Pathophysiology of giant cell arteritis

• Published in: La revue de medecine interne Vol. 34; no. 7; pp. 392 - 402
• Main Authors: Ly, K-H, Liozon, E, Fauchais, A-L, Vidal, E
• Format: Journal Article
• Language: French
• Published: France 01-07-2013
• Subjects: Animals; Endothelial Cells - immunology; Endothelial Cells - physiology; Endothelium, Vascular - pathology; Endothelium, Vascular - physiopathology; Genetic Predisposition to Disease; Giant Cell Arteritis - immunology; Host-Pathogen Interactions - immunology; Humans; Immune System - physiology; Infection - complications; Infection - immunology; Interleukin-1beta - physiology; Interleukin-6 - physiology
• ISSN: 1768-3122
• DOI: 10.1016/j.revmed.2013.02.037

Giant cell arteritis is a large-vessel vasculitis affecting all three layers of the arterial wall. Histopathology of this vasculitis consists of an inflammatory infiltrate with CD4(+) T cells, macrophages, multinucleated giant cells, forming granulomas in the media. This infiltrate is associated with a destruction of the arterial wall, a fragmentation of the internal elastic lamina and a vascular remodeling leading to intimal hyperplasia. Recent studies have clarified the role of Th17 cells in the initial phase of the disease, pro-inflammatory cytokines and vascular smooth muscle cells in vascular remodeling. This review aims to update data on giant cell arteritis pathogenesis and to propose clues of investigation for a better understanding of this condition.