Vasculitis: Current Status and Future Directions

Pierre Youinou

Published online: 10 January 2008# Humana Press Inc. 2007

Abstract Vasculitides represent such a heterogeneous groupof disorders that difficulties arise in their classification.Although biopsy examination of involved tissues remainsessential, new serological markers have been developed.Therapeutic strategies have been refined, and B lymphocyte-targeted drugs may prove a satisfactory alternative.

Keywords Vasculitis . Vasculitides . Immunology

This special issue of Clinical Reviews in Allergy andImmunology contains a series of papers that reflects currentthoughts on vasculitis. As noted by Dr. Kallenberg in thisissue, vasculitis is a condition characterized by inflammationof blood vessels. Its clinical manifestations are dependent onthe localization and size of the involved vessels as well as onthe nature of the inflammatory process. Vasculitis can besecondary to other conditions or constitute a primary, in mostof the cases, idiopathic disorder. Underlying conditions inthe secondary vasculitides are infectious diseases, connec-tive tissue diseases, and hypersensitivity disorders. Immunecomplexes, either deposited from the circulation or formed insitu, are involved, in many cases, in the pathophysiology ofthe secondary vasculitides. Those complexes are supposedlycomposed of microbial antigens in case of underlyinginfectious diseases, autoantigens in the connective tissuediseases, and nonmicrobial exogenous antigens in thehypersensitivity disorders. Although immune deposits canbe demonstrated in the involved vessel wall by directimmunofluorescence of biopsy material, the specificities ofthe antigens and their corresponding antibodies have not

been demonstrated in most of the cases [1]. Other issues inthis theme include animal models [2], current perspectiveson Wegener’s granulomatosus [3, 4], the role of hepatitis C[5], Behcet’s syndrome [6], and antineutrophil, antiendo-thelial, and anti-heat shock protein 60 antibodies [7–9].Finally, there is quite a bit of discussion by Dr. Guillevinand Drs. Coca and Anolik on treatment [10, 11].

It is clearly impossible to present all the features ofvasculitis, and the purpose of this theme is to focus onclinically important issues that can advance the therapy ofpatients. For a generic discussion of mechanisms ofautoimmunity, we refer the reader to a number of recentpapers in the Journal of Autoimmunity and AutoimmunityReviews [11–59]. Finally, we note a number of paperspublished in Clinical Reviews in Allergy and Immunology.The parent journal of this theme, Clinical Reviews inAllergy and Immunology, focuses on vasculitis but also,more importantly, other issues that relate to the lung or toimmune responsiveness [60–121].

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Clinic Rev Allerg Immunol (2008) 35:1–4DOI 10.1007/s12016-007-8061-y

P. Youinou (*)Laboratory of Immunology,Brest University Medical School Hospital,BP 824, 29609 Brest, Francee-mail: youinou@univ-brest.fr

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