Abstract
To evaluate whether CD3 staining performed routinely on temporal artery biopsy specimens might improve the sensitivity of temporal artery biopsy in patients with biopsy-negative GCA. Two hundred and seventy biopsies were considered for this study, stained with haematoxylin and eosin and with an anti-CD3 antibody. The addition of CD3 staining modified the sensibility and the specificity of the histologic examination in 89.47 and 95.00%, respectively, with a positive and negative predictive values of 97.00 and 79.78% . The addition of CD3 immunostaining to the classic histologic evaluation is accompanied by a significant increase in the sensibility with a comparable specificity.
Highlights
GCA is a large- and medium-sized arteries systemic vasculitis [1] resulting in a wide variety of systemic, neurologic and ophthalmologic complications
Due to the important role of CD3+ T cells in the pathogenesis of the disease we aimed to investigate whether CD3 staining performed routinely on temporal artery biopsy (TAB) specimens may improve the sensitivity of TAB in patients with biopsy-negative GCA
Quantitative evaluation of CD3+ cells demonstrated a significantly higher number of CD3+ cells in TAB-positive and -negative GCA arteries compared with controls (Fig. 1G)
Summary
GCA is a large- and medium-sized arteries systemic vasculitis [1] resulting in a wide variety of systemic, neurologic and ophthalmologic complications. GCA is histopathologically characterized by transmural inflammation of the all the layers of affected arteries by monocyte-derived macrophages, activated T cells and multinucleated giant cells. A massive infiltration by Th1, Th9 and Th17 CD3+ effector T cells is observed in temporal artery biopsy (TAB) specimens obtained from patients affected by GCA with positive biopsy [2, 3]. GCA is diagnosed by combining symptoms, clinical findings, laboratory results and diagnostic imaging. The gold standard for the diagnosis of GCA is the demonstration of artery wall inflammation on TAB [1]. TAB results in falsenegative biopsies in a relevant number of patients, leading
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