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Primary cerebral vasculitis: two important studies at the Polyclinic of Modena

Two important studies on vasculitides, rare diseases affecting the blood vessels, which are the centre of the inflammation reaction, have been the result of the cooperation between the Rheumatology department of the University Hospital of Modena, headed by professor Carlo Salvarani, and the Rheumatology and Neurology department of the Mayo Clinic of Rochester, MN (US),  Scientific works were published on two of the highest impact factor journals in the field of autoimmune diseases: Journal of Autoimmunity and Autoimmunity Reviews.

Vasculitis is an inflammation of blood vessels that may affect the blood vessels of the brain in isolation and is known as cerebral primary vasculitis of the central nervous system (CNS). Professor Carlo Salvarani explained that “this inflammation causes a vascular damage that may develop in a stricture/obstruction of the vessels or development of aneurisms of the vessels with devastating complications and ischemic or haemorrhagic organ damage. In the project on isolated vasculitis of the CNS, for years now a collaboration with various Divisions of Mayo Clinic has been in place, such as the Division of Neurology, Rheumatology, NeuroRadiology, Neuropathology and Biostatistics. This collaboration continues with two new important projects currently being developed: the first one on the therapy of isolated vasculitis of the central nervous system, and the second one on the immunological definition/characterisation of the inflammation of the wall of blood vessels. This knowledge will allow for the identification of new innovative therapies for such devastating vasculitis that only affects brain vessels. The two studies published are the result of this collaboration”. 

The first work named Primary Central Nervous System Vasculitis mimicking brain tumour: comprehensive analysis of 13 cases from a single institutional cohort of 191 cases  was published on the last issue of the Journal of Autoimmunity. The study showed that cerebral primary vasculitis may look like a tumour, and as such it is often associated with amyloid cerebral angiopathy, and that immuno-depressive therapy, instead of a surgical operation with after-effects that are sometimes devastating, may fully resolve such vasculitis.

The second study is named “Rituximab therapy for primary central nervous system vasculitis: a 6 patient experience and review of the literature” and has just been accepted by Autoimmunity Reviews. For the first time, this work has shown that a biological therapy with rituximab (monoclonal antibody addressed to lymphocytes B that destroys such cells in our body) is highly effective in this vasculitis.  

Professor Carlo Salvarani explained that “in the most serious cases, vasculitis of the nervous system is a devastating and rapidly progressive disease, with repeated and multiple brain strokes that may cause the death of the patient in a few months. Traditional immuno-depressive therapy (cyclophosphamide and cortisone) is scarcely effective on such patients, and knowing that a drug is available, that for the first time proved effective on that group of patients, is a great piece of news for all the patients affected by that devastating vasculitis”. The study is the result of the collaboration between Mayo Clinic and Unimore. Together with professor Salvarani, doctor Giulia Cassone (Research PhD in Rheumatology), doctor Elena Galli (specialising in Rheumatology) and doctor Francesco Muratore who, when the work was drawn up/accepted was a researcher in Rheumatology, worked on the project.

For years, Rheumatology has been strictly linked to Neurology for the diagnosis and therapy of patients affected by such vasculitis. An Italian study group is also being created on that vasculitis, and our Rheumatology will coordinate it with the Carlo Besta Neurological Institute of Milan, which for the first time will give us the opportunity to have Italian data on such vasculitis.

Categorie: International - english

Articolo pubblicato da: Ufficio Stampa Unimore - ufficiostampa@unimore.it