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Current Rheumatology Reports
Erschienen in: Current Rheumatology Reports 10/2020

01.10.2020 | Recent Advances in Large Vessel Vasculitis (C Dejaco and C Duftner, Section Editors)

Pathogenesis of Giant Cell Arteritis and Takayasu Arteritis—Similarities and Differences

verfasst von: Ryu Watanabe, Gerald J. Berry, David H. Liang, Jörg J. Goronzy, Cornelia M. Weyand

Erschienen in: Current Rheumatology Reports | Ausgabe 10/2020

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Abstract

Purpose of Review

Giant cell arteritis (GCA) and Takayasu arteritis (TAK) are auto-inflammatory and autoimmune diseases with a highly selective tissue tropism for medium and large arteries. In both diseases, CD4+ T cells and macrophages form granulomatous lesions within the arterial wall, a tissue site normally protected by immune privilege. Vascular lesions can be accompanied by an extravascular component, typically an intense hepatic acute phase response that produces well-known laboratory abnormalities, e.g., elevated ESR and CRP. It is unclear whether GCA and TAK lie on a spectrum of disease or whether they represent fundamentally different disease processes.

Recent Findings

GCA and TAK share many clinical features, but there are substantial differences in genetics, epidemiology, disease mechanisms, response to treatment, and treatment complications that give rise to different disease trajectories. A significant difference lies in the composition of the wall-infiltrating immune cell compartment, which in TAK includes a significant population of CD8+ T cells as well as natural killer cells, specifying disparate disease effector pathways mediating tissue damage and vessel wall remodeling.

Summary

Despite the similarities in tissue tropism and histomorphology, GCA and TAK are two distinct vasculitides that rely on separate disease mechanisms and require disease-specific approaches in diagnosis and management.
Literatur
1.
Cuffy MC, Silverio AM, Qin L, Wang Y, Eid R, Brandacher G, et al. Induction of indoleamine 2,3-dioxygenase in vascular smooth muscle cells by interferon-gamma contributes to medial immunoprivilege. J Immunol. 2007;179:5246–54.PubMed
2.
Weyand CM, Goronzy JJ. Medium- and large-vessel vasculitis. N Engl J Med. 2003;349:160–9.PubMed
3.
Jennette JC, Falk RJ, Bacon PA, Basu N, Cid MC, Ferrario F, et al. 2012 revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. Arthritis Rheum. 2013;65:1–11.PubMed
4.
Weyand CM, Goronzy JJ. Immune mechanisms in medium and large-vessel vasculitis. Nat Rev Rheumatol. 2013;9:731–40.PubMedPubMedCentral
5.
Kermani TA. Takayasu arteritis and giant cell arteritis: are they a spectrum of the same disease? Int J Rheum Dis. 2019;22(Suppl 1):41–8.PubMed
6.
Yoshida M, Watanabe R, Ishii T, Machiyama T, Akita K, Fujita Y, et al. Retrospective analysis of 95 patients with large vessel vasculitis: a single center experience. Int J Rheum Dis. 2016;19:87–94.PubMed
7.
Kang EJ, Kim SM, Choe YH, Lee GY, Lee KN, Kim DK. Takayasu arteritis: assessment of coronary arterial abnormalities with 128-section dual-source CT angiography of the coronary arteries and aorta. Radiology. 2014;270:74–81.PubMed
8.
Subramanyan R, Joy J, Balakrishnan KG. Natural history of aortoarteritis (Takayasu’s disease). Circulation. 1989;80:429–37.PubMed
9.
Watanabe Y, Miyata T, Tanemoto K. Current clinical features of new patients with Takayasu arteritis observed from cross-country research in Japan: age and sex specificity. Circulation. 2015;132:1701–9.PubMed
10.
Chasset F, Frances C. Cutaneous manifestations of medium- and large-vessel vasculitis. Clin Rev Allergy Immunol. 2017;53:452–68.PubMed
11.
Yoshifuji H. Pathophysiology of large vessel vasculitis and utility of interleukin-6 inhibition therapy. Mod Rheumatol. 2019;29:287–93.PubMed
12.
Watanabe R, Ishii T, Nakamura K, Shirai T, Fujii H, Saito S, et al. Ulcerative colitis is not a rare complication of Takayasu arteritis. Mod Rheumatol. 2014;24:372–3.PubMed
13.
Costello JM Jr, Nicholson WJ. Severe aortic regurgitation as a late complication of temporal arteritis. Chest. 1990;98:875–7.PubMed
14.
Ghinoi A, Pipitone N, Nicolini A, Boiardi L, Silingardi M, Germano G, et al. Large-vessel involvement in recent-onset giant cell arteritis: a case-control colour-Doppler sonography study. Rheumatology (Oxford). 2012;51:730–4.
15.
Agard C, Barrier JH, Dupas B, Ponge T, Mahr A, Fradet G, et al. Aortic involvement in recent-onset giant cell (temporal) arteritis: a case-control prospective study using helical aortic computed tomodensitometric scan. Arthritis Rheum. 2008;59:670–6.PubMed
16.
Prieto-Gonzalez S, Arguis P, Garcia-Martinez A, et al. Large vessel involvement in biopsy-proven giant cell arteritis: prospective study in 40 newly diagnosed patients using CT angiography. Ann Rheum Dis. 2012;71:1170–6.PubMed
17.
Saleh M, Turesson C, Englund M, Merkel PA, Mohammad AJ. Visual complications in patients with biopsy-proven giant cell arteritis: a population-based study. J Rheumatol. 2016;43:1559–65.PubMedPubMedCentral
18.
Kermani TA, Sreih AG, Cuthbertson D, Carette S, Hoffman GS, Khalidi NA, et al. Evaluation of damage in giant cell arteritis. Rheumatology (Oxford). 2018;57:322–8.
19.
Chen JJ, Leavitt JA, Fang C, Crowson CS, Matteson EL, Warrington KJ. Evaluating the incidence of arteritic ischemic optic neuropathy and other causes of vision loss from giant cell arteritis. Ophthalmology. 2016;123:1999–2003.PubMedPubMedCentral
20.
Weyand CM, Goronzy JJ. Clinical practice. Giant-cell arteritis and polymyalgia rheumatica. N Engl J Med. 2014;371:50–7.PubMedPubMedCentral
21.
Weyand CM, Watanabe R, Zhang H, Akiyama M, Berry GJ, Goronzy JJ. Cytokines, growth factors and proteases in medium and large vessel vasculitis. Clin Immunol. 2019;206:33–41.PubMedPubMedCentral
22.
23.
24.
Rushing L, Schoen FJ, Hirsch A, Lie JT. Granulomatous aortic valvulitis associated with aortic insufficiency in Takayasu aortitis. Hum Pathol. 1991;22:1050–3.PubMed
25.
Miller DV, Isotalo PA, Weyand CM, Edwards WD, Aubry MC, Tazelaar HD. Surgical pathology of noninfectious ascending aortitis: a study of 45 cases with emphasis on an isolated variant. Am J Surg Pathol. 2006;30:1150–8.PubMed
26.
Wen Z, Shen Y, Berry G, Shahram F, Li Y, Watanabe R, et al. The microvascular niche instructs T cells in large vessel vasculitis via the VEGF-Jagged1-Notch pathway. Sci Transl Med. 2017;9:eaal3322.PubMedPubMedCentral
27.
Watanabe R, Maeda T, Zhang H, Berry GJ, Zeisbrich M, Brockett R, et al. MMP (matrix metalloprotease)-9-producing monocytes enable T cells to invade the vessel wall and cause vasculitis. Circ Res. 2018;123:700–15.PubMedPubMedCentral
28.
•• Zhang H, Watanabe R, Berry GJ, et al. Immunoinhibitory checkpoint deficiency in medium and large vessel vasculitis. Proc Natl Acad Sci U S A. 2017;114:E970–9. This is the first report that patients with giant cell arteritis have a disease-relevant defect in the immunoinhibitory PD-1/PD-L1 checkpoint.PubMedPubMedCentral
29.
Watanabe R, Zhang H, Berry G, Goronzy JJ, Weyand CM. Immune checkpoint dysfunction in large and medium vessel vasculitis. Am J Physiol Heart Circ Physiol. 2017;312:H1052–9.PubMedPubMedCentral
30.
Chen DS, Mellman I. Oncology meets immunology: the cancer-immunity cycle. Immunity. 2013;39:1–10.PubMed
31.
Chen DS, Mellman I. Elements of cancer immunity and the cancer-immune set point. Nature. 2017;541:321–30.PubMed
32.
Topalian SL, Hodi FS, Brahmer JR, Gettinger SN, Smith DC, McDermott DF, et al. Safety, activity, and immune correlates of anti-PD-1 antibody in cancer. N Engl J Med. 2012;366:2443–54.PubMedPubMedCentral
33.
Brahmer JR, Tykodi SS, Chow LQ, et al. Safety and activity of anti-PD-L1 antibody in patients with advanced cancer. N Engl J Med. 2012;366:2455–65.PubMedPubMedCentral
34.
Brekke LK, Fevang BS, Diamantopoulos AP, et al. Survival and death causes of patients with giant cell arteritis in Western Norway 1972-2012: a retrospective cohort study. Arthritis Res Ther. 2019;21:154.PubMedPubMedCentral
35.
Zhang H, Watanabe R, Berry GJ, Nadler SG, Goronzy JJ, Weyand CM. CD28 signaling controls metabolic fitness of pathogenic T cells in medium and large vessel vasculitis. J Am Coll Cardiol. 2019;73:1811–23.PubMedPubMedCentral
36.
Zhang H, Watanabe R, Berry GJ, Tian L, Goronzy JJ, Weyand CM. Inhibition of JAK-STAT signaling suppresses pathogenic immune responses in medium and large vessel vasculitis. Circulation. 2018;137:1934–48.PubMed
37.
Maleszewski JJ, Younge BR, Fritzlen JT, Hunder GG, Goronzy JJ, Warrington KJ, et al. Clinical and pathological evolution of giant cell arteritis: a prospective study of follow-up temporal artery biopsies in 40 treated patients. Mod Pathol. 2017;30:788–96.PubMedPubMedCentral
38.
Wen Z, Shimojima Y, Shirai T, Li Y, Ju J, Yang Z, et al. NADPH oxidase deficiency underlies dysfunction of aged CD8+ Tregs. J Clin Invest. 2016;126:1953–67.PubMedPubMedCentral
39.
Suzuki M, Jagger AL, Konya C, Shimojima Y, Pryshchep S, Goronzy JJ, et al. CD8+CD45RA+CCR7+FOXP3+ T cells with immunosuppressive properties: a novel subset of inducible human regulatory T cells. J Immunol. 2012;189:2118–30.PubMedPubMedCentral
40.
Goronzy JJ, Weyand CM. Mechanisms underlying T cell ageing. Nat Rev Immunol. 2019;19:573–83.PubMed
41.
42.
43.
Heath JJ, Grant MD. The immune response against human cytomegalovirus links cellular to systemic senescence. Cells. 2020;9:766.
44.
Jergovic M, Contreras NA, Nikolich-Zugich J. Impact of CMV upon immune aging: facts and fiction. Med Microbiol Immunol. 2019;208:263–9.PubMedPubMedCentral
45.
Dejaco C, Duftner C, Al-Massad J, et al. NKG2D stimulated T-cell autoreactivity in giant cell arteritis and polymyalgia rheumatica. Ann Rheum Dis. 2013;72:1852–9.PubMed
46.
47.
Weyand CM, Goronzy JJ. Immunometabolism in the development of rheumatoid arthritis. Immunol Rev. 2020;294:177–87.PubMed
48.
•• Watanabe R, Hilhorst M, Zhang H, et al. Glucose metabolism controls disease-specific signatures of macrophage effector functions. JCI Insight. 2018;3:e123047. This study defines a metabolic signature for macrophages in patients with giant cell arteritis, supporting the concept that pro-inflammatory macrophages could be re-educated through metabolic interference.
49.
Shirai T, Nazarewicz RR, Wallis BB, Yanes RE, Watanabe R, Hilhorst M, et al. The glycolytic enzyme PKM2 bridges metabolic and inflammatory dysfunction in coronary artery disease. J Exp Med. 2016;213:337–54.PubMedPubMedCentral
50.
Donato AJ, Morgan RG, Walker AE, Lesniewski LA. Cellular and molecular biology of aging endothelial cells. J Mol Cell Cardiol. 2015;89:122–35.PubMedPubMedCentral
51.
Tesauro M, Mauriello A, Rovella V, Annicchiarico-Petruzzelli M, Cardillo C, Melino G, et al. Arterial ageing: from endothelial dysfunction to vascular calcification. J Intern Med. 2017;281:471–82.PubMed
52.
Deng J, Younge BR, Olshen RA, Goronzy J̈J, Weyand CM. Th17 and Th1 T-cell responses in giant cell arteritis. Circulation. 2010;121:906–15.PubMedPubMedCentral
53.
Saadoun D, Garrido M, Comarmond C, Desbois AC, Domont F, Savey L, et al. Th1 and Th17 cytokines drive inflammation in Takayasu arteritis. Arthritis Rheum. 2015;67:1353–60.
54.
Terao C, Yoshifuji H, Kimura A, Matsumura T, Ohmura K, Takahashi M, et al. Two susceptibility loci to Takayasu arteritis reveal a synergistic role of the IL12B and HLA-B regions in a Japanese population. Am J Hum Genet. 2013;93:289–97.PubMedPubMedCentral
55.
Nakajima T, Yoshifuji H, Shimizu M, Kitagori K, Murakami K, Nakashima R, et al. A novel susceptibility locus in the IL12B region is associated with the pathophysiology of Takayasu arteritis through IL-12p40 and IL-12p70 production. Arthritis Res Ther. 2017;19:197.PubMedPubMedCentral
56.
Watanabe R, Hosgur E, Zhang H, Wen Z, Berry G, Goronzy JJ, et al. Pro-inflammatory and anti-inflammatory T cells in giant cell arteritis. Joint Bone Spine. 2017;84:421–6.PubMed
57.
Seko Y, Minota S, Kawasaki A, Shinkai Y, Maeda K, Yagita H, et al. Perforin-secreting killer cell infiltration and expression of a 65-kD heat-shock protein in aortic tissue of patients with Takayasu’s arteritis. J Clin Invest. 1994;93:750–8.PubMedPubMedCentral
58.
Terao C, Yoshifuji H, Matsumura T, Naruse TK, Ishii T, Nakaoka Y, et al. Genetic determinants and an epistasis of LILRA3 and HLA-B*52 in Takayasu arteritis. Proc Natl Acad Sci U S A. 2018;115:13045–50.PubMedPubMedCentral
59.
Kurata A, Saito A, Hashimoto H, Fujita K, Ohno SI, Kamma H, et al. Difference in immunohistochemical characteristics between Takayasu arteritis and giant cell arteritis: it may be better to distinguish them in the same age. Mod Rheumatol. 2019;29:992–1001.PubMed
60.
Matsumoto K, Suzuki K, Yoshimoto K, Seki N, Tsujimoto H, Chiba K, et al. Significant association between clinical characteristics and changes in peripheral immuno-phenotype in large vessel vasculitis. Arthritis Res Ther. 2019;21:304.PubMedPubMedCentral
61.
De Smit E, Lukowski SW, Anderson L, et al. Longitudinal expression profiling of CD4+ and CD8+ cells in patients with active to quiescent giant cell arteritis. BMC Med Genet. 2018;11:61.
62.
Zhang J, Zhao L, Wang J, Cheng Z, Sun M, Zhao J, et al. Targeting mechanistic target of rapamycin complex 1 restricts proinflammatory T cell differentiation and ameliorates Takayasu arteritis. Arthritis Rheum. 2020;72:303–15.
63.
Watanabe R. CD4+ T cells as key players in the immunopathology of Takayasu arteritis: comment on the article by. Arthritis Rheum. 2020;72:696–7.
64.
Arnaud L, Haroche J, Mathian A, Gorochov G, Amoura Z. Pathogenesis of Takayasu’s arteritis: a 2011 update. Autoimmun Rev. 2011;11:61–7.PubMed
65.
•• Mutoh T, Shirai T, Ishii T, et al. Identification of two major autoantigens negatively regulating endothelial activation in Takayasu arteritis. Nat Commun. 2020;11:1253. This study has identified endothelial protein C receptor (EPCR) and scavenger receptor class B type 1 (SR-BI) as autoantigens on endothelial cells in patients with Takayasu arteritis. Bound autoantibodies promote inflammation by blocking the negative regulatory role of the two receptors.PubMedPubMedCentral
66.
Pazzola G, Muratore F, Pipitone N, Crescentini F, Cacoub P, Boiardi L, et al. Rituximab therapy for Takayasu arteritis: a seven patients experience and a review of the literature. Rheumatology (Oxford). 2018;57:1151–5.
67.
Ramirez FD, Jamison BM, Hibbert B. Infectious aortitis. Int Heart J. 2016;57:645–8.PubMed
68.
Bossone E, Pluchinotta FR, Andreas M, Blanc P, Citro R, Limongelli G, et al. Aortitis. Vasc Pharmacol. 2016;80:1–10.
69.
Keser G, Aksu K. Diagnosis and differential diagnosis of large-vessel vasculitides. Rheumatol Int. 2019;39:169–85.PubMed
70.
Bowen CJ, Calderon Giadrosic JF, Burger Z, et al. Targetable cellular signaling events mediate vascular pathology in vascular Ehlers-Danlos syndrome. J Clin Invest. 2020;130:686–98.PubMed
71.
Kasashima F, Kawakami K, Matsumoto Y, Endo M, Kasashima S, Kawashima A. IgG4-related arterial disease. Ann Vasc Dis. 2018;11:72–7.PubMedPubMedCentral
72.
Akiyama M, Kaneko Y, Takeuchi T. Characteristics and prognosis of IgG4-related periaortitis/periarteritis: a systematic literature review. Autoimmun Rev. 2019;18:102354.PubMed
73.
Oshima Y, Takahashi S, Tani K, Tojo A. Granulocyte colony-stimulating factor-associated aortitis in the Japanese Adverse Drug Event Report database. Cytokine. 2019;119:47–51.PubMed
74.
Parodis I, Dani L, Notarnicola A, Martenhed G, Fernström P, Matikas A, et al. G-CSF-induced aortitis: two cases and review of the literature. Autoimmun Rev. 2019;18:615–20.PubMed
75.
Salem JE, Manouchehri A, Moey M, Lebrun-Vignes B, Bastarache L, Pariente A, et al. Cardiovascular toxicities associated with immune checkpoint inhibitors: an observational, retrospective, pharmacovigilance study. Lancet Oncol. 2018;19:1579–89.PubMedPubMedCentral
76.
Goldstein BL, Gedmintas L, Todd DJ. Drug-associated polymyalgia rheumatica/giant cell arteritis occurring in two patients after treatment with ipilimumab, an antagonist of ctla-4. Arthritis Rheum. 2014;66:768–9.
77.
Daxini A, Cronin K, Sreih AG. Vasculitis associated with immune checkpoint inhibitors-a systematic review. Clin Rheumatol. 2018;37:2579–84.PubMed
78.
Metadaten
Titel
Pathogenesis of Giant Cell Arteritis and Takayasu Arteritis—Similarities and Differences
verfasst von
Ryu Watanabe
Gerald J. Berry
David H. Liang
Jörg J. Goronzy
Cornelia M. Weyand
Publikationsdatum
01.10.2020
Verlag
Springer US
Erschienen in
Current Rheumatology Reports / Ausgabe 10/2020
Print ISSN: 1523-3774
Elektronische ISSN: 1534-6307
DOI
https://doi.org/10.1007/s11926-020-00948-x

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