Title:Risk Factors, Mechanisms and Treatments of Thromboangiitis Obliterans: An Overview of Recent Research
Volume: 27
Issue: 35
Author(s): Meng-di Li, Yi-fan Wang, Mei-wen Yang, Fen-fang Hong*Shu-long Yang*
Affiliation:
- Department of Experimental Teaching Center, Nanchang University, Nanchang 330031,China
- Department of Physiology, College of Medicine, Nanchang University, Nanchang 330006,China
Keywords:
Thromboangiitis obliterans, buerger’s disease, risk-factors, pathological mechanism, treatments, clinical
features of TAO.
Abstract:
Background: Thromboangiitis obliterans (TAO) is a nonatherosclerotic thromboticocclusive
vasculitis that affects the vessels of the small and medium-sized extremities. No explicit
etiology or pathogenesis of TAO has been proven, and more effective treatments are needed.
Objective: The study aimed to summarize and present an overview of recent advances regarding the
risk factors, mechanisms and treatments of TAO and to organize the related information in figures to
provide a comparatively complete reference.
Methods: We searched PubMed for English-language literature about TAO without article type
limits, including articles about the risk factors, pathological mechanisms and treatments of TAO in
the last 10 years with essential supplements (references over ranges and English abstracts of Russian
literature).
Results: After screening content of works of literature, 99 references were evaluated. We found that
risk factors of TAO include smoking, gene factors and periodontal diseases. The underlying mechanism
of TAO involves oxidative stress, immunity, hemodynamic changes, inflammation and so on.
Moreover, similarities in genetic factors and cigarette relevance existed between periodontal diseases
and TAO, so further study of relationship was required. For TAO treatment, medicine, endovascular
intervention and revascularization surgery, autologous cell therapy and novel therapies
were also mentioned. Besides, a hypothesis that infection triggers autoimmunity in TAO could be
speculated, in which TLR4 plays a key role.
Conclusion: 1. A hypothesis is put forward that infections can trigger autoimmunity in TAO development,
in which TLR4, as a key agent, can activate immune signaling pathways and induce autoimmune
cytokines expression. 2. It is suggested to reconsider the association between periodontal
diseases and TAO, as they share the same high-risk population. Controlling periodontal disease
severity in TAO studies may provide new clues. 3. For TAO treatment, endovascular intervention
and autologous cell therapy both showed promising long-term therapeutic effectiveness, in which
autologous cell therapy is becoming more popular, although more clinical comparisons are needed.
