The immune landscape in thoracic aortic aneurysms and type A dissections: a scoping review

Thoracic aortic aneurysms and type A aortic dissections (TAA/D) are cardiovascular conditions characterized by structural weakening of the aortic wall. Research on inflammatory cells and their role in the pathophysiology of TAA/D remains unclear. The aim of this scoping review is to characterize and map the existing literature on immune cell infiltration in TAA/D. To assess immune cell involvement in TAA/D, a literature search was conducted in PubMed database. All studies published from January 2021 to August 23, 2026 were screened for scientific quality and suitability for this scoping review. A total of 33 articles were included. Across all studies, macrophages were most frequently investigated and showed the most consistent findings for infiltration in TAA/D tissue. Dendritic cells, T cells, and B cells also showed increased infiltration in most studies. Thirteen studies investigated neutrophils. Ten studies reported increased infiltration or marker gene expression and one study reported increased clusters of non-resident neutrophils. Two studies, however, reported no significant difference in neutrophil involvement. Two studies included eosinophils and reported increased marker gene expression and infiltration. Results regarding natural killer cells were heterogeneous and basophils were not investigated among the included studies. This scoping review provides an integrated overview of immune cell involvement in TAA/D, where macrophages represent the most consistently elevated and extensively characterized immune cell type in TAA/D. In addition, T cells and dendritic cells also appear to be frequently involved. However, the methodology and analysis of the studies are heterogeneous.