title: Anti-cytokine treatment for Takayasu arteritis: State of the art.
abstract: Takayasu arteritis (TA) is a rare and idiopathic large-vessel arteritis typically affecting young women which has important morbidity and mortality. There are no animal models of TA and pathogenesis is still mysterious. Clinical assessment lacks accurate activity indexes and is based on the integration of clinical, laboratory and radiological data. TA rarity has hampered randomized clinical trials and the achievement of high-quality evidence to guide clinical activity. Prevention of vascular progression, with progressive vessel wall remodelling and hyperplasia, is the main therapeutic goal. Medical therapy remains the mainstay of management and comprises traditional immunosuppressive agents and anti-inflammatory drugs, such as steroids and blockers of pivotal cytokines, TNF-α and IL-6. These strategies however only partially limit vascular progression, indicating that local molecular events are involved. Here we discuss recent data suggesting that selected cellular components of TA lesions should be evaluated as novel therapeutic targets.
authors.affiliation: Unit of Internal Medicine and Clinical Immunology, San Raffaele Scientific Institute, Milan, Italy; ; Università Vita-Salute San Raffaele, Milan, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Tombetti
authors.affiliation: Unit of Internal Medicine and Clinical Immunology, San Raffaele Scientific Institute, Milan, Italy; ; Università Vita-Salute San Raffaele, Milan, Italy.
authors.forename: Maria Chiara
authors.initials: MC
authors.lastname: Di Chio
authors.affiliation: Unit of Internal Medicine and Clinical Immunology, San Raffaele Scientific Institute, Milan, Italy; ; Università Vita-Salute San Raffaele, Milan, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Sartorelli
authors.affiliation: Unit of Internal Medicine and Clinical Immunology, San Raffaele Scientific Institute, Milan, Italy;
authors.forename: Enrica
authors.initials: E
authors.lastname: Bozzolo
authors.affiliation: Unit of Internal Medicine and Clinical Immunology, San Raffaele Scientific Institute, Milan, Italy; ; Università Vita-Salute San Raffaele, Milan, Italy.
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Sabbadini
authors.affiliation: Unit of Internal Medicine and Clinical Immunology, San Raffaele Scientific Institute, Milan, Italy; ; Università Vita-Salute San Raffaele, Milan, Italy.
authors.forename: Angelo A
authors.initials: AA
authors.lastname: Manfredi
authors.affiliation: Unit of Internal Medicine and Clinical Immunology, San Raffaele Scientific Institute, Milan, Italy;
authors.forename: Elena
authors.initials: E
authors.lastname: Baldissera
keywords: Takayasu arteritis; angioplasty; surgery; tocilizumab; tumor necrosis factor (TNF)