INFLAMMATORY PROCESSES IN VASCULITIS - FR OM IMMUNE-COMPLEXES TO PAUCI-IMMUNE FORMS

Immune complexes are involved in the pathogenesis of Henoch-Schonlein purpura, essential mixed cryoglobulinemia, hepatitis B-associated peri arteritis nodosa and hypersensitivity vasculitis (related to infection or medications). ANCA's probably play a pathogenic role in Wegener's Granulomatosis, microscopic polyangiitis and renal-limited vasculitis. Pathologic responses of T-lymfocytes and granuloma formation have bee n demonstrated in temporal arteritis, Takayasu arteritis, Wegener's Gr anulomatosis, Churg-Strauss syndrome and Kawasaki syndrome. The eventu al pathogenic role of AECA's is less clear, with the possible exceptio n of rheumatoid arthritis and systemic lupus erythematosus. These four pathogenic factors are not mutually exclusive: several mechanisms may play in one disorder, as has been demonstrated for Wegener's Granulom atosis. From these new insights in the pathogenesis of vasculitis, new therapies with better efficacy and fewer side effects may arise.