A scope systematic review to clarify immune response to tobacco in Buerger

Background Progressive Thromboangiitis Obliterans (TAO) is a progressive and segmental inflammatory disorder known as Buerger's disease that affects the medium and small arteries of the upper limbs. The major risk factor for Buerger's disease is cigarettes and tobacco products, which can activate several inflammatory and pre-inflammatory parameters. Methods For this systematic review, based on the accepted criteria of Prisma, we searched from 2017 to 2022 in PubMed, Web of Science, science direct and followed the results of Google Scholar cytokines. We reviewed the literature on these smoking-related immune parameters in Buerger's disease as a potential treatment for this disease. Results In TOA patients, IL-17, RORγt, HMGB1 and RAGE mRNA expression are positively correlated with symptom severity. TLR family is associated with changes in the TOA population as a significant difference in TLR4 in the resting and acute phases. TLR9 may also be responsible for the secretion of IL-8 TNF involves in inflammation, muscle weakness, and pain in TOA. significant difference of IL-33 levels between TOA patients, healthy smokers and non-smokers of this cytokine. Conclusion Our results suggest that Buerger's disease can be considered an autoimmune disease caused by smoking. Buerger increase pro-inflammation markers in TOA and reduce angiogenetic factors. We recommend that pro-inflammatory cytokines should be considered in treatment and diagnosis programs and further research should focus on them.