RESUMO
Large vessels vasculitis includes two diseases : 1) giant cell arteritis, formerly known as Horton's arteritis and 2) Takayasu arteritis. In this article, we will describe and compare the epidemiology, pathogenesis, diagnostic criteria and medical management of both vasculitis. T helper (Th) 1 and Th17 responses, genetic links and the role of viral (varicella zoster) and bacterial infection (Mycoplasma pneumoniae or Chlamydia pneumoniae) will be discussed. Classification criteria, inflammation biomarkers and progress in imaging tools will also be described. Finally, we will review the medical management including corticosteroids, aspirin and biologicals.
Les artérites ou vasculites des grands vaisseaux regroupent deux maladies : 1) l'artérite à cellules géantes ou gigantocellulaire (GCA), anciennement dénommée maladie de Horton et 2) l'artérite de Takayasu (TA). Le but de cet article est de détailler et comparer l'épidémiologie, la pathogenèse, les critères diagnostiques ainsi que la prise en charge de ces deux vasculites. Nous discuterons en particulier du rôle de la signature immune T helper (Th) 1 versus Th17, l'influence de la génétique et aussi le lien avec des infections virale (varicelle zoster) ou bactérienne (Mycoplasma pneumoniae/Chlamydia pneumoniae). Les critères de classification, les biomarqueurs de l'inflammation ainsi que le rôle de l'imagerie seront aussi discutés. Finalement, nous ferons la revue des corticostéroïdes, de l'aspirine et des biologiques dans la prise en charge de ces patients.
Assuntos
Arterite de Células Gigantes/fisiopatologia , Arterite de Takayasu/fisiopatologia , Aspirina/uso terapêutico , Produtos Biológicos/uso terapêutico , Arterite de Células Gigantes/diagnóstico , Arterite de Células Gigantes/terapia , Glucocorticoides/uso terapêutico , Humanos , Inflamação/diagnóstico , Inflamação/fisiopatologia , Inflamação/terapia , Arterite de Takayasu/diagnóstico , Arterite de Takayasu/terapiaRESUMO
Cancer immunotherapy is a promising approach for treating malignancies through the activation of anti-tumor immunity. However, the effectiveness and safety of immunotherapy can be limited by tumor complexity and heterogeneity, caused by the diverse molecular and cellular features of tumors and their microenvironments. Undifferentiated tumor cell niches, which we refer to as the "Origin of Tumor Development" (OTD) cellular population, are believed to be the source of these variations and cellular heterogeneity. From our perspective, the existence of distinct features within the OTD is expected to play a significant role in shaping the unique tumor characteristics observed in each patient. Single-cell transcriptomics is a high-resolution and high-throughput technique that provides insights into the genetic signatures of individual tumor cells, revealing mechanisms of tumor development, progression, and immune evasion. In this review, we explain how single-cell transcriptomics can be used to develop personalized cancer immunotherapy by identifying potential biomarkers and targets specific to each patient, such as immune checkpoint and tumor-infiltrating lymphocyte function, for targeting the OTD. Furthermore, in addition to offering a possible workflow, we discuss the future directions of, and perspectives on, single-cell transcriptomics, such as the development of powerful analytical tools and databases, that will aid in unlocking personalized cancer immunotherapy through the targeting of the patient's cellular OTD.