Vasculitis Explained - What Triggers It & How It’s Treated
Vasculitis is also known as the inflammation of blood vessels. Inflammations can cause the thickening of the walls of blood vessels. There are a variety of factors that can cause vasculitis in humans, although the exact cause is still unknown and is under research.
Possible Causes of Vasculitis in Humans
These are some of the possible causes of vasculitis in humans, including:
- Autoimmune Disorders: Conditions, such as lupus, scleroderma, and rheumatoid arthritis, can cause vasculitis, as in these conditions, our immune system mistakenly attacks blood vessels. The immune system exhibits abnormal behaviour under these autoimmune disorders. Thus, it gets turned against its cells and tissues. Rheumatoid arthritis or systemic lupus can cause vasculitis, especially in the hands and feet.
- Infections: Infections, such as Hepatitis B or C, can trigger vasculitis in certain individuals, as the HBV and HBC induce the production of antibodies against the viral proteins. These antibodies form complexes with the viral antigen, which gets deposited on the inner walls of blood vessels. The depositions of these immune complexes activate the complement system, which eventually causes inflammation and damage.
- Medications: Certain drugs, like propylthiouracil and hydralazine, can trigger vasculitis through an immune-mediated reaction. Both these drugs can trigger the production of autoantibodies, which attack the body’s tissues, including the blood vessels. Studies suggest that PTU also produces anti-neutrophil cytoplasmic antibodies (ANCAs), which are markers for vasculitis.
- Blood Cancer: Lymphoma, a specific type of blood cancer, can cause vasculitis through two main mechanisms: direct infiltration of blood vessels and paraneoplastic effects. This blood cancer produces abnormal antibodies, known as cryoglobulins, which are deposited in the walls of blood vessels. Lymphoma cells can directly infiltrate and damage blood vessels, causing inflammation and obstructed blood flow.
- Genetic Factors: Various genetic factors can increase the risk of developing vasculitis. Those factors include specific HLA (Human Leukocyte Antigen) alleles, like HLA-DRB104, HLA-B51, SERPINA1, and HLA-B52:01. These alleles are mainly present on Chromosome 6, which primarily causes giant cell arteritis. In addition, the MEFV gene causes Behçet’s disease and leads to vasculitis.
- Stress: Extreme levels of stress can contribute to vasculitis flare-ups due to the release of stress hormones, such as cortisol. Higher cortisol levels worsen the immune system and potentially trigger or worsen vasculitis. Frequent stress can disrupt the delicate balance of the immune system, leading to granulomatosis.
- Environmental Factors: Certain environmental factors, like smoking or tobacco usage, can trigger vasculitis, especially in adults. Toxins in cigarettes promote vascular inflammation, increasing the expression of IL-1β, IL-6, and TNF-ɑ. These cytokines trigger the production of increased autoantibodies, leading to inflammation of blood vessels.
Treatments for Vasculitis
Treatments for vasculitis primarily focus on managing inflammation and suppressing the abnormal immune response. These treatments are a combination of different medications to enhance the overall response.
Here are certain types of medications to treat vasculitis:
- Corticosteroids: Prednisone is a common corticosteroid which can be beneficial in reducing inflammation of blood vessels and controlling vasculitis. As it may have certain side effects, you must consult with healthcare providers before using it.
- Immunosuppressive Agents: Immunosuppressive agents, such as methotrexate, mycophenolate mofetil, and mycophenolate, can suppress your immune system. This will eventually reduce the inflammation, preventing the immune system from self-attack.
- Biologics: Doctors recommend certain biologics, like TNF inhibitors, rituximab, or tocilizumab, to target specific immune system complexes. These molecules act as antagonists to those proteins that are responsible for vasculitis.
Apart from these, doctors sometimes provide blood-thinning medicines. These medicines prevent blood clots and damage to the blood vessels.