Materiały źródłowe

• #1 Buerger Disease | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/18685

  There is no definitive etiology of Buerger disease, yet tobacco exposure is required for both disease initiation and progression. The mechanism of the disease remains a mystery, but it may involve immunologic dysfunction and tobacco hypersensitivity that is associated with enhanced cellular sensitivity to type-1 and type-3 collagen, impaired endothelium-dependent vasorelaxation, and increased anti-endothelial cell antibody titers. A genetic link may exist as affected subjects have an increased prevalence of human leukocyte antigen (HLA)-A9, HLA-B5, and HLA-54. […] Pathologically, in Buerger disease, thrombosis occurs in small to medium arteries and veins with associated dense polymorphonuclear leukocyte aggregation, microabscesses, and multinucleated giant cells. The chronic phase of the disease shows a decrease in the hypercellularity and frequent recanalization of the vessel lumen. End-stage lesions demonstrate organized thrombus and blood vessel fibrosis. Although the disease is common in Asia, North American males do not appear to have any particular predisposition, as the diagnosis is made in less than 1% of patients with severe limb ischemia.

• #2 Thromboangiitis Obliterans (Buerger Disease): Practice Essentials, Pathophysiology and Etiology, Epidemiology

  https://emedicine.medscape.com/article/460027-overview

  Thromboangiitis obliterans (TAO), an inflammatory vasculopathy also known as Buerger disease, is characterized by an inflammatory endarteritis that causes a prothrombotic state and subsequent vaso-occlusive phenomena. The inflammatory process is initiated within the tunica intima. It characteristically affects small and medium-sized arteries as well as veins of the upper and lower extremities. The condition is strongly associated with heavy tobacco use, and disease progression is closely linked to continued use. […] A few observations suggest the existence of an immunologic phenomenon leading to vasodysfunction and inflammatory thrombi. Patients with TAO exhibit hypersensitivity to intradermally injected tobacco extracts, increased cellular sensitivity to collagen types I and III, elevated serum antiendothelial cell antibody titers, and impaired peripheral endothelium-dependent vasorelaxation. They also show a higher prevalence of human leukocyte antigen (HLA)A9, HLA-A54, and HLA-B5, suggesting a genetic component to the disease.

• #3 Buerger’s Disease (Thromboangiitis Obliterans) among Smokers: A Literature Review

  https://clinmedjournals.org/articles/ijrdd/international-journal-of-rare-diseases-and-disorders-ijrdd-6-050.php?jid=ijrdd

  Buerger’s disease or thromboangiitis obliterans [TAO] is a progressive inflammatory disease that is non atherosclerotic and segmental. Small and medium arteries in the upper and lower extremities are most commonly affected. […] Despite the etiology and pathophysiology of TAO being still unclear, smoking plays a vital role in the emergence and development of the disease. […] Although etiology of TAO is still unclear, TAO, which attacks the peripheral blood vessels, has a strong relationship with smoking. Thromboangiitis obliterans are mostly found in young to middle-aged male patients (21-45 years) with a smoking history. Both directly and indirectly, cigarette exposure is associated with disease progression. […] Thromboangiitis obliterans which is an autoimmune vasculitic disease that affects medium and large sized vessels has an unclear etiology, but smoking exposure is considered as the initiation of disease emergence and disease progression. Smoking exposure is thought to cause immunological dysfunction and hypersensitivity correlated with increased type-1 and type-3 collagen, impaired vasorelaxation in the endothelium, and increased anti-endothelial cell antibody titers.

• #4 Etiology and Pathogenesis of Buerger’s Disease | IntechOpen

  https://www.intechopen.com/chapters/1155446

  This chapter delves into the multifaceted etiology of Buergers disease, also known as thromboangiitis obliterans (TAO), exploring a spectrum of factors contributing to its onset and the initiation of vascular inflammation. […] Our research unequivocally confirms TAO as an autoimmune disease characterized by multiple hypersensitivity reactions, primarily type III hypersensitivity, accompanied by type II, type IV, and type I reactions. Furthermore, our investigation uncovers a hypercoagulation state in the blood of TAO patients, shedding light on the intricate interplay between vascular immune dysregulation and thrombosis. […] Buergers disease is an autoimmune disease. And what is the immunological pathogenesis? Over the past 50 years, some scholars have enabled people to have a clearer understanding of the immune pathogenesis of TAO.

• #5 Etiology and Pathogenesis of Buerger’s Disease | IntechOpen

  https://www.intechopen.com/chapters/1155446

  In summary, TAO appears to involve a combination of type III, type II, type I, and type IV hypersensitivity reactions. […] Combined, our study identified TAO as an autoimmune disease involving multiple hypersensitivity reactions. Mainly, type III hypersensitivity, in addition to type IV hypersensitivity, also has type II hypersensitivity, and there is the involvement of type I hypersensitivity. […] It is believed immune dysregulation and blood hypercoagulability are very important. […] These abnormalities collectively indicate a state of blood hypercoagulability in patients with Buergers disease, rendering them more susceptible to the formation of thrombi within affected blood vessels. Regarding the relationship between thrombosis and immune-vasculitis in Buergers disease, it is believed that immune-vasculitis plays a dominant role, and the consequences of various hypersensitivity reactions lead to blood hypercoagulability and thrombosis within the vascular.

• #6 Thromboangiitis obliterans (Buerger’s disease) | Orphanet Journal of Rare Diseases | Full Text

  https://ojrd.biomedcentral.com/articles/10.1186/1750-1172-1-14

  Thromboangiitis obliterans or Buerger’s disease is a segmental occlusive inflammatory condition of arteries and veins, characterized by thrombosis and recanalization of the affected vessels. […] The etiology of thromboangiitis obliterans is unknown, but use or exposure to tobacco is central to the initiation and progression of the disease. […] Although the cause of Buerger’s disease remains unknown, a strong association with tobacco use has been established. Use or exposure to tobacco plays central role in the initiation and progression of the disease. […] Recent immunocytochemical studies have demonstrated a linear deposition of immunoglobulins and complement factors along the elastic lamina. […] Peripheral endothelium-dependent vasodilation is impaired in patients with Buerger’s disease, while non-endothelial mechanisms of vasodilation seem to be intact.

• #7 Buerger Disease | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/18685

  In contrast to atherosclerosis, which involves the intima and media, Buerger disease is manifested by the infiltration of round cells in all 3 layers of the arterial wall. Patients with Buerger disease may have specific cellular immunity against arterial antigens, specific humoral anti-arterial antibodies, and elevated circulatory, immune complexes, but a precise diagnosis can be made only by tissue histology.

• #8 Thromboangiitis Obliterans (Buerger’s Disease) | Thoracic Key

  https://thoracickey.com/thromboangiitis-obliterans-buergers-disease-2/

  Several observations implicate an immunologic phenomenon in the etiology of Buergers disease. […] Previous data suggest that T cell-mediated cellular immunity and B cell-mediated humoral immunity associated with the activation of macrophages or dendritic cells in the intima play a key role in Buergers disease. […] The importance of a genetic predisposition to tobacco sensitivity is not well documented, although some data suggest that an association is present. […] Buergers disease is characterized by segmental inflammatory cell infiltration of the vessel wall and arterial or venous thrombotic occlusions. […] The specific pathologic mechanisms in TAO are still unknown. Lesions occur in both the arterial and venous circulations. […] Today, there are compelling reasons to believe that the primary event is the activation of antigen-presenting cells after endothelial cell damage induced by an unidentified antigen, possibly tobacco glycoproteins. […] Intimal inflammation followed by T-cell infiltrations might result in early arterial occlusion, which is the pathognomonic finding in TAO.

• #9 Thromboangiitis Obliterans (Buerger Disease) – Clinical Tree

  https://clinicalpub.com/thromboangiitis-obliterans-buerger-disease/

  Thromboangiitis obliterans (TAO) describes a segmental, nonatherosclerotic inflammatory disorder that primarily involves the small and medium arteries, veins, and nerves of the extremities. […] TAO is a vasculitis characterized by a highly cellular inflammatory thrombus with relative sparing of the vessel wall. The precise etiology of TAO remains unknown. […] Exposure to tobacco is critical to the initiation, maintenance, and progression of TAO. […] It has been hypothesized that some patients develop an immunological reaction to a constituent of tobacco that triggers small vessel occlusive disease. […] Abnormalities in immunoreactivity are believed to play a critical role in the inflammatory process that characterizes TAO. […] In patients with a definite diagnosis of TAO as determined by clinical criteria, linear arrangement of macrophages, B-lymphocytes, and T-lymphocytes along vascular elastic fibers has been found to be a predictable and specific inflammatory response to the internal elastic lamina of affected vessels. […] Abnormalities of endothelial function also appear to contribute to the pathogenesis of TAO.

• #10 Endarteritis Obliterans in the Pathogenesis of Buerger’s Disease From the Pathological and Immunohistochemical Points of View

  https://www.jstage.jst.go.jp/article/circj/advpub/0/advpub_CJ-14-0656/_html/-char/en

  Recently, we studied the expression of Notch in the cells infiltrating the intima of arteries affected by Buergers disease and we discovered that Notch signaling could be related to the arterial occlusive mechanism of Buergers disease. […] Our findings demonstrate that, in Buergers disease, the Notch signaling pathway is expressed in the inflammatory cells infiltrating the intima and thrombus. Therefore, it is possible that the Notch signaling pathway interacts with the mechanism responsible for the forming of a thrombus and for the inflammation in Buergers disease. […] Furthermore, the Notch signaling pathway is expressed in the activated angiogenesis in the intima along the internal elastic lamina and the thrombus. Therefore, we speculate that the Notch signaling pathway may contribute to the underlying mechanism of endarteritis, angiogenesis, and recanalization of the arteries in patients suffering from Buergers disease.

• #11 Endarteritis Obliterans in the Pathogenesis of Buerger’s Disease From the Pathological and Immunohistochemical Points of View

  https://www.jstage.jst.go.jp/article/circj/78/12/78_CJ-14-0656/_html/-char/en

  We hypothesize that the differences might be related to the degree of extracellular matrix (ECM) degradation, which is caused by the plasminogen activator system and matrix metalloproteinases (MMPs). […] Our findings demonstrate that, in Buergers disease, the Notch signaling pathway is expressed in the inflammatory cells infiltrating the intima and thrombus. […] Therefore, we speculate that the Notch signaling pathway may contribute to the underlying mechanism of endarteritis, angiogenesis, and recanalization of the arteries in patients suffering from Buergers disease. […] On the basis of our pathologic and histopathologic observations, we believe that Buergers disease is an endarteritis induced by some antigen that has not yet been detected, in the intimal layer and/or thrombus.

• #12 Buerger’s disease pathophysiology – wikidoc

  https://www.wikidoc.org/index.php/Buerger%27s_disease_pathophysiology

  This increased cellular sensitivity leads to an impaired relaxation mechanism of the peripheral vessels. […] Cytokines are also thought to be produced in large quantities and may lead to the activation of inflammatory signals. […] The presence of elevated anti-cardiolipin antibodies is thought to be indicative of prognosis and severity. […] Rickettsial infection has been proposed to be involved in the pathogenesis of Buerger’s disease.

• #13 Buerger’s disease: providing integrated care | JMDH

  https://www.dovepress.com/buergerrsquos-disease-providing-integrated-care-peer-reviewed-fulltext-article-JMDH

  More recently, agonistic autoantibodies directed against G-protein-coupled receptors were identified as potentially promoting vasospasm, compromising microcirculation, damaging vessel structures, and inducing proliferative processes. […] A first model of this new paradigm has recently been published by Ketha and Cooper.

• #14 Thromboangiitis obliterans – Wikipedia

  https://en.wikipedia.org/wiki/Thromboangiitis_obliterans

  There are characteristic pathologic findings of acute inflammation and thrombosis (clotting) of arteries and veins of the hands and feet (the lower limbs being more common). The mechanisms underlying Buerger’s disease are still largely unknown, but smoking and tobacco consumption are major factors associated with it. […] It has been suggested that the tobacco may trigger an immune response in susceptible persons or it may unmask a clotting defect, either of which could incite an inflammatory reaction of the vessel wall. […] A possible role for Rickettsia in this disease has been proposed.

• #15 Buerger’s Disease (Thromboangiitis Obliterans) among Smokers: A Literature Review

  https://clinmedjournals.org/articles/ijrdd/international-journal-of-rare-diseases-and-disorders-ijrdd-6-050.php?jid=ijrdd

  Pathophysiology of TAO is still unclear, but infection, thrombosis, and the presence of some autoantibodies are thought to play a role in the occurrence of the disease. […] From several existing pathophysiology, smoking has been found to play a central role in the pathophysiology and incidence of TAO. […] Smoking can cause an inflammatory response through increased levels of neutrophil elastase (NE) and reactive oxygen intermediates (ROIs) which cause tissue damage. […] Smoking can also damage vascular walls, resulting in impaired prostacyclin production and increased interactions between blood vessel walls and platelets. […] Exposure to cigarette smoke also triggers the release of inflammatory cytokines that activate cellular signaling pathways through adhesion of immunocytes and endothelial cells, thereby causing intravascular thrombosis and vasculitis.

• #16 Buerger’s Disease (Thromboangiitis Obliterans) among Smokers: A Literature Review

  http://clinmedjournals.org/articles/ijrdd/international-journal-of-rare-diseases-and-disorders-ijrdd-6-050.php?jid=ijrdd

  Pathophysiology of TAO is still unclear, but infection, thrombosis, and the presence of some autoantibodies are thought to play a role in the occurrence of the disease. […] From several existing pathophysiology, smoking has been found to play a central role in the pathophysiology and incidence of TAO. […] Smoking can cause an inflammatory response through increased levels of neutrophil elastase (NE) and reactive oxygen intermediates (ROIs) which cause tissue damage. […] Smoking can also damage vascular walls, resulting in impaired prostacyclin production and increased interactions between blood vessel walls and platelets. […] Exposure to cigarette smoke also triggers the release of inflammatory cytokines that activate cellular signaling pathways through adhesion of immunocytes and endothelial cells, thereby causing intravascular thrombosis and vasculitis.

• #17 Recent Updates and Advances in Winiwarter-Buerger Disease (Thromboangiitis Obliterans): Biomolecular Mechanisms, Diagnostics and Clinical Consequences

  https://www.mdpi.com/2075-4418/11/10/1736

  Thromboangiitis obliterans (TAO) or Buerger’s disease is a segmental inflammatory, thrombotic occlusive peripheral vascular disease with unknown aetiology that usually involves the medium and small-sized vessels of young male smokers. […] Due to its unknown aetiology and similarities with atherosclerosis and vasculitis, TAO diagnosis is still challenging. […] Our review highlighted that pro-inflammatory and cell-mediated immunity cytokines, IL-33, HMGB1, neopterin, MMPs, ICAM1, complement components, fibrinogen, oxidative stress, NO levels, eNOS polymorphism, adrenalin and noradrenalin, lead, cadmium, and homocysteine are common markers. […] Nitric oxide, MPV, TLRs, MDA, ox-LDL, sST2, antioxidant system, autoantibodies, and type of infection are differential markers, whereas platelet and leukocyte count, haemoglobin, lipid profile, CRP, ESR, FBS, creatinine, d-dimer, hypercoagulation activity, as well as protein C and S are controversial markers.

• #18

  https://journals.lww.com/00002281-200601000-00005

  While tobacco is central to the initiation and continuance of Buerger’s disease activity, two interesting pathophysiologic observations have been made. There is endothelial dysfunction in arteries not yet clinically or angiographically involved in thromboangiitis obliterans. There are elevated levels of antiendothelial cell antibodies and measurement of these antibody titers may be useful in following disease activity in Buerger’s disease patients. […] The difficulty in studying rare diseases such as thromboangiitis obliterans is that there are no significant research dollars available and even the most active centers only see a few patients per year. Therefore, there has been little progress in understanding the pathogenesis of the disease.

• #19 Thromboangiitis obliterans (Buerger Disease)

  https://dermnetnz.org/topics/thromboangiitis-obliterans

  Thromboangiitis obliterans is a smoking-related condition that results in blood clot formation (thrombosis) in small and medium-sized arteries, and less commonly veins. […] The cause of thromboangiitis obliterans is not fully understood but it is probable that the smoking triggers thrombosis in the blood vessels, leading to a lack of oxygen and nutrients to the affected tissue. Research has demonstrated the presence of immunoglobulins and endothelial cell antibodies suggesting an immunological mechanism. The blood level of these antibodies can be used as a marker of disease activity. […] Response to acetylcholine (a chemical which leads to relaxation of blood vessels) has also been shown to be decreased in patients with thromboangiitis obliterans compared to normal subjects.

• #20 BUERGER’S DISEASE (THROMBOANGIITIS OBLITERANS) | Hand Surgery Resource

  https://www.handsurgeryresource.net/buergers

  Buerger’s disease is a vasculitis that attacks the small and medium vessels of the extremities. […] There are three phases of Buerger’s disease: Acute: polymorphonuclear leukocytes (PMNs) are predominant at the site of inflammation, and they may form microabscesses within the thrombus. […] Subacute: PMNs are surrounded by a granulomatous inflammation, which may lead to formation of a new path (recanalization) through the thrombus. […] Chronic: a mature thrombus with vascular fibrosis is evident. […] The normal structure of the affected vessel, and particularly the internal elastic lamina, remains intact in all three phases. […] Histopathology: highly inflammatory thrombus infiltrated with PMNs and multinucleated giant cells, affecting both arteries and veins. […] Arteriography (at least one of the following is required): Multiple segmental occlusions of distal arterial sections (distally from the elbow and knee). […] Chronic vascular occlusion due to secondary thrombosis. […] Absence of atherosclerotic lesions, such as calcification of vascular walls. […] Tapering and abrupt obstruction of vessels, a twisting course of the involved vessels Corkscrew or tree-root collaterals.

• #21 Azthena logo with the word Azthena

  https://www.news-medical.net/health/What-is-Buergere28099s-Disease.aspx

  Buerger’s disease, also known as thromboangiitis obliterans, is a rare condition that primarily affects young to middle-aged male smokers. […] Despite its significant link to tobacco use, little is known about the disease’s overall pathogenesis. […] The actual cause of Buerger’s disease is yet to be identified. Tobacco usage, on the other hand, has been linked to the development of the illness. […] Buerger’s illness is thought to be an autoimmune disorder by some scientists. […] Because the prevalence of Buerger’s illness varies greatly between ethnic groups, genetic factors may play a role in its development or severity. […] Buerger’s disease is defined by the constriction or occlusion (occlusion) of the intermediate or small arteries and veins of the extremities, resulting in decreased blood flow to these areas (peripheral vascular disease). […] Buerger’s disease is an unidentified medical ailment that is intrinsically associated with cigarette consumption.

• #22 Buerger’s Disease: Clinical Aspects and Evidence-Based Treatments | IntechOpen

  https://www.intechopen.com/chapters/59613

  Buergers disease (thromboangiitis obliterans) is a nonatherosclerotic, segmental, occlusive, and recurring progressive inflammatory form of vasculitis that most commonly affects the small- and medium-sized arteries, veins, and nerves in the upper and lower extremities. […] The etiology remains unknown but involves tobacco exposure (sine qua non), hereditary susceptibility, immune response, and coagulation changes. […] Currently, a possible infectious role is gaining interest, especially after the findings of bacteria of the oral flora in occlusive thrombi in patients with Buergers disease and moderate to severe periodontitis. […] Another hypothesis is the possibility of rickettsial infection (associated with environment conditions and genetic susceptibility) in Buergers disease pathogenesis.

• #23 :: IC :: Infection & Chemotherapy

  https://icjournal.org/DOIx.php?id=10.3947/ic.2021.0146

  The main target of Rickettsia and Orientia is vascular endothelial cells, and rickettsiae are observed within these cells. Vasculitis and perivasculitis are the main pathological findings. […] T cell-mediated cellular immunity plays a major role in the defense against Orientia and Rickettsia infections. […] Based on the above findings, we hypothesize the pathogenesis of BD as follows. BD patients acquired a rickettsial infection far before the onset of BD, and the rickettsiae infected endothelial cells of systemic vasculature in a scattered localized pattern, proliferated slowly, and were released to infect neighboring endothelial cells. The infected area expands circumferentially as well as longitudinally to become a segment of the infected vessel over years. As the number of endothelial cells with defects on their cell surfaces increases, these cells are predisposed to thrombosis. Subsequently, thrombus develops on and adhere to the luminal surface of the infected endothelial cells, and then is infected with the rickettsiae through its adherent part from these cells. As previous investigations suggest, the vessel with the infected thrombus evolves into a fibrous non-occluding or occluding vessel by cell-mediated immunity and other inflammatory reactions, in contrast to the resolution of vascular obstruction by thrombolysis in bland thrombosis. In conclusion, it is postulated that the aforementioned two-stage process, i.e., Rickettsia or Orientia endangiitis and superimposed thrombosis, produces the major clinical manifestations of BD.

• #24 Buerger’s disease: providing integrated care | JMDH

  https://www.dovepress.com/buergerrsquos-disease-providing-integrated-care-peer-reviewed-fulltext-article-JMDH

  Buergers disease, also known as thromboangiitis obliterans (TAO), is a segmental inflammatory disease affecting small- and medium-sized vessels, which is strongly associated with tobacco use. […] Although the etiology is still unknown, recent studies suggest an immunopathogenesis. […] There is a very tight correlation between the manifestation, flaring, and recurrence of Buergers disease (no tobacco, no Buergers disease). […] Chronic infectious disease especially periodontal disease was found to be associated with TAO. […] Nevertheless, smoldering infections such as periodontitis might trigger autoimmune mechanisms and coagulation. […] Signs of endothelial activation and proliferation as well as the presence of immunocompetent cells are seen in acute type lesions. […] Overall, the findings are consistent with the assumption of an immunopathogenesis of TAO.

• #25 Recent Updates and Advances in Winiwarter-Buerger Disease (Thromboangiitis Obliterans): Biomolecular Mechanisms, Diagnostics and Clinical Consequences

  https://www.mdpi.com/2075-4418/11/10/1736

  However, inflammation, thrombosis, infection, and the presence of some autoantibodies are a part of the pathophysiology of TAO, ASO, and vasculitis and could be detected in patients with any of these diagnoses. […] Although some biomarkers might be common in ASO, TAO, and vasculitis, each disease occurs through a different pathway with different origins. […] Hence, the mechanistic investigation of biomarkers is more useful and applicable. […] Based on this approach, there are three groups of markers: (1) similar markers, (2) controversial markers, (3) and differential markers. […] Pro-inflammatory and cell-mediated immunity (CMI) cytokines, IL-33, HMGB1, neopterin, MMPs, ICAM1, complement components, fibrinogen, oxidative stress, NO levels, eNOS polymorphism, adrenalin and noradrenalin, lead, cadmium, and homocysteine are the common markers. […] Mechanistic investigations are a kind of fuzzy logic that demonstrate the concept of partial truth, where the truth value may range between completely true (one) and completely false (zero).

• #26

  https://link.springer.com/article/10.1007/s00595-013-0566-9

  Under pathological conditions, the Notch signal pathway is involved in the inflammatory process in arteriosclerosis, atherosclerosis and angiogenesis under ischemic conditions. The purpose of this study was to observe whether or not Buergers disease is associated with Notch signal activation. […] Our findings are the first demonstration that Notch signal activation in inflammatory cells may be involved in the pathophysiological mechanism underlying Buergers disease.

• #27 Buerger’s Disease: Clinical Aspects and Evidence-Based Treatments | IntechOpen

  https://www.intechopen.com/chapters/59613

  Features distinguishing Buergers disease from atherosclerosis (the main differential diagnosis) include the anatomical distribution of the occlusions (with involvement of both the upper and lower extremities in many cases), associated superficial venous thrombosis, a paucity of atherosclerotic risk factors, and normal proximal large arteries.

• #28 Buerger’s disease | PPT

  https://www.slideshare.net/slideshow/buergers-disease-78796807/78796807

  Buerger’s disease is a progressive inflammatory disease that causes blockages in small and medium blood vessels, most commonly in the lower limbs of young and middle-aged male smokers. […] Buerger’s disease is a segmental, progressive, occlusive, inflammatory disease of small and medium sized vessels with superficial thrombophlebitis. […] Pathogenesis: Smoke- carbon monoxide and nicotinic acid, vasospasm, hyperplasia of intima, thrombosis of vessels, obliteration of vessels, panarteritis segmental. […] Artery, vein, and nerve are together involved. Nerve involvement due to blockage of vasa nervosa causes rest pain. Artery involvement leads to features like claudication pain. With blockage, plenty of collaterals open up. Collaterals maintain the blood supply to the ischemic area; this is known as compensatory peripheral vascular disease. Disease progression due to smoking leads to blockage of collaterals also leading to severe ischemia known as decompensatory peripheral vascular disease or critical limb ischemia.

• #29 Buerger’s Disease: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/21680-buergers-disease

  Buergers disease (thromboangiitis obliterans) is a rare disease of the blood vessels in your arms, legs, fingers and toes. Inflammation in your blood vessels makes it hard for your blood to flow through them. Blood clots can form, which create obstacles inside your blood vessels. As a result, you can have pain and damaged tissues starting in your fingers and toes and spreading to your arms and legs. […] The cause of Buergers disease isnt known, but scientists think something in tobacco hurts the lining in your blood vessels. Most people with Buergers disease use tobacco. […] Your genes may make you more likely to get Buergers disease. Some scientists think its an autoimmune disease. […] Theres no cure for Buergers disease, but stopping all tobacco, marijuana and nicotine use is the best way to keep Buergers disease from getting worse.

• #30 Buerger’s Disease: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/21680-buergers-disease

  When people with Buergers disease stop smoking, their symptoms usually get better. In some people, the disease goes into remission (becomes inactive) once they stop smoking. […] Some medications are helpful in Buergers disease treatment, including: Vasodilators, like calcium channel blockers, to make your blood flow better. […] Although theres no cure for Buergers disease, you can quit using tobacco products to keep it from getting worse. If you keep using tobacco products, youll need medicines and possibly surgeries to help you with your symptoms. […] The best thing you can do is to stop using any type of tobacco to keep Buergers disease from getting worse.

• #31 Thromboangiitis Obliterans (Buerger’s Disease) | SpringerLink

  https://link.springer.com/10.1007/978-3-642-37393-0_114-1

  Thromboangiitis obliterans, or Buergers disease, is a unique disorder characterized by chronic inflammation and acute thrombosis of the medium and small arteries of the extremities, leading to vascular insufficiency. […] A disease pattern characterized by exacerbation and remission is common over a defined period of disease activity, usually declining drastically after the age of 60. […] The only proven therapy is cessation of smoking, which significantly decreases the risk of amputation and improves quality of life.

• #32 Buerger’s Disease : Johns Hopkins Vasculitis Center

  https://www.hopkinsvasculitis.org/types-vasculitis/buergers-disease/

  This disease was first reported by Buerger in 1908, who described a disease in which the characteristic pathologic findings acute inflammation and thrombosis (clotting) of arteries and veins affected the hands and feet. […] The association of Buergers Disease with tobacco use, particularly cigarette smoking, cannot be overemphasized. Most patients with Buergers are heavy smokers, but some cases occur in patients who smoke moderately; others have been reported in users of smokeless tobacco. It has been postulated that Buergers Disease is an autoimmune reaction (one in which the bodys immune system attacks the bodys own tissues) triggered by some constituent of tobacco. […] Despite the clear presence of inflammation in this disorder, anti-inflammatory agents such as steroids have not been shown to be beneficial. Similarly, strategies of anticoagulation (thinning of the blood with aspirin or other agents to prevent clots) have not proven effective. The only way to prevent the progression of the disease is to abstain from all tobacco products.

• #33 Stem Cell Therapy for Thromboangiitis Obliterans (Buerger’s Disease)

  https://www.mdpi.com/2227-9717/8/11/1408

  The chief aim of this paper is to provide an overview of the current treatment modalities of TAO and outline approaches using stem cell therapy that may provide new therapeutic solutions to halt the pathogenesis of TAO. […] The stimulation of angiogenesis is critical to reversing the pathogenesis of TAO. […] It has been recently reported that cell therapy using mononuclear stem cells (MNCs), endothelial progenitor cells (EPCs), mesenchymal stem cells (MSCs), and pluripotent stem cells (PSCs) may have useful roles in prevention of the progression of disease and reduction in major amputation rates. […] The infusion resulted in the improvement of Walking Impairment Questionnaire scores and quality of life and the patient did not need any amputation sixteen months after the infusion. […] The success of this therapy can be attributed to the immunomodulatory activity BM-MSC against IL-33 mediated inflammation in TAO.

• #34 Treatment of Buerger’s disease… | F1000Research

  https://f1000research.com/articles/8-2016

  These findings demonstrate that focally injected AdMSCs could conduct systemic angiogenetic characteristics in patients with Buergers disease. […] The outcomes of the present clinical cases are considered as a result of the synergy between angiogenetic properties and anti-inflammatory/immunomodulatory action of AdMSC. […] The angiogenetic potential is essential for recovering damaged tissues.

• #35 Buerger’s Disease – Vascular Specialists of Central Florida

  https://arteryandvein.com/buergers-disease/

  Buergers disease is a rare condition affecting the arteries and veins in a patients arms and legs. Medically termed thromboangiitis obliterans, Buergers disease causes the blood vessels in those areas to become inflamed, swollen and can generate blood clotting. […] However, the mechanism by which tobacco affects the development of the disease has not been clarified. Many doctors believe that genetic factors also play a part in the development of the condition. […] In extreme cases, a board-certified vascular surgeon may recommend surgical intervention for Buergers disease. Surgical sympathectomy has been shown to control pain and increase blood flow, however, it is considered controversial and lacks empirical study. […] If Buergers disease goes unaddressed, the blood flow to the patients arms and legs will continue to deteriorate. Without the oxygen and nutrients needed to survive, tissues cannot remain healthy. This eventually leads to gangrene, which usually precedes amputation of the affected area.

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