Modern aspects of Takayasu syndrome
Abstract
Takayasu arteritis (TA) is a rare systemic vasculitis affecting large arteries, in particular the aorta, and its branches. This review examines aspects of epidemiology, etiology, pathogenesis, diagnosis and treatment of TA, taking into account the latest achievements in this field. The greatest prevalence of this disease is observed in Japan, and most often girls suffer from it. Clinical manifestations depend on ethnic and gender factors. The exact etiology of TA remains uncertain, but modern ideas point to its autoimmune origin, primarily associated with T cells, although B cells also play a significant role in the pathogenesis of the disease. Most often, the process of diagnosing TA is complicated due to non-specific clinical symptoms and the lack of specialized diagnostic methods. Some noninvasive imaging techniques, such as positron emission tomography with 18F-fluorodeoxyglucose, ultrasound Dopplerography, computed tomography and magnetic resonance imaging of blood vessels, are of key importance in the diagnosis of TA, since they allow to assess the condition of blood vessels and determine the degree of disease. TA treatment consists of invasive and non-invasive (medical) methods. Basic antirheumatic drugs (HDL) are in the center of noninvasive therapy. Synthetic and biological HDL, as well as immunosuppressive therapy, are used to control the inflammatory process, prevent complications and achieve remission. With the progression of the disease against the background of non-invasive therapy, non-invasive methods are resorted to, in particular endovascular therapy and open surgery. Additional research is needed to gain a deeper understanding of the mechanisms behind TA, as well as to create targeted therapies.
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