Importance and Feasibility of Point-of-care Testing in Takayasu’s Arteritis

Abstract

Takayasu’s arteritis (TAK) is known to be a unique, rare, and chronic vasculitis disease that affects large elastic arteries such as aorta and its major branches. TAK is characterized by adventitial thickening, weak pulses and ocular disturbances. The prognosis and diagnosis of TAK are challenging due to the non-specific, silent, or paucisymptomatic presentation of the disease. The effective understanding of TAK lies with the timely recognition of the symptoms and a rapid diagnosis of the disease. Point-of-care testing (POCT) is vital for the quick and reliable detection of parameters near bedside for disease diagnosis, assessment, monitoring, and therapeutics management. Ultrasonography is the most reliable POCT technique. Moreover, erythrocyte sedimentation rate and C-reactive protein assay are the two most valuable non-imaging POCT tests used to determine inflammation and onset of the disease. Other potential biomarkers such as matrix metalloproteinases, soluble receptor for advanced glycation end products, interleukin (IL)-6, and IL-18 have also been advocated for tracking the progression of TAK. Furthermore, vasculitis associated-anti-neutrophil cytoplasmic antibodies have also been reported to reflect the inflammatory phase of the disease. Therefore, the development of POCT based on these blood-based biomarkers may help in quick clinical decision-making for early diagnosis of TAK and targeted therapeutics to improve clinical outcome in patients suffering from this debilitating disease.