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InflammatoryDiseases ofBloodVessels Inflammatory Diseases of Blood Vessels EDITED BY Gary S. Hoffman MD, MS ProfessorofMedicine DepartmentofRheumaticandImmunologicDiseases CenterforVasculitisCareandResearch ClevelandClinic LernerCollegeofMedicine Cleveland,OH,USA Cornelia M. Weyand MD, PhD ProfessorofMedicine DepartmentofMedicine StanfordUniversitySchoolofMedicine Stanford,CA,USA Carol A. Langford MD, MHS Director,CenterforVasculitisCareandResearch DepartmentofRheumaticandImmunologicDiseases ClevelandClinic LernerCollegeofMedicine Cleveland,OH,USA Jo¨ rg J. Goronzy MD, PhD ProfessorofMedicine DepartmentofMedicine StanfordUniversitySchoolofMedicine Stanford,CA,USA SECOND EDITION A John Wiley & Sons, Ltd., Publication Thiseditionfirstpublished2012,(cid:1)C 2012byBlackwellPublishingLtd. Previousedition:Informa BlackwellPublishingwasacquiredbyJohnWiley&SonsinFebruary2007.Blackwell’s publishingprogramhasbeenmergedwithWiley’sglobalScientific,TechnicalandMedical businesstoformWiley-Blackwell. Registeredoffice: JohnWiley&Sons,Ltd,TheAtrium,SouthernGate,Chichester, WestSussex,PO198SQ,UK Editorialoffices: 9600GarsingtonRoad,Oxford,OX42DQ,UK TheAtrium,SouthernGate,Chichester,WestSussex,PO198SQ,UK 111RiverStreet,Hoboken,NJ07030-5774,USA Fordetailsofourglobaleditorialoffices,forcustomerservicesandforinformationabout howtoapplyforpermissiontoreusethecopyrightmaterialinthisbookpleaseseeour websiteatwww.wiley.com/wiley-blackwell Therightoftheauthortobeidentifiedastheauthorofthisworkhasbeenassertedin accordancewiththeUKCopyright,DesignsandPatentsAct1988. Allrightsreserved.Nopartofthispublicationmaybereproduced,storedinaretrieval system,ortransmitted,inanyformorbyanymeans,electronic,mechanical,photocopying, recordingorotherwise,exceptaspermittedbytheUKCopyright,DesignsandPatentsAct 1988,withoutthepriorpermissionofthepublisher. Designationsusedbycompaniestodistinguishtheirproductsareoftenclaimedas trademarks.Allbrandnamesandproductnamesusedinthisbookaretradenames,service marks,trademarksorregisteredtrademarksoftheirrespectiveowners.Thepublisherisnot associatedwithanyproductorvendormentionedinthisbook.Thispublicationisdesigned toprovideaccurateandauthoritativeinformationinregardtothesubjectmattercovered.It issoldontheunderstandingthatthepublisherisnotengagedinrenderingprofessional services.Ifprofessionaladviceorotherexpertassistanceisrequired,theservicesofa competentprofessionalshouldbesought. Thecontentsofthisworkareintendedtofurthergeneralscientificresearch,understanding, anddiscussiononlyandarenotintendedandshouldnotberelieduponasrecommending orpromotingaspecificmethod,diagnosis,ortreatmentbyphysiciansforanyparticular patient.Thepublisherandtheauthormakenorepresentationsorwarrantieswithrespectto theaccuracyorcompletenessofthecontentsofthisworkandspecificallydisclaimall warranties,includingwithoutlimitationanyimpliedwarrantiesoffitnessforaparticular purpose.Inviewofongoingresearch,equipmentmodifications,changesingovernmental regulations,andtheconstantflowofinformationrelatingtotheuseofmedicines, equipment,anddevices,thereaderisurgedtoreviewandevaluatetheinformationprovided inthepackageinsertorinstructionsforeachmedicine,equipment,ordevicefor,among otherthings,anychangesintheinstructionsorindicationofusageandforaddedwarnings andprecautions.Readersshouldconsultwithaspecialistwhereappropriate.Thefactthatan organizationorWebsiteisreferredtointhisworkasacitationand/orapotentialsourceof furtherinformationdoesnotmeanthattheauthororthepublisherendorsesthe informationtheorganizationorWebsitemayprovideorrecommendationsitmaymake. Further,readersshouldbeawarethatInternetWebsiteslistedinthisworkmayhavechanged ordisappearedbetweenwhenthisworkwaswrittenandwhenitisread.Nowarrantymaybe createdorextendedbyanypromotionalstatementsforthiswork.Neitherthepublishernor theauthorshallbeliableforanydamagesarisingherefrom. AcataloguerecordforthisbookisavailablefromtheBritishLibrary. LibraryofCongressCataloging-in-PublicationData Inflammatorydiseasesofbloodvessels/editedbyGaryS.Hoffman...[etal.].–2nded. p.;cm. Includesbibliographicalreferencesandindex. ISBN978-1-4443-3822-5(hardcover:alk.paper) I.Hoffman,GaryS.,1942– [DNLM:1.Vasculitis. 2.Arteriosclerosis. 3.ImmunologicFactors. 4.VascularDiseases–immunology. WG515] 616.1(cid:2)3–dc23 2012002558 Wileyalsopublishesitsbooksinavarietyofelectronicformats.Somecontentthatappears inprintmaynotbeavailableinelectronicbooks. (cid:1) Setin9/12ptMinionbyAptaraR Inc.,NewDelhi,India 1 2012 Contents ListofContributors,vii 12 Arteries,SmoothMuscleCellsandGeneticCausesof ThoracicAorticAneurysms,126 Preface,xiv AmyJ.ReidandDiannaM.Milewicz 13 InnateImmunityinAtherosclerosis,136 PartI BiologyofBloodVesselsand ShuangChen,PredimanK.ShahandMosheArditi MechanismsofVascularInflammation 14 AdaptiveImmunityinAtherosclerosis,147 1 VascularDevelopment,3 JanNilsson DomenicoRibattiandEnricoCrivellato 2 VascularRepair,15 PartII PrimaryAutoimmuneVascular ChristianTroidl,KerstinTroidl,GeorgJung,Thomas Disease Schmitz-RixenandWolfgangSchaper 15 HistoricalPerspectivesofVasculitis,161 3 LeukocyteTrafficking,28 EricMatteson BraedonMcDonaldandPaulKubes 16 ApproachtotheDifferentialDiagnosisof 4 DendriticCellsandVascularInflammation,39 Vasculitis,170 CorneliaM.Weyand EamonnS.MolloyandCarolA.Langford 5 TCellsandVascularInflammation,50 17 ImagingofMediumandLargeVessels Jo¨rgJ.Goronzy (CT/MR/PET),184 6 AutoantibodiesandVascularInflammation,61 ThorstenAlexanderBley AbrahamRutgers,JanS.F.Sanders, 18 KawasakiDisease,194 JanWillemCohenTervaertandCeesG.M.Kallenberg RaeS.M.Yeung 7 NeutrophilsandVascularInflammation,71 19 Henoch–Scho¨nleinPurpura,205 MatthewDavidMorganandCarolineO.S.Savage PhilipJ.HashkesandAlexandraVilla-Forte 8 CytokinesandVascularInflammation,82 20 PolyarteritisNodosa,217 MariaC.Cid,MarcCorbera-Bellalta,Ester EliM.MiloslavskyandJohnH.Stone Planas-Rigol,EsterLozano,GeorginaEsp´ıgol-Frigol´e, AnaGarc´ıa-Mart´ınez,Jos´eHerna´ndez-Rodr´ıguezand 21 MicroscopicPolyangiitis,227 MartaSegarra CoenA.Stegeman 9 OxidativeStressandVascularInflammation,94 22 GranulomatosiswithPolyangiitis(Wegener’s),238 DavidG.Harrison GaryS.Hoffman,CarolA.Langford andUlrichSpecks 10 HemostasisandVascularInflammation,105 LawrenceLeungandJohnMorser 23 EosinophilicGranulomatosiswithPolyangiitis (Churg–StraussSyndrome),252 11 AnimalModelsofVasculitis,115 ChristianPagnouxandLo¨ıcGuillevin MasatoNose v vi Contents 24 GiantCellArteritis,263 40 VasculitisandRelapsingPolychondritis,441 CorneliaM.WeyandandJo¨rgJ.Goronzy TanazA.KermaniandKennethJ.Warrington 25 Takayasu’sArteritis,276 41 SystemicVasculitisinSarcoidosis,451 KathleenMaksimowicz-McKinnonand AlexandraVilla-ForteandGaryS.Hoffman GaryS.Hoffman 42 VasculitisasaParaneoplasticSyndromeandDirect 26 Behc¸et’sSyndrome,289 TumorInvasionofVessels,460 YusufYazici,IsmailSimsekandHasanYazici ClaireE.BarberandSimonCarette 27 Cogan’sSyndrome,299 RexM.McCallumandE.WilliamSt.Clair PartIV RecognizingRisksandTreatingDamage 28 IdiopathicCryoglobulinemicVasculitis,312 fromVasculitis BenjaminTerrierandPatriceCacoub 43 CholesterolandModificationsofCholesterolin 29 PrimaryCentralNervousSystemVasculitis,322 RheumaticDisorders,475 RulaA.Hajj-AliandLeonardH.Calabrese JanWillemCohenTervaert 30 SingleOrganVasculitis,332 44 PreventionandTreatmentofMedical Jos´eHerna´ndez-Rodr´ıguezandGaryS.Hoffman Complications,484 AtulKhasnisandCarolA.Langford 31 PrimaryCutaneousVasculitis(SmallVessel Vasculitis),343 45 OphthalmicRisksandComplicationsAssociated JeffreyP.Callen withtheTreatmentofSystemicVasculitis,495 StevenYehandJamesT.Rosenbaum 32 Buerger’sDisease(ThromboangiitisObliterans),351 AhmetRuchanAkarandSerkanDurdu 46 SubglotticStenosisofGranulomatosiswith Polyangiitis(Wegener’s),505 RahulSethandDanielS.Alam PartIII SecondaryCausesofVasculitis 47 SinonasalManifestationsofGranulomatosiswith 33 Virus-AssociatedVasculitides,369 Polyangiitis(Wegener’s),512 DimitriosVassilopoulosandLeonardH.Calabrese DanielS.Alam,RahulSethandRajSindwani 34 Drug-InducedVasculitis,380 48 NeurologicDamageofVasculitis,521 PeterA.Merkel C.DavidLin 35 RheumatoidVasculitis,392 49 End-StageRenalDiseaseandVasculitis,534 KimberlyP.Liang,CarlTuressonand KirstendeGrootandCharlesPusey LarryW.Moreland 50 CardiothoracicSurgeryforTakayasu’sArteritisand 36 SystemicSclerosiswithVascularEmphasis,403 GiantCellArteritis,544 NezamAltorok,OmarR.KahalyandBasharKahaleh TurkiAlbackerandLarsSvensson 37 VasculitisandSjo¨gren’sSyndrome,412 51 PeripheralVascularSurgeryforLargeVessel GeorgeE.FragoulisandHaralamposM. Vasculitis,558 Moutsopoulos RaviR.RajaniandVikramS.Kashyap 38 VasculitisinSystemicLupusErythematosus,419 RicardoGarciaandAndrasPerl Index,567 39 VasculitisintheIdiopathicInflammatory Myopathies,433 FrederickW.MillerandChesterV.Oddis List of Contributors Ahmet Ruchan Akar MD,FRCS(CTh) Patrice P. Cacoub MD ProfessorofCardiovascularSurgery ProfessorofMedicine DepartmentofCardiovascularSurgery NationalReferralCenterforAutoimmuneandSystemic AnkaraUniversitySchoolofMedicine Diseases DeputyDirectorofAnkaraUniversityStemCellInstitute DepartmentofInternalMedicine Ankara,Turkey HoˆpitallaPitie´Salpeˆtrie`re Paris,France Daniel S. Alam MDFACS Leonard H. Calabrese DO SectionHead,FacialAestheticandReconstructiveSurgery HeadandNeckInstitute ProfessorofMedicine,ClevelandClinicLerner ClevelandClinic CollegeofMedicine Cleveland,OH,USA RJFasenmyerChairofClinicalImmunology DepartmentofRheumaticandImmunologicDiseases Cleveland,OH,USA Turki Albacker MD,MSc,FRCSC,FACS,FACC AssistantProfessorofCardiacSciences Jeffrey P. Callen MD,FACP,FAAD ConsultantCardiacSurgeon ProfessorofMedicine(Dermatology) KingFahadCardiacCenter Chief,DivisionofDermatology CollegeofMedicine,KingSaudUniversity UniversityofLouisvilleSchoolofMedicine Riyadh,SaudiArabia Louisville,KY,USA Nezam Altorok MD Simon Carette MD,MPhil,FRCPC Resident ProfessorofMedicine DivisionofRheumatologyandImmunology DivisionofRheumatology UniversityofToledoMedicalCenter TorontoWesternHospitaland Toledo,OH,USA MountSinaiHospital Toronto,ON,Canada Moshe Arditi MD ProfessorofPediatrics Shuang Chen MD,PhD DivisionofInfectiousDiseasesandImmunology AssistantProfessor BurnsandAllenResearchInstitute,Cedars-SinaiMedical DivisionofInfectiousDiseasesandImmunology CenterandDavidGeffenSchoolofMedicineatUCLA BurnsandAllenResearchInstitute LosAngeles,CA,USA Cedars-SinaiMedicalCenter LosAngeles,CA,USA Claire E. Barber MD Maria C. Cid MD RheumatologyResident SeniorConsultant UniversityofToronto VasculitisResearchUnit,DepartmentofSystemicAutoimmune Toronto,ON,Canada Diseases HospitalCl´ınic; Thorsten Alexander Bley MD AssociateProfessor AssociateProfessorofRadiology UniversityofBarcelona DepartmentofInterventionalandDiagnosticRadiology Institutd’InvestigacionsBiome`diquesAugustPiiSunyer UniversityMedicalCenterHamburg-Eppendorf (IDIBAPS) Hamburg,Germany Barcelona,Spain vii viii ListofContributors Jan Willem Cohen Tervaert MD,PhD Ricardo Garcia MD Chairman,DivisionofClinicalandExperimentalImmunology RheumatologyFellow ProfessorofMedicineandImmunology DivisionofRheumatology DepartmentofInternalMedicine StateUniversityofNewYork MaastrichtUniversityMedicalCenter UpstateMedicalUniversity Maastricht,TheNetherlands Syracuse,NY,USA Marc Corbera-Bellalta BA Ana Garcı´a-Martı´nez MD PhDStudent SeniorSpecialist VasculitisResearchUnit,DepartmentofSystemicAutoimmune DepartmentofEmergencyMedicine Diseases, HospitalCl´ınic HospitalCl´ınic Institutd’InvestigacionsBiome`diquesAugustPiiSunyer Institutd’InvestigacionsBiome`diquesAugustPiiSunyer (IDIBAPS) (IDIBAPS) Barcelona,Spain Barcelona,Spain Enrico Crivellato MD Jo¨rg J. Goronzy MD,PhD ProfessorofMedicine AssociateProfessor DepartmentofMedicine DepartmentofMedicalandMorphologicalResearch StanfordUniversitySchoolofMedicine AnatomySection Stanford,CA,USA UniversityofUdineMedicalSchool Udine,Italy Loı¨c Guillevin MD Kirsten de Groot MD ProfessorandDirector,FrenchVasculitisStudyGroup Chief,3rdMedicalDepartment,SectionofNephrologyand NationalReferralCenterforRareSystemicandAutoimmune Rheumatology Diseases,NecrotizingVasculitidesandSystemicSclerosis KlinikumOffenbach,GmbH DepartmentofInternalMedicine KfHNierenzentrumOffenbach HoˆpitalCochin Offenbach/Main,Germany UniversityParis-Descartes Paris,France Serkan Durdu MD,PhD ConsultantCardiovascularSurgeon Rula A. Hajj-Ali MD DepartmentofCardiovascularSurgery AssistantProfessorofMedicine AnkaraUniversitySchoolofMedicine CenterforVasculitisCareandResearch AnkaraUniversityStemCellInstitute DepartmentofRheumaticandImmunologicDiseases Ankara,Turkey ClevelandClinic Cleveland,OH,USA Georgina Espı´gol-Frigole´ MD VisitingFellow David G. Harrison MD CellularandMolecularBiologySection,LaboratoryofCellular BettyandJackBaileyProfessorofMedicineandPharmacology Oncology DirectorofClinicalPharmacology NationalCancerInstitute VanderbiltUniversitySchoolofMedicine NationalInstitutesofHealth Nashville,TN,USA Bethesda,MD,USA; AssociateProfessor UniversityofGirona Philip J. Hashkes MD,MSc Girona,Spain Head,PediatricRheumatologyUnit ShaareZedekMedicalCenter George E. Fragoulis MD Jerusalem,Israel; PhDCandidate AssociateProfessorofMedicineandPediatrics PathophysiologyDepartment ClevelandClinicLernerMedicalSchoolofCaseWestern SchoolofMedicine ReserveUniversity UniversityofAthens Cleveland,OH,USA Athens,Greece ListofContributors ix Jose´ Herna´ndez-Rodrı´guez MD Tanaz A. Kermani MD SeniorSpecialist AssistantProfessorofMedicine VasculitisResearchUnit,DepartmentofAutoimmuneand DivisionofRheumatology SystemicDiseases CollegeofMedicine HospitalCl´ınic,UniversityofBarcelona MayoClinic Insititutd’InvestigacionsBiome`diquesAugustPiiSunyer Rochester,MN,USA (IDIBAPS) Barcelona,Spain Atul Khasnis MD,MS Staff Gary S. Hoffman MD,MS CenterforVasculitisCareandResearch DepartmentofRheumaticandImmunologicDiseases ProfessorofMedicine ClevelandClinic DepartmentofRheumaticandImmunologicDiseases Cleveland,OH,USA CenterforVasculitisCareandResearch ClevelandClinic Paul Kubes, PhD LernerCollegeofMedicine Director,SnyderInstituteofInfection,Immunityand Cleveland,OH,USA Inflammation Professor,DepartmentofPhysiologyandPharmacology Georg Jung FacultyofMedicine,UniversityofCalgary DepartmentofPharmacology HealthResearchInnovationCenter Max-Planck-InstituteforHeartandLungResearch Calgary,Canada BadNauheim,Germany; DepartmentofVascularandEndovascularSurgery Carol A. Langford MD,MHS Goethe-University Director,CenterforVasculitisCareandResearch FrankfurtamMain,Germany DepartmentofRheumaticandImmunologicDiseases ClevelandClinic Bashar Kahaleh MD LernerCollegeofMedicine Cleveland,OH,USA ProfessorandChief DivisionofRheumatologyandImmunology UniversityofToledoMedicalCenter Lawrence Leung MD Toledo,OH,USA ChiefofStaff VAPaloAltoHealthCareSystem PaloAlto,CA,USA; Omar R. Kahaly BSc MaureenLylesD’AmbrogioProfessorofMedicine MedicalStudent AssociateDeanforVeteransAffairs DivisionofRheumatologyandImmunology StanfordUniversitySchoolofMedicine UniversityofToledoMedicalCenter Stanford,CA,USA Toledo,OH,USA Kimberly P. Liang MD Cees G.M. Kallenberg MD,PhD AssistantProfessorofMedicine ProfessorofMedicine DepartmentofMedicineandDivisionofRheumatologyand DepartmentofRheumatologyandClinicalImmunology ClinicalImmunology UniversityMedicalCenterGroningen UniversityofPittsburgh UniversityofGroningen Pittsburgh,PA,USA Groningen,TheNetherlands C. David Lin MD AssociateProfessorofClinicalRehabilitationMedicine Vikram S. Kashyap MD,FACS WeillCornellMedicalCollege ProfessorofSurgery,CaseWesternReserveUniversity; NewYork,NY,USA Chief,DivisionofVascularSurgeryandEndovascularTherapy; Co-Director,Harrington-McLaughlinHeart&Vascular Ester Lozano PhD Institute VisitingFellow UniversityHospitalsCaseMedicalCenter DepartmentofNeurology Cleveland,OH,USA YaleSchoolofMedicine,UniversityofYale NewHaven,CT,USA x ListofContributors Kathleen Maksimowicz-McKinnon Eamonn S. Molloy MD,MS,MRCPI DO ConsultantRheumatologist AssistantProfessorofMedicine DepartmentofRheumatology Director,UPMCandUniversityofPittsburghCenterfor StVincent’sUniversityHospital Vasculitis Dublin,Ireland DivisionofRheumatologyandClinicalImmunology Pittsburgh,PA,USA Larry W. Moreland MD MargaretJaneMillerEndowedProfessorofArthritisResearch Eric Matteson MD,MPH Chief,DivisionofRheumatologyandClinicalImmunology ProfessorofMedicine UniversityofPittsburgh Consultant,DivisionsofRheumatologyandEpidemiology Pittsburgh,PA,USA Chair,DivisionofRheumatology MayoClinicCollegeofMedicine Matthew David Morgan MB,ChB,PhD Rochester,MN,USA SeniorLecturer RenalImmunobiology Rex M. McCallum MD,FACP,FACR CollegeofMedicalandDentalSciences VicePresident,ChiefPhysicianExecutive UniversityofBirmingham ProfessorofMedicine/Rheumatology Birmingham,UK DepartmentofMedicine,DivisionofRheumatology UniversityofTexasMedicalBranch John Morser PhD Galveston,TX,USA SeniorResearchScientist DivisionofHematology,DepartmentofMedicine Braedon McDonald BSc(Hon) StanfordUniversitySchoolofMedicineand MD/PhDCandidate VAPaloAltoHealthCareSystem DepartmentofPhysiologyandPharmacology Stanford,CA,USA FacultyofMedicine,UniversityofCalgary HealthResearchInnovationCenter Calgary,Canada Haralampos M. Moutsopoulos MD, FACP,FRCP(hc),MasterACR Peter A. Merkel MD,MPH ProfessorandDirector Chief,DivisionofRheumatology PathophysiologyDepartment ProfessorofMedicineandEpidemiology SchoolofMedicine UniversityofPennsylvaniaSchoolofMedicine UniversityofAthens Philadelphia,PA,USA Athens,Greece Dianna M. Milewicz MD,PhD Jan Nilsson MD PresidentGeorgeH.W.BushChairofCardiovascularMedicine Professor Director,DivisionofMedicalGenetics ExperimentalCardiovascularResearchUnit DepartmentofInternalMedicine DepartmentofClinicalSciences UniversityofTexasHealthScienceCenteratHouston Malmo¨LundUniversity Houston,TX,USA Ska˚neUniversityHospital Malmo¨,Sweden Frederick W. Miller MD,PhD Chief,EnvironmentalAutoimmunityGroup Masato Nose MD,PhD ProgramofClinicalResearch EmeritusProfessor NationalInstituteofEnvironmentalHealthSciences DepartmentofPathogenomics NationalInstitutesofHealthClinicalResearchCenter EhimeUniversityGraduateSchoolofMedicine Bethesda,MD,USA Proteo-MedicineResearchCenter EhimeUniversity Eli M. Miloslavsky MD Ehime,Japan RheumatologyFellow DivisionofRheumatology,AllergyandImmunology MassachusettsGeneralHospital Boston,MA,USA ListofContributors xi Chester V. Oddis MD Domenico Ribatti MD ProfessorofMedicine ProfessorofHumanAnatomy Director,UPMCandUniversityofPittsburghCenterfor DepartmentofBasicMedicalSciences,AnatomyandHistology Myositis Section DivisionofRheumatologyandClinicalImmunology UniversityofBariMedicalSchool UniversityofPittsburghSchoolofMedicine Bari,Italy Pittsburgh,PA,USA James T. Rosenbaum MD Christian Pagnoux MD,MPH,MSc ProfessorofOphthalmology,Medicine,andCellBiology Vice-Director,CanadianVasculitisResearchNetwork(CanVasc) EdwardE.RosenbaumProfessorofInflammationResearch (Past)Vice-President,FrenchVasculitisStudyGroup Chair,DivisionofArthritisandRheumaticDiseases DivisionofRheumatology OregonHealth&ScienceUniversity MountSinaiHospitalandUniversityHealthNetwork Portland,OR,USA Toronto,ON,Canada Abraham Rutgers MD,PhD Andras Perl MD,PhD AssistantProfessorofClinicalImmunology ProfessorofMedicine,MicrobiologyandImmunology, DepartmentofRheumatologyandClinicalImmunology BiochemistryandMolecularBiology UniversityMedicalCenterGroningen Chief,DivisionofRheumatology UniversityofGroningen StateUniversityofNewYork Groningen,TheNetherlands UpstateMedicalUniversity Syracuse,NY,USA Jan S.F. Sanders MD,PhD AssistantProfessor Ester Planas-Rigol BA DepartmentofNephrology PhDStudent UniversityMedicalCenterGroningen VasculitisResearchUnit,DepartmentofSystemicAutoimmune UniversityofGroningen Diseases Groningen,TheNetherlands HospitalCl´ınic Institutd’InvestigacionsBiome`diquesAugustPiiSunyer Caroline O.S. Savage PhD,FRCP,FMedSci (IDIBAPS) HonoraryProfessorofNephrology Barcelona,Spain RenalImmunobiology CollegeofMedicalandDentalSciences Charles Pusey DSc,FRCP UniversityofBirmingham Professor Birmingham,UK RenalSection DepartmentofMedicine Wolfgang Schaper MD,PhD ImperialCollegeLondon DirectorEmeritus London,UK DepartmentofArteriogenesisResearch Max-Planck-InstituteforHeartandLungResearch Ravi R. Rajani MD BadNauheim,German AssistantProfessorofSurgery DivisionofVascularSurgeryandEndovascularTherapy, Thomas Schmitz-Rixen MD,PhD DepartmentofSurgery ProfessorofVascularSurgery EmoryUniversitySchoolofMedicine Director,DepartmentofVascularandEndovascularSurgery Atlanta,GA,USA Goethe-University DepartmentofWoundCare Amy J. Reid BA GoetheUniversityHospital MD/PhDCandidate FrankfurtamMain,Germany DivisionofMedicalGenetics DepartmentofInternalMedicine UniversityofTexasHealthScienceCenteratHouston Houston,TX,USA

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