Is Rickettsia the key to solving the puzzle of Buerger’s disease?

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]).…”

<p>Detection of Rickettsia Endosymbiont Bemisia Tabaci in the Amputated Limbs of Three Buerger’s Disease Patients</p>

“…Amongst the suggested infectious pathogens, Rickettsia infection drew our attention because it could explain the ratio of male to female involvement with BD, the pain characteristics, the involvement of small-and medium-sized vessels and also the pathological characteristics of BD. 8 Following evaluation of the IgG class antibody against Rickettsia rickettsii, which has cross-reactions with the spotted fever group, and Rickettsia typhi, which has cross-reactions with the typhus fever group, 92% of the patients were positive for Rickettsia rickettsii antibodies. 5 In this study, we aimed to evaluate the presence of any Rickettsia pathogen inside the vascular tissue of the amputees using PCR for 16sRNA, specifically for Rickettsials.…”

Buerger’s Disease: Clinical Aspects and Evidence-Based Treatments

“…Currently, a possible infectious role is gaining interest, especially after the findings of bacteria of the oral flora in occlusive thrombi in patients with Buerger's disease and moderate to severe periodontitis [6,7]. Another hypothesis is the possibility of rickettsial infection (associated with environment conditions and genetic susceptibility) in Buerger's disease pathogenesis [8,9]. Features distinguishing Buerger's disease from atherosclerosis (the main differential diagnosis) include the anatomical distribution of the occlusions (with involvement of both the upper and lower extremities in many cases), associated superficial venous thrombosis, a paucity of atherosclerotic risk factors, and normal proximal large arteries [10].…”