How to treat microvascular inflammation

Vascular inflammation is a more difficult type of inflammation because the causes of many vasculitis attacks are not very clear. Patients are unable to determine the specific cause and therefore cannot receive symptomatic treatment, and can only use some simple anti-inflammatory drugs. If vasculitis occurs, the blood may become diseased and the body's immune function will decline rapidly, causing a decline in major body functions. So, what should we do about microvascular inflammation?

1. Causes of vasculitis

The causes of most diseases are unknown, while the causes of a few are relatively clear, such as serum sickness, drug allergy and infection. Hepatitis B virus has been confirmed to be the cause of long-term multiple vasculitis. Subsequently, it has been discovered that Chinese cytomegalovirus, herpes simplex virus and adult T-cell leukemia virus can all cause vasculitis.

Pathogenesis of vasculitis

The occurrence of primary vasculitis is mainly caused by immune abnormalities, and more research has been done on humoral immunity, while less research has been done on cellular immunity. There are two types of allergens: endogenous and exogenous. Endogenous antigens include nuclear antigens, cryoglobulins and denatured immunoglobulins, while exogenous antigens include various drugs and infectious factors. However, in most diseases, the cause is still difficult to determine.

Sometimes, certain specific histological changes can be seen (such as the presence of a large number of giant cells or patchy fibrinoid necrosis, and the entire section of the vascular wall is destroyed by inflammation and liquefaction). Wherever inflammation of the vessel wall occurs, secondary luminal occlusion due to intimal hypertrophy or thrombosis can be expected. In addition, once the integrity of the blood vessel wall is destroyed, red blood cells and fibrin can seep into the connective tissue around the blood vessels.

Any blood vessel can be affected by an inflammatory response, including arteries, arterioles, veins, venules, and capillaries. However, due to the diverse pathophysiological changes caused by vasculitis, most of them can be summarized as arterial inflammation, which may lead to complete or partial vascular occlusion and subsequent tissue necrosis.

Because vascular inflammation always presents as segmental or focal lesions, biopsy of clinically suspicious tissue may not necessarily provide definitive histological evidence of vasculitis. However, the fibrotic response around the intima and adventitia caused by inflammatory lesions on the vessel wall often extends inward and outward from the primary lesion. Therefore, histological findings such as intimal hypertrophy and fibrosis or periadventitial inflammation often indicate nearby vasculitis.