Current and Future Treatments for Takayasu Arteritis: Toward Cardiovascular Risk Modification.

Although glucocorticoids and conventional immunosuppressive therapies remain the cornerstone of treatment, relapse rates are high, and current strategies fail to adequately mitigate future cardiovascular risk.

尽管糖皮质激素和传统免疫抑制治疗仍然是治疗的基础，但复发率高，且当前策略未能充分降低未来的心血管风险。

This review synthesizes evidence on current treatment strategies, unmet clinical needs, and novel approaches, including immunological and vascular-targeted therapies, and argues for a shift in management paradigm toward integrated cardiovascular risk reduction.

本综述综合了当前治疗策略、未满足的临床需求以及包括免疫学和血管靶向疗法在内的新方法的证据，并主张向综合心血管风险降低的管理范式转变。

We discuss advances in understanding the pathogenesis of TAK, highlighting the roles of innate and adaptive immunity in disease progression, and the challenges of early diagnosis and disease monitoring.

我们讨论了对TAK发病机制理解的进展，强调了先天和适应性免疫在疾病进展中的作用，以及早期诊断和疾病监测的挑战。

We critically appraise current treatment paradigms, including glucocorticoids, conventional disease-modifying antirheumatic drugs, and biologics such as tocilizumab and tumor necrosis factor-α inhibitors, and outline emerging therapies targeting novel pathways, including interleukin-17, interleukin-12/23, Janus kinase/signal transducer and activator of transcription, and Notch-1/mammalian target of rapamycin complex signaling.

我们批判性地评估了当前的治疗模式，包括糖皮质激素、传统疾病修饰性抗风湿药物以及包括托珠单抗和肿瘤坏死因子-α抑制剂在内的生物制剂，并概述了针对新途径的新兴疗法，包括白细胞介素-17、白细胞介素-12/23、Janus激酶/信号转导和转录激活因子以及Notch-1/哺乳动物雷帕霉素靶蛋白复合信号通路的治疗。

We highlight the increasing recognition of cardiovascular morbidity as a major contributor to mortality in TAK and the need for integrated approaches to risk factor modification.

我们强调了心血管疾病作为TAK主要死亡原因的认识日益增加，以及需要综合方法来改变风险因素。

We explore a road map for advancing management of cardiovascular disease in TAK, including comprehensive screening tools that integrate serological and imaging biomarkers to interrogate cardiovascular risk and potential therapeutic cardioprotective strategies such as sodium-glucose cotransporter 2 inhibitors and endothelin receptor antagonists.

我们探讨了一条推进TAK心血管疾病管理的道路图，包括整合血清和影像生物标志物的综合筛查工具，以探究心血管风险和潜在的治疗性心脏保护策略，如钠-葡萄糖共转运蛋白2抑制剂和内皮素受体拮抗剂。

Despite recent progress, clinical management remains limited by diagnostic uncertainty, heterogeneous treatment approaches, and a paucity of high-quality randomized controlled trials.

尽管最近取得了一些进展，但临床管理仍受到诊断不确定性、治疗方法的异质性以及高质量随机对照试验的缺乏的限制。

Future work should focus on interventions that target both immune-mediated vascular injury and cardiovascular disease progression.

未来的工作应集中在针对免疫介导的血管损伤和心血管疾病进展的干预措施上。

Achieving long-term disease remission while reducing cardiovascular mortality must become the primary therapeutic goal in TAK.

在TAK中，实现长期疾病缓解同时降低心血管死亡率必须成为主要的治疗目标。