Yang WU, Wint Shwe Yee PHYO
Acta Medica Ruha - 2026;4(3):159-168
Introduction: Moyamoya disease (MMD) is a chronic, progressive cerebrovascular disorder characterized by stenosis or occlusion of the distal internal carotid arteries and the formation of abnormal collateral vascular networks. Current limitations in effective non-invasive diagnostic methods create challenges for early diagnosis and timely intervention of MMD. Although the exact underlying etiology remains unclear, increasing evidence suggests that inflammatory and immune-mediated mechanisms play a critical role in disease development and progression. Objective: To review the role and significance of systemic and vascular inflammatory markers in the pathophysiology of Moyamoya disease, and to evaluate their clinical relevance in disease progression, diagnosis, and prognosis. Methods: This narrative review summarizes current evidence regarding systemic and vascular inflammatory markers in Moyamoya disease. A comprehensive literature search was conducted using PubMed, Web of Science, and Google Scholar to identify relevant studies published primarily between January 2020 and October 2025. Original research articles, clinical studies, systematic reviews, and high-quality review articles were included, whereas conference abstracts, editorials, duplicate publications, and studies lacking direct relevance to inflammatory mechanisms were excluded. Results: This review found that elevated levels of inflammatory biomarkers, including C-reactive protein, interleukin-6, fibrinogen, and composite indicators are associated with disease severity and progression, including stroke recurrence. Molecular studies highlight key signaling pathways and genetic susceptibility factors. Inflammatory marker levels exhibit dynamic changes according to disease staging and may lead to hemodynamic alterations. Conclusion: Inflammatory markers play a major role in the pathogenesis and progression of Moyamoya disease. A deeper understanding through multi-omics and single-cell technologies may enhance early diagnosis, risk stratification, and prognostic assessment. Future research integrating these approaches and large-scale longitudinal studies is essential to validate these biomarkers and advance precision medicine strategies in Moyamoya disease.
