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1دورية أكاديمية
المؤلفون: Fazeli B, Mirhosseini A, Hashemi Z, Taheri H
المصدر: International Medical Case Reports Journal, Vol Volume 13, Pp 33-40 (2020)
مصطلحات موضوعية: thromboangiitis obliterans, buerger’s disease, rickettsia, tobacco, smoking, Medicine (General), R5-920
الوصف: Bahare Fazeli, 1, 2 Ali Mirhosseini, 1 Zahra Hashemi, 1 Hossein Taheri 3 1Immunology Research Center, Inflammation and Inflammatory Diseases Division, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran; 2Vascular Independent Research and Education, European Foundation, Milan, Italy; 3Surgery Department, Farabi Hospital, Mashhad, IranCorrespondence: Bahare FazeliImmunology Research Center, Inflammation and Inflammatory Diseases Division, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IranTel +98 51 38002379Fax +985138414499Email bahar.fazeli@gmail.comAbstract: Until recently, the aetiology of Buerger’s disease (BD) has been unknown. Although there is a close relationship between BD and smoking, it cannot explain the low prevalence of BD among smokers or the disease’s geographical distribution. Infectious pathogens, such as Rickettsial infection, have also been suggested as the trigger of BD development, but this theory has neither been proven nor ruled out. The aim of this study was to evaluate the footprint of Rickettsial infection in tissue specimens obtained from amputees with Buerger’s disease. Forty-nine tissue biopsies were obtained from three below-the-knee amputees who also had a diagnosis of BD according to Olin’s criteria (between 14– 21 biopsies for each patient). After extraction of DNA from the tissue samples, the existence of 16srRNA was evaluated using a PCR test. The sequence of PCR products was evaluated using Geneious 11.1.2 software and NCBI blast. The 16srRNA was found in 3 to 7 samples from each patient. The sequence of the PCR products had a 98% homology with Rickettsia Tabaci. The sequences of the three patients were aligned, and no difference was found in the sequence of 16srRNA amongst the patients. Rickettsia Tabaci is a pathogen that infects tobacco leaves. Thus, BD might be an infectious disease for which smoking could be the route of pathogen entry into the bloodstreams of the sufferers. However, further studies are highly recommended to confirm this hypothesis.Keywords: thromboangiitis obliterans, Buerger’s disease, rickettsia, tobacco, smoking
وصف الملف: electronic resource
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2دورية أكاديمية
المؤلفون: Fazeli B, Farzadnia M, Taheri H
المصدر: International Medical Case Reports Journal, Vol Volume 12, Pp 119-123 (2019)
مصطلحات موضوعية: Thromboangiitis Obliterans, Buerger’s disease, Vasa-nervorum, pain, pathophysiology, Medicine (General), R5-920
الوصف: Bahare Fazeli,1,2 Mahdi Farzadnia,3 Hossein Taheri41Immunology Research Center, Inflammation and Inflammatory Diseases Division, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran; 2Vascular Independent Research and Education, European Foundation, Milan, Italy; 3Department of Pathology, Emam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran; 4Surgery Department, Farabi Hospital, Mashhad, IranAbstract: Buerger’s disease (BD) is an episodic, inflammatory, and occlusive peripheral vascular disease with unknown etiology, which can lead to tissue or limb loss. BD patients usually present neurological symptoms from the early stages of the disease including numbness, cold sensation, and allodynia as the disease progresses. Pain in the late stages of BD is very severe, almost resistant to opioid pain killers, and sometimes compels the patient to pursue major amputation. Therefore, pain management in BD patients is one of the most important and, at the same time, challenging issues since its main etiology is not well understood. Recently, a 39-year-old male smoker with a diagnosis of BD underwent a below-knee amputation in his left leg. Oddly, we found that the vasa-nervorum of the sural nerve had the pathological changes usually observed in BD, including inflammation and proliferation of endothelial cells. Notably, the inflammation was limited to the vasa-nervorum and did not extend to the nerve fascicles. Our findings could provide a clue to taking the approach of managing pain in BD as if it were vasculitis neuropathy; and the inflammation of the vasa-nervorum individually might be responsible for the pain characteristic of BD. In addition, our findings could indicate that BD is a systemic vasculitis of microcirculation and, hence, a different treatment approach for BD might be needed in addition to antithrombotic and vasodilator.Keywords: thromboangiitis obliterans, Buerger’s disease, vasa-nervorum, pain, pathophysiology
وصف الملف: electronic resource
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