A meta-analysis of plasma homocysteine in Buerger's disease

Buerger’s disease (BD) is a vascular inflammatory disease that commonly affects all three layers of small and medium arteries of upper and lower extremities in a progressive and segmental fashion; characteristically, BD develops in males, mostly smokers, within the 20 to 50 years age range. Claudication of feet, legs, arms or hands can be presenting signs that might evolve toward critical limb ischaemia, ulcerations and necrosis. The pathogenesis of BD is multifactorial: from the haemostasis point of view, decreased fibrinolysis, enhanced coagulation activation and tighter fibrin clots have been reported; from the histology viewpoint there is increased expression of integrins and selectins that favour leucocyte adhesion on the endothelial lining, and from the functional point of view there is reduced flow mediated vasodilatation