What is the pathophysiology of thromboangiitis obliterans (TAO) (Buerger disease)?

Updated: Jul 27, 2020
  • Author: Naiem Nassiri, MD; Chief Editor: Vincent Lopez Rowe, MD  more...
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As noted, the development of TAO is strongly associated with heavy use of tobacco, and the progression of the disease is closely linked to continued use.

A few observations suggest the existence of an immunologic phenomenon leading to vasodysfunction and inflammatory thrombi. Patients with TAO exhibit hypersensitivity to intradermally injected tobacco extracts, increased cellular sensitivity to collagen types I and III, elevated serum anti–endothelial cell antibody titers, and impaired peripheral endothelium-dependent vasorelaxation. They also show a higher prevalence of human leukocyte antigen (HLA)–A9, HLA-A54, and HLA-B5, suggesting a genetic component to the disease.

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