What is vasculitis?

Vasculitis is a group of rare diseases characterized by inflammation of blood vessels, including arteries, veins, and capillaries. This inflammation can lead to narrowing, weakening, or even blockage of blood vessels, disrupting blood flow and causing damage to organs and tissues throughout the body. The severity and specific symptoms of vasculitis vary depending on the type and size of blood vessels affected, as well as the extent of inflammation.


There are many types of vasculitis, classified based on the size of the blood vessels involved and the underlying cause. Some common types of vasculitis include:


  • Large vessel vasculitis: Affects large arteries such as the aorta and its branches. Examples include giant cell arteritis and Takayasu arteritis.


  • Medium vessel vasculitis: Affects medium-sized arteries. Examples include polyarteritis nodosa and Kawasaki disease.


  • Small vessel vasculitis: Affects small blood vessels, including capillaries and small arteries. Examples include granulomatosis with polyangiitis (formerly known as Wegener’s granulomatosis), microscopic polyangiitis, and eosinophilic granulomatosis with polyangiitis (formerly known as Churg-Strauss syndrome).


  • Vasculitis associated with systemic diseases: Some forms of vasculitis are associated with underlying systemic diseases, such as rheumatoid arthritis, systemic lupus erythematosus, or infections like hepatitis B or C.


The exact cause of vasculitis is often unknown, but it is believed to involve a combination of genetic, environmental, and immunological factors. In many cases, vasculitis is thought to result from an abnormal immune response, where the immune system mistakenly attacks blood vessel walls, triggering inflammation. This can lead to a wide range of symptoms, including fever, fatigue, weight loss, joint pain, skin rashes, nerve damage, and organ dysfunction, depending on the organs affected.


What is the relationship between vasculitis and oxidative stress?

The relationship between vasculitis and oxidative stress involves a complex interplay between inflammation, immune dysregulation, and oxidative damage within blood vessels. Oxidative stress refers to an imbalance between the production of reactive oxygen species (ROS) and the body’s ability to neutralize them with antioxidants. In the context of vasculitis, oxidative stress can contribute to tissue injury, endothelial dysfunction, and progression of vascular damage. Here’s how vasculitis and oxidative stress are related:


  • Inflammation-induced ROS production: In vasculitis, the immune system launches an inflammatory response against blood vessel walls, leading to the release of pro-inflammatory cytokines and the recruitment of immune cells to the site of inflammation. Activated immune cells, such as neutrophils and macrophages, generate ROS as part of their antimicrobial defense mechanisms. However, excessive ROS production can overwhelm antioxidant defenses and contribute to oxidative stress.


  • Endothelial dysfunction: The endothelium, which lines the inner surface of blood vessels, plays a crucial role in regulating vascular tone, inflammation, and coagulation. Oxidative stress can disrupt endothelial function by damaging endothelial cells and impairing the release of vasodilators such as nitric oxide (NO). This endothelial dysfunction further exacerbates inflammation and promotes vascular injury in vasculitis.


  • Lipid peroxidation: ROS can react with lipids in cell membranes, initiating a chain reaction known as lipid peroxidation. This process generates lipid hydroperoxides and other toxic byproducts, which can damage endothelial cells and promote atherosclerosis and thrombosis. In vasculitis, lipid peroxidation contributes to vascular remodeling and the formation of inflammatory lesions within blood vessel walls.


  • Antioxidant defense mechanisms: The body has intrinsic antioxidant defense mechanisms to counteract oxidative stress and protect against cellular damage. However, in vasculitis, the balance between ROS production and antioxidant defense may be disrupted, leading to sustained oxidative stress and tissue injury. Reduced levels of endogenous antioxidants, such as superoxide dismutase, catalase, and glutathione peroxidase, have been observed in individuals with vasculitis, further exacerbating oxidative damage.


  • Role in disease progression: Oxidative stress is implicated in the pathogenesis and progression of vasculitis, contributing to endothelial dysfunction, vascular remodeling, and tissue damage. Chronic oxidative stress can perpetuate inflammation, promote immune dysregulation, and increase susceptibility to vascular complications such as thrombosis, aneurysm formation, and tissue ischemia.


Overall, oxidative stress plays a significant role in the pathophysiology of vasculitis, contributing to vascular injury and disease progression.