Recent Updates and Advances in Winiwarter-Buerger Disease (Thromboangiitis Obliterans): Biomolecular Mechanisms, Diagnostics and Clinical Consequences

Abstract

Thromboangiitis obliterans (TAO) or Buerger’s disease is a segmental inflammatory, thrombotic occlusive peripheral vascular disease with unknown aetiology that usually involves the medium and small-sized vessels of young male smokers. Due to its unknown aetiology and similarities with atherosclerosis and vasculitis, TAO diagnosis is still challenging. We aimed to review the status of biomolecular and laboratory para-clinical markers in TAO compared to atherosclerosis and vasculitis. We reported that, although some biomarkers might be common in TAO, atherosclerosis, and vasculitis, each disease occurs through a different pathway and, to our knowledge, there is no specific and definitive marker for differentiating TAO from atherosclerosis or vasculitis. Our review highlighted that pro-inflammatory and cell-mediated immunity cytokines, IL-33, HMGB1, neopterin, MMPs, ICAM1, complement components, fibrinogen, oxidative stress, NO levels, eNOS polymorphism, adrenalin and noradrenalin, lead, cadmium, and homocysteine are common markers. Nitric oxide, MPV, TLRs, MDA, ox-LDL, sST2, antioxidant system, autoantibodies, and type of infection are differential markers, whereas platelet and leukocyte count, haemoglobin, lipid profile, CRP, ESR, FBS, creatinine, d-dimer, hypercoagulation activity, as well as protein C and S are controversial markers. Finally, our study proposed diagnostic panels for laboratory differential diagnosis to be considered at first and in more advanced stages.

Baiying qingmai formulation ameliorates thromboangiitis obliterans by inhibiting HMGB1/RAGE/NF-κB signaling pathways

“…Endothelial cells, platelets, and leukocytes are the main components involved in the vascular inflammatory response and thrombosis. Several pro-inflammatory cytokines including IL-6, TNF-α, HMGB1, and IL-1β are abnormally high in the blood of Frontiers in Pharmacology frontiersin.org patients with TAO (Fazeli et al, 2021;Shapouri-Moghaddam et al, 2021). An increase in IL-6 issues a warning signal during tissue damage or infectious lesions.…”

“…Therefore, several patients are incapacitated, which is burdensome for themselves as well as society. The pathogenesis of TAO is unclear ( Fazeli et al, 2021 ) and no effective treatments are currently known. Thus, the study on TAO and its etiology warrant more attention.…”

Buerger’s Disease (Thromboangiitis Obliterans) among Smokers: A Literature Review

“…The last set of criteria is Papa's criteria, which have the same criteria as the previous ones but a lower age of onset, specifically between 30-40 years, as well as Raynaud's syndrome, which is characterized by intermittent foot claudication, single limb involvement (a negative criterion), and female gender (a negative variation) (38). Among the aforementioned criteria, the Shionoya clinical criteria are one of the most widely utilized and acknowledge worldwide (16).…”

An Unusual Case of Buerger’s Disease in a Pregnant Female

“…It is characterized by thrombosis and recanalization of the vessels. It is a non-atherosclerotic occlusive inflammatory disease of the upper and lower extremities of small and medium-sized vessels [ 1 , 2 , 3 ]. The prevalence of the disease among all patients with peripheral arterial disease ranges from values as low as 0.5 to 5.6% in Western Europe to values as high as 45% to 63% in India [ 4 ].…”