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Curr Med Chem. 2019 Aug 16. doi: 10.2174/0929867326666190816233042. [Epub ahead of print]

Risk Factors, Mechanisms and Treatments of Thromboangiitis Obliterans: An Overview of Recent Research.

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Department of Physiology, College of Medicine, Nanchang University, Nanchang 330006,. China.
Institute of Cancer Research, Jiangxi Academy of Medical Science, Nanchang, Jiangxi 330006,. China.
Department of Nurse, Nanchang University hospital, Nanchang, Jiangxi 330006,. China.
Department of Experimental Teaching Center, Nanchang University, Nanchang 330031,. China.


Thromboangiitis obliterans (TAO) is a nonatherosclerotic thrombotic-occlusive 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. <p></p> Objective: To summarize and present an overview of recent advances regarding the risk factors, mechanisms and treatments of TAO and to organize the related information into figures to provide a comparatively complete reference. <p></p> 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). <p></p> Results: After screening content of literatures, 99 references were evaluated. We found that risk factors of TAO include smoking, gene factors and periodontal diseases. The underlying mechanism of TAO involves in 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 relationship study of them are 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. <p></p> Conclusions: 1. Puts forward a hypothesis that infections can trigger autoimmunity in TAO development, in which TLR4, as a key role, can activate immune signaling pathways and induce autoimmune cytokines expression. 2. Suggests a reconsideration about the association between periodontal diseases and TAO, such as they just 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 needed. <p></p>.


Thromboangiitis Obliterans; Buerger's disease; Risk factors; Pathological mechanism; Treatments; Review

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