.

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“…Dendritic cells and macrophages are obligatory components of the granulomatous infiltrates in the wall of GCA-affected arteries (96). DC are thought to act as gate-keepers of the vasculitis by inducing T cell activation, and display a phenotype of strong immune-stimulatory APC (92).…”

Section: Giant-cell Arteritismentioning

confidence: 99%

T Cellâ€“Macrophage Interactions and Granuloma Formation in Vasculitis

et al. 2014

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Granuloma formation, bringing into close proximity highly activated macrophages and T cells, is a typical event in inflammatory blood vessel diseases, and is noted in the name of several of the vasculitides. It is not known whether specific properties of the microenvironment in the blood vessel wall or the immediate surroundings of blood vessels contribute to granuloma formation and, in some cases, generation of multinucleated giant cells. Granulomas provide a specialized niche to optimize macrophage–T cell interactions, strongly activating both cell types. This is mirrored by the intensity of the systemic inflammation encountered in patients with vasculitis, often presenting with malaise, weight loss, fever, and strongly upregulated acute phase responses. As a sophisticated and highly organized structure, granulomas can serve as an ideal site to induce differentiation and maturation of T cells. The granulomas possibly seed aberrant Th1 and Th17 cells into the circulation, which are known to be the main pathogenic cells in vasculitis. Through the induction of memory T cells, aberrant innate immune responses can imprint the host immune system for decades to come and promote chronicity of the disease process. Improved understanding of T cell–macrophage interactions will redefine pathogenic models in the vasculitides and provide new avenues for immunomodulatory therapy.

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Current understanding and management of giant cell arteritis and polymyalgia rheumatica

Cited by 24 publications

References 87 publications

Anti‐interleukin‐6 receptor antibody, tocilizumab, for the treatment of autoimmune diseases

Anti‐interleukin‐6 receptor antibody, tocilizumab, for the treatment of autoimmune diseases

Role of Health Literacy in Self-Reported Musculoskeletal Disorders

T Cellâ€“Macrophage Interactions and Granuloma Formation in Vasculitis

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