A total of 21 patients clinically diagnosed with TAO in
2009 and 2010 were selected for this study at the refer-
ral vascular and endovascular department of Emam
Reza Hospital in the north-east of Iran. For each subject
10 mL of blood samples were taken after obtaining
informed consent. The study protocol was approved by
the Ethics Committee for Clinical Research of the Mash-
had University of Medical Sciences (No: 900133).
The clinical diagnostic criteria for inclusion were
Shionoya’s criteria: age of disease onset before 50 years,
history of cigarette smoking, upper-limb involvement
or thrombophlebitis migrans, infrapopliteal arterial
occlusion and absence of other atherosclerotic risk fac-
tors other than smoking.8 We assessed traditional ath-
erosclerosis risk factors9 including blood pressure,
fasting blood sugar and total cholesterol in this study.
Systolic blood pressure below 12 mmHg, diastolic
blood pressure below 8 mmHg, fasting blood sugar
< 90 mg/dL, and total cholesterol < 180 mg/dL were considered as the upper limits for this assessment.10 Patients who were in acute phases of their disease were included in this study. Suffering from burning pain at rest, with or without gangrene, was the key sign for con- sideration of the acute phase of the disease. A group of 20 age-matched male healthy smokers and a group of 17 age-matched male healthy non- International Journal of Rheumatic Diseases 2014; 17: 106–112 107 Buerger's disease sera activate endothelial cells B. Fazeli et al. smokers were also chosen as a healthy smoker and non- smoker control group, respectively. The number of daily smoked cigarettes and duration of smoking were also matched between the TAO and smoker control groups. All of the patients and control smokers smoked filtered cigarettes. Those patients who had given up smoking at the time of blood sampling were excluded from the study. Since all TAO patients in this study were from low socioeconomic status, based on our suggestive indices, including poverty line, hygiene, education, pro- fessional occupation and long-term unemployment,11 the two control groups were also matched based on their socioeconomic status. For this reason, the num- bers in our control groups became limited. Precise clini- cal examination, including vascular examination, was performed for each control subject before blood sam- pling in order to rule out any site of inflammation or any type of peripheral vascular disease. All of the TAO patients and the control group participants were Cauca- sian males.