Emerging role of the adaptive immunity in aortic aneurysm and dissection.

Aortic aneurysm and dissection (AAD) is a critical aortic disease with high mortality. AAD is characterized by aortic inflammation, which manifests as the infiltration of immune cells and the accumulation of inflammatory mediators. Studies have predominantly focused on the innate immune response, while the role of adaptive immunity in AAD remains poorly characterized. Given the substantial knowledge gaps, this review systematically outlines the development of the adaptive immune response in AAD - from antigen initiation and lymphocyte activation to its ultimate effects on the aortic wall. Additionally, promising immunomodulatory therapies, such as biologic agents and cell-based treatments, are discussed. This review underscores the need for a deeper understanding of the contributions of adaptive immunity to AAD, as elucidating these mechanisms could inform precise therapeutic strategies for this serious condition.