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Perazzio SF, Allenspach EJ, Eklund KK, Varjosalo M, Shinohara MM, Torgerson TR, Seppänen MRJ. Behçet disease (BD) and BD-like clinical phenotypes: NF-κB pathway in mucosal ulcerating diseases. Scand J Immunol 2020; 92:e12973. [PMID: 32889730 DOI: 10.1111/sji.12973] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 08/08/2020] [Accepted: 08/30/2020] [Indexed: 02/06/2023]
Abstract
Behçet's disease (BD) is a heterogeneous multi-organ disorder in search of a unified pathophysiological theory and classification. The disease frequently has overlapping features resembling other disease clusters, such as vasculitides, spondyloarthritides and thrombophilias with similar genetic risk variants, namely HLA-B*51, ERAP1, IL-10, IL-23R. Many of the BD manifestations, such as unprovoked recurrent episodes of inflammation and increased expression of IL-1, IL-6 and TNFα, overlap with those of the hereditary monogenic autoinflammatory syndromes, positioning BD at the crossroads between autoimmune and autoinflammatory syndromes. BD-like disease associates with various inborn errors of immunity, including familial Mediterranean fever, conditions related to dysregulated NF-κB activation (eg TNFAIP3, NFKB1, OTULIN, RELA, IKBKG) and either constitutional trisomy 8 or acquired trisomy 8 in myelodysplastic syndromes. We review here the recent advances in the immunopathology of BD, BD-like diseases and the NF-κB pathway suggesting new elements in the elusive BD etiopathogenesis.
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Affiliation(s)
- Sandro F Perazzio
- Seattle Children's Research Institute, University of Washington and Center for Immunity and Immunotherapies, Seattle, WA, USA.,Division of Rheumatology, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Eric J Allenspach
- Seattle Children's Research Institute, University of Washington and Center for Immunity and Immunotherapies, Seattle, WA, USA
| | - Kari K Eklund
- Division of Rheumatology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,ORTON Orthopaedic Hospital of the Orton Foundation, Helsinki, Finland
| | - Markku Varjosalo
- Division of Rheumatology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,ORTON Orthopaedic Hospital of the Orton Foundation, Helsinki, Finland.,Molecular Systems Biology Research Group and Proteomics Unit, Institute of Biotechnology, University of Helsinki, Helsinki, Finland
| | - Michi M Shinohara
- Divisions of Dermatology and Dermatopathology, University of Washington, Seattle, WA, USA
| | | | - Mikko R J Seppänen
- Rare Disease and Pediatric Research Centers, Hospital for Children and Adolescents and Adult Immunodeficiency Unit, Inflammation Center, University of Helsinki and HUS Helsinki University Hospital, Helsinki, Finland
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De Simone L, Invernizzi A, Aldigeri R, Mastrofilippo V, Marvisi C, Gozzi F, Bolletta E, Adani C, Pipitone N, Muratore F, Fontana L, Salvarani C, Cimino L. Effectiveness of Infliximab and Interferon Alpha-2a for the Treatment of Behçet’s Uveitis: Customizing Therapy according to the Clinical Features. Ocul Immunol Inflamm 2020; 30:506-514. [DOI: 10.1080/09273948.2020.1815797] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Luca De Simone
- Ocular Immunology Unit, Azienda USL-IRCCS of Reggio Emilia, Reggio Emilia, Italy
| | - Alessandro Invernizzi
- Eye Clinic, Department of Biomedical and Clinical Science “L. Sacco”, Luigi Sacco Hospital, University of Milan, Milan, Italy
- Save Sight Institute, University of Sydney, Sydney, Australia
| | | | | | - Chiara Marvisi
- Division of Rheumatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Fabrizio Gozzi
- Ocular Immunology Unit, Azienda USL-IRCCS of Reggio Emilia, Reggio Emilia, Italy
| | - Elena Bolletta
- Ocular Immunology Unit, Azienda USL-IRCCS of Reggio Emilia, Reggio Emilia, Italy
| | - Chantal Adani
- Ocular Immunology Unit, Azienda USL-IRCCS of Reggio Emilia, Reggio Emilia, Italy
| | - Nicolò Pipitone
- Department of Rheumatology, Azienda USL-IRCCS of Reggio Emilia, Reggio Emilia, Italy
| | - Francesco Muratore
- Department of Rheumatology, Azienda USL-IRCCS of Reggio Emilia, Reggio Emilia, Italy
| | - Luigi Fontana
- Ophthalmology Unit, Azienda USL-IRCCS of Reggio Emilia, Reggio Emilia, Italy
| | - Carlo Salvarani
- Division of Rheumatology, University of Modena and Reggio Emilia, Modena, Italy
- Department of Rheumatology, Azienda USL-IRCCS of Reggio Emilia, Reggio Emilia, Italy
| | - Luca Cimino
- Ocular Immunology Unit, Azienda USL-IRCCS of Reggio Emilia, Reggio Emilia, Italy
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53
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Marvisi C. The geographic and clinical clusters of Behçet's syndrome. Intern Emerg Med 2020; 15:933-934. [PMID: 32227285 DOI: 10.1007/s11739-020-02319-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 03/20/2020] [Indexed: 12/01/2022]
Affiliation(s)
- Chiara Marvisi
- Rheumatology Department, University of Modena and Reggio Emilia, Modena, Italy.
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Kuzu Kumcu M, Bakırarar B, Yücesan C. Quality of life in neuro-Behçet's disease: a cross-sectional study. Neurol Sci 2020; 42:1081-1086. [PMID: 32743747 DOI: 10.1007/s10072-020-04630-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 07/24/2020] [Indexed: 12/24/2022]
Abstract
PURPOSE Behçet's disease (BD) is a multisystemic perivasculitis with recurrent oral aphthous ulcers, genital ulcers, and eye involvement which was first described in 1937. Neurological involvement in BD patients is referred to as neuro-Behçet's disease (NBD). Studies have shown that BD worsens quality of life. However, there is no study that conducts a head-to-head comparison of quality of life between NBD patients and healthy controls. METHODS Forty patients with NBD and 39 age-sex-matched healthy control subjects were included in this study. Sociodemographic data of all participants were recorded; SF-36 was used to assess quality of life. RESULTS NBD patients had significantly lower SF-36 scores of physical functioning, physical difficulty, bodily pain, and general health perception compared with healthy controls. However, there was no significant difference between the groups according to the SF-36 scores of role limitation due to emotional problems, mental health, vitality, and social functioning. There was no significant difference between parenchymal and non-parenchymal NBD groups according to SF-36, Beck's Depression Inventory, and Beck's Anxiety Inventory scores. Patients with cerebellar system involvement had significantly lower physical and social functioning scores compared with those who did not. Patients with brain stem involvement were found to have higher role limitation due to emotional problems, vitality, social functioning, physical pain, and general health perception scores compared with those without brain stem findings. CONCLUSIONS NBD negatively affects many aspects of the quality of life.
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Affiliation(s)
- Müge Kuzu Kumcu
- Department of Neurology, Ankara University School of Medicine, Ankara, Turkey.
| | - Batuhan Bakırarar
- Department of Biostatistic, Ankara University School of Medicine, Ankara, Turkey
| | - Canan Yücesan
- Department of Neurology, Ankara University School of Medicine, Ankara, Turkey
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Gur M, Golcuk M, Gul A, Erman B. Molecular dynamics simulations provide molecular insights into the role of HLA-B51 in Behçet's disease pathogenesis. Chem Biol Drug Des 2020; 96:644-658. [PMID: 32691964 DOI: 10.1111/cbdd.13658] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 11/06/2019] [Accepted: 12/07/2019] [Indexed: 12/12/2022]
Abstract
Behçet's disease is an inflammatory disorder of unknown etiology. Genetic tendency has an important role in its pathogenesis, and HLA-B51, a class I MHC antigen, has been recognized as the strongest susceptibility factor for Behçet's disease. Despite the confirmation of the association of HLA-B51 with Behçet's disease in different populations, its pathogenic mechanisms remain elusive. HLA-B51 differs in only two amino acids from HLA-B52, other split antigen of HLA-B5, which is not associated with Behçet's disease. These two amino acids are located in the B pocket of the antigen-binding groove, which occupies the second amino acids of the bound peptides. To understand the nature of the HLA-peptide interactions, differences in structure and dynamics of two HLA alleles were investigated by molecular dynamics simulations using YAYDGKDYI, LPRSTVINI, and IPYQDLPHL peptides. For HLA-B51, all bound peptides fluctuated to larger extent than HLA-B52. Free energy profiles of unbinding process for YAYDGKDYI by steered molecular dynamics simulations showed that unbinding from HLA-B52 results in greater free energy differences than HLA-B51. These results suggest the possibility of an instability of HLA-B51 associated with the repertoire of peptides, and this finding may provide significant insight to its pathogenic role in Behçet's disease.
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Affiliation(s)
- Mert Gur
- Department of Mechanical Engineering, Faculty of Mechanical Engineering, Istanbul Technical University (ITU), Istanbul, Turkey
| | - Mert Golcuk
- Department of Mechanical Engineering, Faculty of Mechanical Engineering, Istanbul Technical University (ITU), Istanbul, Turkey
| | - Ahmet Gul
- Division of Rheumatology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Burak Erman
- Department of Chemical and Biological Engineering, College of Engineering, Koc University, Istanbul, Turkey
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Muñoz SA, Orden AO, Kostianovsky A, Pisoni CN, Scolnik M, Luissi A, Bottinelli Y, Vijoditz G, Garcia M, Pena C, Pera M, Rillo O, Alvarellos T, Más LM, Trunzo AL, Allievi A. The HLA-B*51 Allele is strongly associated with Behçet Disease in an Argentinean population. ACTA ACUST UNITED AC 2020; 16:282-285. [DOI: 10.1016/j.reuma.2018.07.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 06/07/2018] [Accepted: 07/02/2018] [Indexed: 10/28/2022]
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Ralli M, Campo F, Angeletti D, Minni A, Artico M, Greco A, Polimeni A, de Vincentiis M. Pathophysiology and therapy of systemic vasculitides. EXCLI JOURNAL 2020; 19:817-854. [PMID: 32665772 PMCID: PMC7355154 DOI: 10.17179/excli2020-1512] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 06/15/2020] [Indexed: 12/14/2022]
Abstract
Systemic vasculitides represent uncommon conditions characterized by the inflammation of blood vessels that can lead to different complex disorders limited to one organ or potentially involving multiple organs and systems. Systemic vasculitides are classified according to the diameter of the vessel that they mainly affect (small, medium, large, or variable). The pathogenetic mechanisms of systemic vasculitides are still partly unknown, as well as their genetic basis. For most of the primary systemic vasculitides, a single gold standard test is not available, and diagnosis is often made after having ruled out other mimicking conditions. Current research has focused on new management protocol and therapeutic strategies aimed at improving long-term patient outcomes and avoiding progression to multiorgan failure with irreversible damage. In this narrative review, authors describe different forms of systemic vasculitides through a review of the literature, with the aim of highlighting the current knowledge and recent findings on etiopathogenesis, diagnosis and therapy.
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Affiliation(s)
- Massimo Ralli
- Department of Sense Organs, Sapienza University of Rome, Italy
| | - Flaminia Campo
- Department of Sense Organs, Sapienza University of Rome, Italy
| | | | - Antonio Minni
- Department of Sense Organs, Sapienza University of Rome, Italy
| | - Marco Artico
- Department of Sense Organs, Sapienza University of Rome, Italy
| | - Antonio Greco
- Department of Sense Organs, Sapienza University of Rome, Italy
| | - Antonella Polimeni
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Italy
| | - Marco de Vincentiis
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Italy
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58
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Costagliola G, Cappelli S, Consolini R. Behçet's Disease in Children: Diagnostic and Management Challenges. Ther Clin Risk Manag 2020; 16:495-507. [PMID: 32606709 PMCID: PMC7295757 DOI: 10.2147/tcrm.s232660] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Accepted: 05/21/2020] [Indexed: 12/28/2022] Open
Abstract
Behçet’s Disease (BD) is an inflammatory disease of unknown etiology with multisystemic involvement, being the main clinical manifestations represented by recurrent oral and genital ulcerations and uveitis. The disease has typically a chronic-relapsing course and may cause significant morbidity and mortality due to eye, vascular and neurological involvement. Although BD is more frequently diagnosed in adulthood, the disease onset can also be in pediatric age. Pediatric-onset BD is commonly featured by an incomplete clinical picture, and therefore the diagnosis represents a considerable clinical challenge for the physicians. The first classification criteria for pediatric BD, based on a scoring system, have been proposed few years ago. This work focuses on the main difficulties concerning both the diagnostic approach and the treatment of BD in pediatric age. The recommendation for the treatment of pediatric BD has been recently updated and allowed a considerable improvement of the therapeutic strategies. In particular, the use of anti-TNFα drugs as a second-line option for refractory BD, and as a first-line treatment in severe ocular and neurological involvement, has demonstrated to be effective in improving the outcome of BD patients. The knowledge about the molecular pathogenesis is progressively increasing, showing that BD shares common features with autoimmune and autoinflammatory disorders, and thus leading to the use of new biologic agents targeting the main mediators involved in the determination of BD. Anti-IL-17, anti-IL-23, anti-IL-1 and anti-IL-6 agents have shown promising results for the treatment of refractory BD in clinical trials and will represent an important alternative for the therapeutic approach to the disease.
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Affiliation(s)
- Giorgio Costagliola
- Laboratory of Immunology, Department of Clinical and Experimental Medicine, Division of Pediatrics, University of Pisa, Pisa, Italy
| | - Susanna Cappelli
- Laboratory of Immunology, Department of Clinical and Experimental Medicine, Division of Pediatrics, University of Pisa, Pisa, Italy
| | - Rita Consolini
- Laboratory of Immunology, Department of Clinical and Experimental Medicine, Division of Pediatrics, University of Pisa, Pisa, Italy
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59
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Molecular analysis of CTLA4 gene in patients with Behçet's disease from an Iranian Northwest Azeri population. GENE REPORTS 2020. [DOI: 10.1016/j.genrep.2020.100612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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D'Alessandro S, Nicolini F, Formica F. Commentary: A novel surgical strategy for aortic valve replacement in Behçet's disease: Is this the new Silk Road? JTCVS Tech 2020; 2:48-49. [PMID: 34317748 PMCID: PMC8298920 DOI: 10.1016/j.xjtc.2020.03.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 03/08/2020] [Accepted: 03/11/2020] [Indexed: 11/16/2022] Open
Affiliation(s)
- Stefano D'Alessandro
- Cardiac Surgery Unit, Department of Medicine and Surgery, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy
| | - Francesco Nicolini
- Cardiac Surgery Unit, Department of Medicine and Surgery, Parma General Hospital, University of Parma, Pharma, Italy
| | - Francesco Formica
- Cardiac Surgery Unit, Department of Medicine and Surgery, Parma General Hospital, University of Parma, Pharma, Italy
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Yu H, Du L, Yi S, Wang Q, Zhu Y, Qiu Y, Jiang Y, Li M, Wang D, Wang Q, Yuan G, Cao Q, Kijlstra A, Yang P. Epigenome-wide association study identifies Behçet's disease-associated methylation loci in Han Chinese. Rheumatology (Oxford) 2020; 58:1574-1584. [PMID: 30863869 DOI: 10.1093/rheumatology/kez043] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Revised: 01/09/2019] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE The aetiology of Behçet's disease (BD), known as a systemic vasculitis, is not completely understood. Increasing evidence suggests that aberrant DNA methylation may contribute to the pathogenesis of BD. The aim of this epigenome-wide association study was to identify BD-associated methylation loci in Han Chinese. METHODS Genome-wide DNA methylation profiles were compared between 60 BD patients and 60 healthy controls using the Infinium Human Methylation 450 K Beadchip. BD-associated methylation loci were validated in 100 BD patients and 100 healthy controls by pyrosequencing. Gene expression and cytokine production was quantified by real-time PCR and ELISA. RESULTS A total of 4332 differentially methylated CpG sites were associated with BD. Five differentially methylated CpG sites (cg03546163, cg25114611, cg20228731, cg23261343 and cg14290576) revealed a significant hypomethylation status across four different genes (FKBP5, FLJ43663, RUNX2 and NFIL3) and were validated by pyrosequencing. Validation results showed that the most significant locus was located in the 5'UTR of FKBP5 (cg03546163, P = 3.81E-13). Four CpG sites with an aberrant methylation status, including cg03546163, cg25114611, cg23261343 and cg14290576, may serve as a diagnostic marker for BD (area under the receiver operating curve curve = 83.95%, 95% CI 78.20, 89.70%). A significantly inverse correlation was found between the degree of methylation at cg03546163 as well as cg25114611 and FKBP5 mRNA expression. Treatment with a demethylation agent, 5-Aza-2'-deoxycytidine resulted in an increase of FKBP5 mRNA expression and a stimulated IL-1β production. CONCLUSION Our findings suggest that aberrant DNA methylation, independently of previously known genetic variants, plays a vital role in the pathogenesis of BD. TRIAL REGISTRATION Chinese Clinical Trial Registry, chictr.org.cn, ChiCTR-CCC-12002184.
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Affiliation(s)
- Hongsong Yu
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology, and Chongqing Eye Institute, Chongqing
| | - Liping Du
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology, and Chongqing Eye Institute, Chongqing
| | - Shenglan Yi
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology, and Chongqing Eye Institute, Chongqing
| | - Qingfeng Wang
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology, and Chongqing Eye Institute, Chongqing
| | - Yunyun Zhu
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology, and Chongqing Eye Institute, Chongqing
| | - Yiguo Qiu
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology, and Chongqing Eye Institute, Chongqing
| | - Yan Jiang
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology, and Chongqing Eye Institute, Chongqing
| | - Minghui Li
- Shanghai Biotechnology Corporation, Shanghai, China and
| | - Detao Wang
- Shanghai Biotechnology Corporation, Shanghai, China and
| | - Qing Wang
- Shanghai Biotechnology Corporation, Shanghai, China and
| | - Gangxiang Yuan
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology, and Chongqing Eye Institute, Chongqing
| | - Qingfeng Cao
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology, and Chongqing Eye Institute, Chongqing
| | - Aize Kijlstra
- Department of Ophthalmology, University Eye Clinic Maastricht, Maastricht, The Netherlands
| | - Peizeng Yang
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology, and Chongqing Eye Institute, Chongqing
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Yıldız M, Köker O, Adrovic A, Şahin S, Barut K, Kasapçopur Ö. Pediatric Behçet's disease - clinical aspects and current concepts. Eur J Rheumatol 2020; 7:S38-S47. [PMID: 31556871 PMCID: PMC7004268 DOI: 10.5152/eurjrheum.2019.19121] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Accepted: 07/30/2019] [Indexed: 12/14/2022] Open
Abstract
Behçet's Disease was first described by a Turkish dermatologist, Hulusi Behçet, in 1937 as a triple symptom complex; aphthous stomatitis, genital ulcers, and uveitis. Today, in light of current trials and experiments, we know that the disease may have a wider involvement with a multisystemic recurrent course, causing significant morbidity and mortality. However, there are still unanswered questions, particularly about Pediatric Behçet's Disease. Although several immunological and genetic associations have been demonstrated, the real etiologic mechanism of the disease is unclear. The diagnosis is difficult due to its rarity in childhood, the lack of validation of the diagnostic criteria obtained from adult studies, and the inadequacy of large case-controlled studies. Also, the management is challenging and controversial due to the various geographic distribution of clinical spectrum. New therapeutic options under development in light of pathogenetic hypothesis seem to be promising.
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Affiliation(s)
- Mehmet Yıldız
- Department of Pediatric Rheumatology, İstanbul University-Cerrahpaşa, Cerrahpaşa School of Medicine, İstanbul, Turkey
| | - Oya Köker
- Department of Pediatric Rheumatology, İstanbul University, İstanbul School of Medicine, İstanbul, Turkey
| | - Amra Adrovic
- Department of Pediatric Rheumatology, İstanbul University-Cerrahpaşa, Cerrahpaşa School of Medicine, İstanbul, Turkey
| | - Sezgin Şahin
- Department of Pediatric Rheumatology, İstanbul University-Cerrahpaşa, Cerrahpaşa School of Medicine, İstanbul, Turkey
| | - Kenan Barut
- Department of Pediatric Rheumatology, İstanbul University-Cerrahpaşa, Cerrahpaşa School of Medicine, İstanbul, Turkey
| | - Özgür Kasapçopur
- Department of Pediatric Rheumatology, İstanbul University-Cerrahpaşa, Cerrahpaşa School of Medicine, İstanbul, Turkey
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63
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Louthrenoo W, Kasitanon N, Pathanapitoon K, Wangkaew S, Kuwata S, Nishi A, Kaburaki T, Tanaka R, Takeuchi F. Contribution of HLA-B*51:01 and -A*26:01 to Behçet's disease and their clinical association in Thai patients. Int J Rheum Dis 2020; 23:247-255. [PMID: 31944588 DOI: 10.1111/1756-185x.13785] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 11/30/2019] [Accepted: 12/16/2019] [Indexed: 11/29/2022]
Abstract
AIMS To investigate susceptible human leukocyte antigen (HLA) alleles and their associations with clinical features in Thai patients with Behçet's disease (BD). METHOD Eighteen HLA-A and 36 HLA-B alleles were determined in 42 Thai BD patients and 99 healthy controls (HCs) by reverse line blot assay, and reconfirmed by MICRO SSP assay. RESULTS The BD patients had significantly higher allele frequency (AF) of HLA-B*51 than the HCs (13.10% vs 5.05%, P = .025). The AF of HLA-A*26, -A*26:01 and -B*51:01 also was higher and almost reached statistical significance (5.59% vs 1.52%, P = .054, 5.95% vs 1.52%, P = .054 and 10.71% vs 4.04%, P = .051, respectively). However, the BD patients had significantly higher AF of either HLA-A*26:01 or -B*51:01 (16.67% vs 5.56%, P = .005), or -A*26:01 or -B*51X (19.05% vs 6.56%, P = .003). The AF of HLA-B*51:01 and -B*51X increased significantly in -A*26:01 non-carrier BD patients (12.16% vs 4.17%, P = .024 and 14.86% vs 5.21%, P = .019, respectively); and that of HLA-A*26:01 was significantly higher in -B*51X non-carrier BD patients (7.58% vs 1.67%, P = .034). HLA-B*51:01 associated significantly with the presence of posterior uveitis and visual impairment (18.18% vs 2.50%, P = .031 for both conditions). HLA-B*51:01 was not observed in BD patients with gastrointestinal involvement or arthritis. Furthermore, the AF of HLA-B*51:01 was significantly higher in HLA-A*26:01 non-carrier BD patients without arthritis (17.30% vs 0%, P = .050). CONCLUSION HLA-B*51:01 was a susceptible allele for Thai BD patients, and associated with posterior uveitis and visual impairment. HLA-A*26:01 was another susceptible allele in HLA-B*51X non-carrier patients. The protective effect of HLA-B*51:01 on arthritis needs further investigation.
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Affiliation(s)
- Worawit Louthrenoo
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Nuntana Kasitanon
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Kessara Pathanapitoon
- Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Suparaporn Wangkaew
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Shoji Kuwata
- Department of Internal Medicine, Faculty of Medicine, Teikyo University School of Medicine, Ichihara, Japan
| | - Ai Nishi
- Department of Ophthalmology, The University of Tokyo Hospital, Tokyo, Japan
| | - Toshikatsu Kaburaki
- Department of Ophthalmology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Rie Tanaka
- Department of Ophthalmology, The University of Tokyo Hospital, Tokyo, Japan
| | - Fujio Takeuchi
- Department of Internal Medicine (Allergy and Rheumatology), Faculty of Medicine, University of Tokyo, Tokyo, Japan
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Shahriyari E, Vahedi L, Roshanipour N, Jafarabadi MA, Khamaneh A, Laleh MG. Exploring the association of IL-10 polymorphisms in Behcet's disease: a systematic review and meta-analysis. JOURNAL OF INFLAMMATION-LONDON 2019; 16:26. [PMID: 31889911 PMCID: PMC6929502 DOI: 10.1186/s12950-019-0230-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 12/05/2019] [Indexed: 12/21/2022]
Abstract
Background Polymorphisms in the interleukin-10 (IL-10) gene have been studied in various ethnic groups for possible association with Behçet’s disease (BD). This study aimed to perform a meta-analysis of eligible studies to calculate the association of IL-10 polymorphisms with BD. A systematic literature search was carried out in PubMed, Embase, Web of Science, and Scopus databases to identify relevant publications, and extracted the respective results. Pooled odds ratio (OR) with 95% confidence interval (CI) was used to evaluate the power of association with a random-effects model. Results A total of 19 articles, consisting of 10,626 patients and 13,592 controls were included in the meta-analysis. The meta-analysis revealed significant associations in allelic and genotypic test models of − 819 (C vs. T: OR = 0.691, P < 0.001; CC vs. TT: OR = 0.466, P < 0.001; CC + CT vs. TT: OR = 0.692, P < 0.001; and CC vs. CT + TT: OR = 0.557, P < 0.001), − 592 (C vs. A: OR = 0.779, P = 0.002; CC + AA vs. AA: OR = 0.713, P = 0.021; and CA vs. AA: OR = 0.716, P = 0.016), rs1518111 (G vs. A: OR = 0.738, P < 0.001; GG vs. AA: OR = 0.570, P < 0.001; GG + AG vs. AA: OR = 0.697, P < 0.001; GG vs. GA + AA: OR = 0.701, P < 0.001; and AG vs. GG: OR = 0.786, P = 0.004) and rs1554286 (C vs. T: OR = 0.582, P < 0.001; CC vs. TT: OR = 0.508, P < 0.001; CC + CT vs. TT: OR = 0.605, P < 0.001; CC vs. CT + TT: OR = 0.665, P = 0.012; and CT vs. TT: OR = 0.646, P = 0.001). However, we failed to find any association between − 1082 polymorphism and susceptibility of BD. Conclusion This meta-analysis demonstrated that the interleukin-10 -819, − 596, rs1518111 and rs1554286 polymorphisms could be responsible against BD susceptibility, and should probably be regarded as a protective factor for Behçet’s disease.
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Affiliation(s)
- Elham Shahriyari
- 1Center of Excellence for Biodiversity, Faculty of Natural Sciences, University of Tabriz, Tabriz, Iran.,2Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Leila Vahedi
- 2Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nasrin Roshanipour
- 3Department of Biology, School of Genetic, Azad University of Tabriz, Tabriz, Iran
| | - Mohammad Asghari Jafarabadi
- 4Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amin Khamaneh
- 5Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Maryam Ghaffari Laleh
- 1Center of Excellence for Biodiversity, Faculty of Natural Sciences, University of Tabriz, Tabriz, Iran.,4Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
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Clinical features and disease course of neurological involvement in Behcet's disease: HUVAC experience. Mult Scler Relat Disord 2019; 38:101512. [PMID: 31733425 DOI: 10.1016/j.msard.2019.101512] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 09/27/2019] [Accepted: 11/05/2019] [Indexed: 11/21/2022]
Abstract
BACKGROUND/AIM Neurological involvement (Neuro-Behcet's Disease: NBD) is a rare manifestation of Behcet's Disease (BD) and it is related with significant mortality and morbidity. We aimed to evaluate disease course and outcome of NBD patients registered in Hacettepe University Vasculitis Center (HUVAC) prospective database starting from October 2014. METHODS Totally, 419 patients (329 of the patients had fulfilled the International Study Group (ISG) criteria and 90 patients were considered as incomplete BD) were recorded as BD to March 2018. We retrospectively reviewed the charts of 123 patients with neurological complaints/ symptoms according International Consensus Recommendations (ICR) Criteria for Neuro-Behçet's disease. In final analysis, 77 NBD patients (Definite NBD = 61, possible NBD = 16) were included. Demographics, clinical features, treatment characteristics, disability status and survival status of the patients were evaluated. RESULTS Forty-seven (61%) of the patients were male. Median time to neurological involvement from first diagnosis of BD is 6 (IQR = 8.8) years in patients who had diagnosis of BD before neurological involvement. Distribution of NBD: parenchymal (pNBD), non-parenchymal (npNBD), mixed (mNBD) and peripheral nervous system (pnsNBD) were 47 (61%), 22 (28.6%), 5 (6.5%), 3 (3.9%), respectively. Eye involvement was more frequent in pNBD compared to npNBD. Brainstem (72.9%) was the most frequently affected parenchymal area and followed by cerebellum (43.8%) and diencephalon (37.5%). Twelve patients had spinal cord involvement (n = 12, 24.5%). Among the patients with pNBD and mNBD (total n = 52), 48 patients were considered as acute onset parenchymal disease and 4 patients were evaluated as chronic progressive disease. Fifty-eight percent of the patients with acute onset parenchymal disease had only one attack. Totally 14 BD patients deceased during a median 9.4 (IQR = 13) years disease duration and 9 of these patients had NBD (pNBD = 6, mNBD = 2, pnsNBD = 1). Corticosteroids (IV pulse = 75.5% and oral medium-high dose = 90%), alpha-interferon (76.9%), cyclophosphamide (57.1%), and TNF inhibitors (23.5%) were the most frequently preferred treatment options for pNBD. CONCLUSIONS Neurological involvement is seen about 5 years after the diagnosis of BD, and ocular involvement more commonly seen in these patients than non-NBD patients. More than half of the patients with acute onset parenchymal NBD had only one attack. No death was observed in the patients with non-parenchymal NBD. Biologic agents (Interferon-alpha and anti-TNF agents) were used in most patients.
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Auluck I, Karimi A, Taylor S. Lessons of the month 2: A case of Behçet's disease: 70% have ophthalmic involvement. Clin Med (Lond) 2019; 19:519-522. [PMID: 31732597 PMCID: PMC6899251 DOI: 10.7861/clinmed.2019.0149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
A 34-year-old man presented to the emergency department with acute painless loss of vision of the left eye. Past medical history included painful lumps in the legs and frequent mouth ulcers, which were undiagnosed. The patient's visual acuity was 6/5 and counting fingers in the right and left eye, respectively. There were extensive intraretinal haemorrhages and venous sheathing in the superior quadrant of the left eye with associated disc oedema. The case was discussed in a multidisciplinary team meeting in the presence of ophthalmology, dermatology and immunology and a diagnosis of Behçet's disease was reached. The patient was commenced on intravenous methylprednisolone for 3 days followed by a switch to oral prednisolone. Due to recalcitrant uveitis, an intravitreal dexamethasone implant was administered. Eventually, systemic azathioprine and infliximab were commenced with frequent review by ophthalmology and immunology. The macular oedema improved but, unfortunately, the patient's visual acuity did not recover. Behçet's disease is a complex vasculitis involving multiple organ systems. Ocular manifestations can occur in 70% of patients, comprising retinal vasculitis, anterior uveitis, iridocyclitis, chorioretinitis, scleritis, keratitis, vitreous haemorrhage, optic neuritis, conjunctivitis, retinal vein occlusion and retinal neovascularisation. A tailored multidisciplinary approach is required, with corticosteroids being the mainstay of treatment.
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Characteristics of Behcet's Disease in the American Southwest. Semin Arthritis Rheum 2019; 49:296-302. [DOI: 10.1016/j.semarthrit.2019.03.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 02/23/2019] [Accepted: 03/04/2019] [Indexed: 11/23/2022]
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El-Ghobashy N, El-Garf K, Abdo M. Arterial aneurysms in Behçet’s disease patients: Frequency, clinical characteristics and long-term outcome. EGYPTIAN RHEUMATOLOGIST 2019. [DOI: 10.1016/j.ejr.2018.12.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Petrushkin H, Norman PJ, Lougee E, Parham P, Wallace GR, Stanford MR, Fortune F. KIR3DL1/S1 Allotypes Contribute Differentially to the Development of Behçet Disease. THE JOURNAL OF IMMUNOLOGY 2019; 203:1629-1635. [PMID: 31405953 DOI: 10.4049/jimmunol.1801178] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 07/08/2019] [Indexed: 11/19/2022]
Abstract
Behçet disease is a chronic, relapsing-remitting autoinflammatory syndrome with a strong HLA-B*51 association. In this paper, we describe a human cohort of 267 individuals with Behçet disease and 445 matched controls from a tertiary referral center in the U.K. HLA-B*51 was confirmed as a genetic risk factor in this group (p = 0.0006, Bonferroni-Dunn correction for multiple testing [Pc] = 0.0192, odds ratio [OR] 1.92, 95% confidence interval [CI] 1.33-2.76). KIR3DL1/S1 allele-level analysis indicated that low-expressing KIR3DL1/S1 alleles in combination with KIR3DS1 increased the risk of developing Behçet disease (KIR3DL1LOW/KIR3DS1: p = 0.0004, Pc = 0.0040, OR 2.47, 95% CI 1.43-4.25), whereas high-expressing KIR3DL1/S1 alleles in combination with a null-expressing KIR3DL1 reduced the risk of disease (KIR3DL1HIGH/KIR3DL1NULL: p = 0.0035, Pc = 0.0350, OR 0.53, 95% CI 0.33-0.87). Behçet disease can manifest as a purely mucocutaneous disease or can involve other organ systems such as the eyes. In the U.K. cohort studied in this study, KIR3DL1LOW/KIR3DS1 increased the risk of ophthalmic disease (p = 1.2 × 10-5, OR 3.92, 95% CI 2.06-7.47), whereas KIR3DL1HIGH/KIR3DL1NULL reduced the risk of having purely mucocutaneous disease (p = 0.0048, OR 0.45, 95% CI 0.25-0.81). To our knowledge, this is the first analysis of KIR3DL1/S1 allelic variation in Behçet disease and may provide insight into the pathogenic role of HLA-B*51 and its interaction with KIR3DL1/S1.
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Affiliation(s)
- Harry Petrushkin
- Moorfields Eye Hospital National Health Service Foundation Trust, Medical Retina Department, London EC1V 2PD, United Kingdom.,Clinical and Diagnostic Oral Sciences, Queen Mary University of London, Blizard Institute, E1 2AT London, United Kingdom
| | - Paul J Norman
- Division of Biomedical Informatics and Personalized Medicine, Department of Microbiology and Immunology, University of Colorado, Aurora, CO 80045
| | - Emma Lougee
- Viapath, Clinical Transplantation Laboratory, Guy's Hospital, Guy's and St Thomas' National Health Service Foundation Trust, London SE1 9RT, United Kingdom
| | - Peter Parham
- Department of Structural Biology, Stanford University School of Medicine, Stanford, CA 94305
| | - Graham R Wallace
- Centre for Translational Inflammation Research, University of Birmingham Research Laboratories, Queen Elizabeth Hospital, University of Birmingham, Birmingham B15 2TT, United Kingdom; and
| | - Miles R Stanford
- Medical Eye Unit, St Thomas' Hospital, Guy's and St Thomas' National Health Service Foundation Trust, London SE1 7EH, United Kingdom
| | - Farida Fortune
- Clinical and Diagnostic Oral Sciences, Queen Mary University of London, Blizard Institute, E1 2AT London, United Kingdom;
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Increased risk of atrial fibrillation in patients with Behçet's disease: A nationwide population-based study. Int J Cardiol 2019; 292:106-111. [PMID: 31256991 DOI: 10.1016/j.ijcard.2019.06.045] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 06/07/2019] [Accepted: 06/18/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Chronic inflammation plays a role in the pathophysiology of atrial fibrillation (AF). However, there is a paucity of information about whether Behçet's disease (BD) is associated with an increased risk of AF. This population-based study aimed to determine the risk of AF in patients with BD. METHODS A total of 6636 newly diagnosed BD patients without a history of AF were included from the Korean National Health Insurance Service database between 2010 and 2014. Newly diagnosed non-valvular AF was identified using the claims data. An age- and sex-matched non-BD subjects were extracted at a ratio of 1:5 (n = 31,040). The incidence and risk of AF were compared between groups. RESULTS During a mean follow-up of 3.6 ± 1.5 years, AF was newly diagnosed in 173 patients (51 in the BD group, 122 in the control group). The incidence was 2.3 and 1.1 per 1000 person-years, respectively. After adjustment, the BD group showed a 1.8-fold higher risk of AF compared to the control group. Patients with BD aged ≤40 years had a higher risk of AF, while patients aged ≥65 years showed a similar risk. Men with BD had a 2.5-fold increased risk of AF, whereas women with BD did not. Severe BD had a higher risk for AF compared to non-severe BD and controls. CONCLUSIONS BD was associated with an increased risk of AF, particularly in men and young patients. Active surveillance and treatment are needed in BD patients and those with arrhythmic symptoms.
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Leccese P, Padula MC, Santospirito EV, Colucci R, Lascaro N, D'Angelo S. HLA-B*51 subtypes molecular analysis in a series of Italian patients with Behçet's syndrome. Joint Bone Spine 2019; 86:807-808. [PMID: 31067502 DOI: 10.1016/j.jbspin.2019.04.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 04/24/2019] [Indexed: 11/26/2022]
Affiliation(s)
- Pietro Leccese
- Rheumatology Institute of Lucania (IReL) and Rheumatology Department of Lucania, San Carlo Hospital of Potenza, Via Potito Petrone, Potenza, 85100 Italy.
| | - Maria Carmela Padula
- Rheumatology Institute of Lucania (IReL) and Rheumatology Department of Lucania, San Carlo Hospital of Potenza, Via Potito Petrone, Potenza, 85100 Italy
| | | | - Rosa Colucci
- Tissue typing laboratory C.R.T. Basilicata, Madonna delle Grazie Hospital, Contrada Chiancalata, Matera, 75100 Italy
| | - Nancy Lascaro
- Rheumatology Institute of Lucania (IReL) and Rheumatology Department of Lucania, San Carlo Hospital of Potenza, Via Potito Petrone, Potenza, 85100 Italy
| | - Salvatore D'Angelo
- Rheumatology Institute of Lucania (IReL) and Rheumatology Department of Lucania, San Carlo Hospital of Potenza, Via Potito Petrone, Potenza, 85100 Italy; Basilicata Ricerca Biomedica (BRB) Foundation, via Verrastro, 9, Potenza, 85100 Italy
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Abstract
Patients with Behçet's disease (BD) suffer from episodic ocular and mucocutaneous attacks, resulting in a reduced quality of life. The phenotype of Japanese BD has been changing over the past 20 years, and the rate of human leukocyte antigen (HLA)-B*51-positive complete type is decreasing while that of intestinal type is increasing. This phenotypical evolution may be related to changes in as-yet-unknown environmental factors, as the immigration influx in Japan is low. Mechanisms discovered by genome-wide association studies include ERAP1-mediated HLA class I antigen bounding pathway, autoinflammation, Th17 cells, natural killer cells, and polarized macrophages, a similar genetic architecture to Crohn's disease, ankylosing spondylitis, and psoriasis. As for treatments, management guidelines have been implemented, and the development of tumor necrosis factor (TNF) inhibitors is markedly improving the outcome of BD, but evidence supporting treatment for special-type BD is limited. The classification of BD into distinct clusters based on clinical manifestations and genetic factors is crucial to the development of optimized medicine.
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Affiliation(s)
- Yohei Kirino
- Department of Stem Cell and Immune Regulation, Yokohama City University, Graduate School of Medicine, Japan
| | - Hideaki Nakajima
- Department of Stem Cell and Immune Regulation, Yokohama City University, Graduate School of Medicine, Japan
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El Boghdady NA, Shaker OG. Role of Serum miR-181b, Proinflammatory Cytokine, and Adhesion Molecules in Behçet's Disease. J Interferon Cytokine Res 2019; 39:347-354. [PMID: 30848985 DOI: 10.1089/jir.2018.0116] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Behçet's disease (BD) is a chronic multi-systemic inflammatory disease of uncertain pathogenesis and with no definitive diagnostic test. The aims of this study were to investigate serum levels of miR-181b in BD patients and to correlate this candidate biomarker with disease activity, cytokines, and adhesion molecules to identify new markers that can be used as a diagnostic tool for BD. Blood samples were collected from 96 participants who were classified according to their BD current activity form into 3 groups: healthy control, active BD, and inactive BD patients. MiR-181b was estimated by real-time polymerase chain reaction. However, high sensitive C-reactive protein (hs-CRP), tumor necrosis factor alpha (TNF-α), interleukin-6 (IL-6), E-selectin, and vascular cell adhesion molecule 1 (VCAM-1) levels were determined by enzyme-linked immunosorbent assay. Serum levels of miR-181b, hs-CRP, TNF-α, IL-6, E-selectin, and VCAM-1 were significantly higher in patients than in controls, but no significant difference was observed between the active and inactive BD groups. IL-6 was positively correlated with adhesion molecules, E-selectin, and VCAM-1. MiR-181b was positively correlated with hs-CRP, TNF-α, IL-6, and VCAM-1 in all subjects. In conclusion, miR-181b could play an important role in BD pathophysiology. MiR-181b could be utilized as potential biomarker for diagnosis and therapeutic targeting of BD. However, further studies with larger patient number are required to support these findings.
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Affiliation(s)
| | - Olfat Gamil Shaker
- 2 Medical Biochemistry and Molecular Biology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
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Reduced Risk of BK Polyomavirus Infection in HLA-B51–positive Kidney Transplant Recipients. Transplantation 2019; 103:604-612. [DOI: 10.1097/tp.0000000000002376] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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75
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Irtegun-Kandemir S, Icen-Taskin I, Bozkurt M, Kalkanli-Tas S. mRNA Expression Profile of SFKs and Involvement of SFKs in the Regulation of LPS-Induced Erk1/2 Signaling in PBMCs of Active BD Patients. Endocr Metab Immune Disord Drug Targets 2019; 19:809-817. [PMID: 30659554 DOI: 10.2174/1871530319666190119101756] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 11/06/2018] [Accepted: 01/02/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Behcet's Disease (BD) is a multisystemic inflammatory disorder affecting large vessels, lungs joints, gastrointestinal and neurological systems. The pathogenesis of BD remains poorly understood. Identifying the key signaling pathway is crucial for a complete understanding of the pathogenesis of BD. OBJECTIVE The aim of this study was to determine mRNA expression level of Src family kinases (SFKs) members and their involvement in lipopolysaccharide (LPS)-induced mitogen-activated protein kinases (MAPKs) regulation in peripheral blood mononuclear cells (PBMCs) of active BD patients. METHODS Twenty- five active BD patients and twenty-five healthy controls were included in the study. PBMCs were isolated from total blood by density gradient centrifugation. The mRNA expression levels of SFKs members were measured by real-time quantitative PCR (RT-qPCR). The effect of SFKs activity on LPS-induced activation MAPKs (Erk1/2, p38 and JNK) was examined by Western blot. RESULTS The mRNA expression levels of Hck, Src, Lyn, Yes and Fyn were found to be slightly decreased in active BD patients compared to the control subjects, but a slight change in mRNA level of SFKs members did not impact on protein levels and protein activity. LPS-induced Erk1/2 phosphorylation was significantly increased in the absence of SFKs activity in active BD patients. However, inhibition of SFKs activity had no effect on LPS-induced phosphorylation of p38 and JNK in both controls and active BD patients. CONCLUSION SFKs downregulate LPS-induced Erk1/2 phosphorylation in PBMCs of active BD patients.
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Affiliation(s)
- Sevgi Irtegun-Kandemir
- Department of Medical Biology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey
| | - Irmak Icen-Taskin
- Department of Molecular Biology and Genetics, Faculty of Science and Art, Inonu University, Malatya, Turkey
| | - Mehtap Bozkurt
- Department of Physical Therapy and Rehabilitation, Faculty of Medicine, Dicle University, Diyarbakir, Turkey
| | - Sevgi Kalkanli-Tas
- Department of Immunology, Faculty of Medicine, University of Health Sciences, Istanbul, Turkey
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Piven VD, Krasnov VS, Lashok PA, Neofidoff NA, Bubnova EV, Totolyan NA. Behcet's disease with neurologic manifestations. Zh Nevrol Psikhiatr Im S S Korsakova 2019; 119:67-73. [DOI: 10.17116/jnevro201911910167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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77
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Shahriyari E, Bonyadi M, Jabbarpoor Bonyadi MH, Soheilian M, Yaseri M, Ebrahimiadib N. Ubiquitin Associated and SH3 Domain Containing B (UBASH3B) Gene Association with Behcet’s Disease in Iranian Population. Curr Eye Res 2018; 44:200-205. [DOI: 10.1080/02713683.2018.1524913] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Elham Shahriyari
- Center of Excellence for Biodiversity, Faculty of Natural Sciences, University of Tabriz, Tabriz, Iran
| | - Mortaza Bonyadi
- Center of Excellence for Biodiversity, Faculty of Natural Sciences, University of Tabriz, Tabriz, Iran
| | | | - Masoud Soheilian
- Ocular Tissue Engineering Research Center, Ophthalmic Research Center, Shahid Beheshty University of Medical Sciences, Tehran, Iran
| | - Mehdi Yaseri
- Department of Biostatistics and Epidemiology, Tehran University of Medical Sciences, Tehran, Iran
| | - Nazanin Ebrahimiadib
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Science (TUMS), Tehran, Iran
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AIF-1 gene does not confer susceptibility to Behçet's disease: Analysis of extended haplotypes in Sardinian population. PLoS One 2018; 13:e0204250. [PMID: 30252881 PMCID: PMC6155533 DOI: 10.1371/journal.pone.0204250] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 09/04/2018] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Behçet's disease (BD) is a polygenic immune-mediated disorder characterized by a close association with the HLA-B*51 allele. The HLA region has a strong linkage disequilibrium (LD) and carries several genetic variants (e.g. MIC-A, TNF-α genes) identified as associated to BD because of their LD with HLA-B*51. In fact, the HLA-B*51 is inherited as part of extended HLA haplotypes which are well preserved in patients with BD. Sardinian population is highly differentiated from other Mediterranean populations because of a distinctive genetic structure with very highly preserved HLA haplotypes. PATIENTS AND METHODS In order to identify other genes of susceptibility to BD within the HLA region we investigated the distribution of human Allograft Inflammatory Factor-1 (AIF-1) gene variants among BD patients and healthy controls from Sardinia. Six (rs2736182; rs2259571; rs2269475; rs2857597; rs13195276; rs4711274) AIF-1 single nucleotide polymorphisms (SNPs) and related extended haplotypes have been investigated as well as their LD within the HLA region and with HLA-B*51. Overall, 64 BD patients, 43 HLA-B*51 positive healthy controls (HC) and 70 random HC were enrolled in the study. RESULTS HLA-B*51 was the only allele with significantly higher frequency (pc = 0.0021) in BD patients (40.6%) than in HC (9.8%). The rs2259571T AIF-1 variant had a significantly reduced phenotypic, but not allelic frequency in BD patients (72.1%; pc = 0.014) compared to healthy population (91.3%). That was likely due to the LD between HLA-B*51 and rs2259571G (pc = 9E-5), even though the rs2259571G distribution did not significantly differ between BD patients and HC. CONCLUSION No significant difference in distribution of AIF-1 SNPs haplotypes was observed between BD patients and HC and between HLA-B*51 positive BD patients and HLA-B*51 positive HC. Taken together, these results suggest that AIF-1 gene is not associated with susceptibility to BD in Sardinia.
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Islam SMS, Sohn S. HSV-Induced Systemic Inflammation as an Animal Model for Behçet's Disease and Therapeutic Applications. Viruses 2018; 10:v10090511. [PMID: 30235840 PMCID: PMC6163530 DOI: 10.3390/v10090511] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 09/17/2018] [Accepted: 09/18/2018] [Indexed: 01/06/2023] Open
Abstract
Behçet’s disease (BD) affects multiple organs. It is mainly characterized by recurrent oral, skin, and genital aphthous ulcers, and eye involvement. Successful management of BD is increasing, although its etiology remains unclear. A number of etiologies have been proposed, including environmental, genetic, viral, and immunological factors. To understand its complex etiology and improve its management, animal models of BD have been used to enable more effective therapeutic applications with increased clinical significance. An herpes simplex virus (HSV) type 1-induced BD mouse model has shown disease characteristics similar to those seen in BD patients. An HSV-induced BD animal model has been used to test various therapeutic modalities. The applied modalities are several materials that are derived from natural products, conventional therapeutics, and possible biologics. In this review, we provided how they regulate inflammation in an HSV-induced BD model.
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Affiliation(s)
- S M Shamsul Islam
- Department of Biomedical Science, Ajou University School of Medicine, Suwon 16499, Korea.
| | - Seonghyang Sohn
- Department of Biomedical Science, Ajou University School of Medicine, Suwon 16499, Korea.
- Department of Microbiology, Ajou University School of Medicine, Suwon 16499, Korea.
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Dormegny L, Chibbaro S, Ganau M, Santin M, Kremer L, Proust F. Biopsying a spinal cord lesion: A diagnostic dilemma. Case report and review of literature. Neurochirurgie 2018; 64:425-430. [PMID: 30243464 DOI: 10.1016/j.neuchi.2018.07.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 06/24/2018] [Accepted: 07/23/2018] [Indexed: 12/29/2022]
Abstract
Spinal cord biopsy is a difficult procedure fraught with the risk of false-negative results or even misdiagnosis in up to 30% of cases. Differential diagnoses of spinal cord lesions include a wide range of inflammatory, infectious and neoplastic diseases. Given the importance of correctly managing these pathologies, it is crucial to avoid delays in making the correct diagnosis in order to improve the patient's outcome. We present here the case of a 21-year-old male with rapidly progressing sphincter and lower limb motor dysfunctions up to complete paraplegia with evidence of thoracic spinal cord lesion on magnetic resonance imaging. None of the blood and cerebrospinal fluid tests pointed to a diagnosis, while a first spinal cord biopsy revealed an inflammatory necrotic process. After several weeks of empirical treatments and clinical stability, the patient started having focal structural seizures that became generalized with local progression of the lesion and diffuse leptomeningeal spread on magnetic resonance imaging. A second spinal cord biopsy found a grade IV glioblastoma with H3 K27M histone mutation. Unfortunately the patient passed away before any treatment could be initiated. In this report, the authors analyze the difficulty of making the rapid, correct diagnosis of a highly malignant intrinsic spinal cord lesion, discussing also possible strategies to avoid diagnostic delays and to improve the outcome of these difficult patients.
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Affiliation(s)
- L Dormegny
- Service de neurochirurgie, CHU de Strasbourg, hôpital de Hautepierre, 67000 Strasbourg, France.
| | - S Chibbaro
- Service de neurochirurgie, CHU de Strasbourg, hôpital de Hautepierre, 67000 Strasbourg, France
| | - M Ganau
- Service de neurochirurgie, CHU de Strasbourg, hôpital de Hautepierre, 67000 Strasbourg, France
| | - Mdn Santin
- Service de neurochirurgie, CHU de Strasbourg, hôpital de Hautepierre, 67000 Strasbourg, France
| | - L Kremer
- Service de neurologie, CHU de Strasbourg, hôpital de Hautepierre, 67000 Strasbourg, France
| | - F Proust
- Service de neurochirurgie, CHU de Strasbourg, hôpital de Hautepierre, 67000 Strasbourg, France
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81
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Ibrahim W, Sakr BR, Obaya E, Ghonem H. MicroRNA-146a expression and microRNA-146a rs2910164 polymorphism in Behcet’s disease patients. Clin Rheumatol 2018; 38:397-402. [DOI: 10.1007/s10067-018-4191-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 06/20/2018] [Accepted: 06/24/2018] [Indexed: 10/28/2022]
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82
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Deng Y, Zhu W, Zhou X. Immune Regulatory Genes Are Major Genetic Factors to Behcet Disease: Systematic Review. Open Rheumatol J 2018; 12:70-85. [PMID: 30069262 PMCID: PMC6040213 DOI: 10.2174/1874312901812010070] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 05/04/2018] [Accepted: 06/04/2018] [Indexed: 12/15/2022] Open
Abstract
Behcet's disease (BD) is a chronic refractory multi-system autoimmune disorder that occurs in a genetically susceptible host. Multiple genetic factors have been identified that may contribute to the pathogenesis of BD. The major genes with polymorphisms associated with BD include HLA-B and -A, CIITA, ERAP1, MICA, IL10, IL12A, IL12RB2, IL23R, MEFV, IRF8, TNFAIP3, REL, TLR4, NOD1,2, CCR1,CCR3, GIMAP1,2,4, KLRC4, STAT4, NCOA5, FOXP3, PSORS1C1, FUT2, UBAC2, SUMO4, ADO-EGR2, CEBPB-PTPN1, and JPKL-CNTN5. These genes encode proteins involved mainly in immune regulation and inflammation, and some in transcription and post-translational modification. A complete view of these BD-associated genes may provide a clue to this complex disease in terms of its pathogenesis and exploring potentially targeted therapies for BD.
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Affiliation(s)
- Yan Deng
- The Second Affiliated Hospital of Nanchang University, Nanchangine>, China.,Department of Internal Medicine/Rheumatology, University of Texas Health Science Center at Houston McGovern Medical School, USA
| | - Weifeng Zhu
- Department of Internal Medicine/Rheumatology, University of Texas Health Science Center at Houston McGovern Medical School, USA.,College of Basic Medical Sciences, Nanchang University, Nanchang, China
| | - Xiaodong Zhou
- Department of Internal Medicine/Rheumatology, University of Texas Health Science Center at Houston McGovern Medical School, USA
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83
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Salmaninejad A, Gowhari A, Hosseini S, Aslani S, Yousefi M, Bahrami T, Ebrahimi M, Nesaei A, Zal M. Genetics and immunodysfunction underlying Behçet's disease and immunomodulant treatment approaches. J Immunotoxicol 2018; 14:137-151. [PMID: 28693405 DOI: 10.1080/1547691x.2017.1346008] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Behçet's disease (BD) is a chronic autoimmune condition primarily prevalent in populations along the Mediterranean Sea. The exact etiology of BD has not been fully explained yet, but the disease occurrence is associated with a genetic factor, human leukocyte antigen (HLA)-B51 antigen. Among the various immunodysfunctions that are found in BD, patients are increased neutrophil motility and superoxide production, as well as elevated production of tumor necrosis factor (TNF)-α and decreased production of interleukin (IL)-10. Elevated levels of inflammatory cytokines like IL-1 and IL-17 in BD have been found associated with aberrant expression of microRNA. Gene polymorphisms in BD patients have been observed in molecules involved in responses to pathogens that can ultimately modulate the host antimicrobial response. Moreover, several single nucleotide polymorphisms (SNPs) have been reported in genes encoding chemokines and adhesion molecules; many of these changes manifest as increases in vascular inflammation and vascular damage. Lastly, genetic and epigenetic changes have been suggested as involved in the pathogenesis of BD. Modifications in DNA methylation have been found in BD patient monocytes and lymphocytes, leading to adverse function of these cells. This review presents a comprehensive compilation of the literature with regard to the immunodysfunction underlying BD, as well as of the genetics, newly described clinical specifications and novel treatment strategies using immunomodulants based on the current understanding of BD.
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Affiliation(s)
- Arash Salmaninejad
- a Drug Applied Research Center , Tabriz University of Medical Sciences , Tabriz , Iran.,b Medical Genetics Research Center, Student Research Committee, Department of Medical Genetics, Faculty of Medicine , Mashhad University of Medical Sciences , Mashhad , Iran.,c Rheumatology Research Center , Tehran University of Medical Sciences , Tehran , Iran
| | - Arezoo Gowhari
- d Department of Immunology, Faculty of Medicine , Mashhad University of Medical Sciences , Mashhad , Iran
| | - Seyedmojtaba Hosseini
- b Medical Genetics Research Center, Student Research Committee, Department of Medical Genetics, Faculty of Medicine , Mashhad University of Medical Sciences , Mashhad , Iran
| | - Saeed Aslani
- c Rheumatology Research Center , Tehran University of Medical Sciences , Tehran , Iran
| | - Meysam Yousefi
- b Medical Genetics Research Center, Student Research Committee, Department of Medical Genetics, Faculty of Medicine , Mashhad University of Medical Sciences , Mashhad , Iran
| | - Tayyeb Bahrami
- e Genetics Research Center , University of Social Welfare and Rehabilitation Sciences , Tehran , Iran
| | - Masoume Ebrahimi
- f Department of Biology, Faculty of Sciences , University of Guilan , Rasht , Iran
| | - Abolfazl Nesaei
- g Department of Basic Sciences , Gonabad University of Medical Sciences , Gonabad , Iran
| | - Masoud Zal
- h Department of Medical Genetics , Shahid Beheshti University of Medical Sciences , Tehran , Iran
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84
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Greco A, De Virgilio A, Ralli M, Ciofalo A, Mancini P, Attanasio G, de Vincentiis M, Lambiase A. Behçet's disease: New insights into pathophysiology, clinical features and treatment options. Autoimmun Rev 2018; 17:567-575. [PMID: 29631062 DOI: 10.1016/j.autrev.2017.12.006] [Citation(s) in RCA: 168] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Accepted: 12/21/2017] [Indexed: 12/12/2022]
Abstract
Behçet's disease (BD) is a rare systemic vasculitis characterized by oral aphthous ulcers, genital ulcers, ocular lesions and other systemic manifestations. BD occurs most frequently in Eurasian populations along the ancient trading route known as the "Silk Road" which extends from eastern Asia to the Mediterranean basin. The causes of BD are unknown: it is believed to be due to an autoimmune process triggered by an infectious or environmental agent in genetically predisposed individuals. HLA-B51 allele located in the MHC locus, on chromosome 6p, has been the most strongly associated risk factor for BD in areas along the Old Silk Route. Herpes simplex virus-1 and Streptococcus have been postulated as possible environmental triggers of BD. T cell homeostasis perturbation, especially Th1 and Th17 expansion and decreased regulation by Tregs are now supposed to be the cornerstone of BD pathogenesis. The histology shows vasculitis that involves both arteries and veins, and vessels of any size. BD is a systemic vasculitis with significant neutrophil infiltration, endothelial cell swelling, and fibrinoid necrosis. The diagnosis of BD is only supported by clinical criteria and requires the exclusion of other diagnoses based on clinical presentation. There are no pathognomonic laboratorial findings of BD. This rare disease often leads to blindness and fatal systemic involvement. Main causes of death include major vessel disease and central nervous system involvement. Corticosteroids are commonly used to treat clinical manifestations of BD in combination with immunosuppressant drugs. Tumor necrosis factor (TNF)-blocking agents such as Infliximab, Etanercept, and Adalimumab have been reported to have success in patients with BD.
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Affiliation(s)
- Antonio Greco
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00100 Rome, Italy.
| | - Armando De Virgilio
- Department of Otolaryngology-Head and Neck Surgery, Humanitas Clinical and Research Center, via Manzoni 56, 20089 Rozzano, MI, Italy
| | - Massimo Ralli
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00100 Rome, Italy.
| | - Andrea Ciofalo
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00100 Rome, Italy.
| | - Patrizia Mancini
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00100 Rome, Italy.
| | - Giuseppe Attanasio
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00100 Rome, Italy.
| | - Marco de Vincentiis
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00100 Rome, Italy.
| | - Alessandro Lambiase
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00100 Rome, Italy.
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85
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Cerebrospinal fluid IL-10 as an early stage discriminative marker between multiple sclerosis and neuro-Behçet disease. Cytokine 2018; 108:160-167. [PMID: 29625335 DOI: 10.1016/j.cyto.2018.03.039] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 03/28/2018] [Accepted: 03/29/2018] [Indexed: 12/17/2022]
Abstract
Multiple Sclerosis (MS) and Neuro-Behçet's Disease (NBD) are two recurrent disorders affecting the central nervous system (CNS) by causing inflammation and irreversible damage. Inaugural clinical symptoms for both diseases might be very similar and definitive diagnosis could be delayed. The present study aimed to find out possible differences at early stages in the transcription factors/cytokines expression profiles in blood and cerebrospinal fluid (CSF) of MS and NBD patients which could be useful discriminative markers. Cytokines and transcription factors related to Th1, Th2, Th17 and T regulatory populations were studied by quantitative RT-PCR simultaneously in PBMCs and CSF, from 40 patients presenting a first episode of clinical features related to CNS inflammation and 22 controls with non inflammatory neurological diseases enrolled mainly for severe headache. The follow up of 12 months did allow a definitive diagnosis of remitting relapsing MS (RRMS) in 21 patients and of NBD in the other 19 among those with CNS inflammation compared to controls. In initial blood samples, T-bet was significantly increased in NBD patients only while IFN-γ was elevated in patients who evolved into RRMS or NBD. IL-17a, GATA-3 and IL-4 were significantly lower in RRMS patients than in the NBD group. In initial CSF samples, ROR-γt, IL-17a and IFN-γ were significantly elevated in patients compared to controls. The most striking finding was the significant increase of CSF IL-10 that we did observe in NBD patients only. Thus, we propose CSF IL-10 as a predictive marker to help clinicians discriminating between these two neurological disorders.
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86
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Zhang Q, Li H, Hou S, Yu H, Su G, Deng B, Qi J, Zhou C, Kijlstra A, Yang P. Association of genetic variations in PTPN2 and CD122 with ocular Behcet's disease. Br J Ophthalmol 2018; 102:996-1002. [PMID: 29502070 DOI: 10.1136/bjophthalmol-2017-310820] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 12/29/2017] [Accepted: 02/15/2018] [Indexed: 11/04/2022]
Abstract
BACKGROUND Protein tyrosine phosphatases (PTPs) play critical roles in human autoimmunity. Previous studies found that PTPN2 may be the key regulatory factor in the T-cell-mediated immune response. PTPN2 regulates the Janus kinase/signal transducers and activators of transcription pathway by inhibiting signalling via the interleukin (IL)-2 receptor (CD122). An association between genetic variations in PTPN2 and CD122 with ocular Behcet's disease (BD) has not yet been addressed and was therefore the purpose of this study. METHODS A two-stage case-control study was performed in 906 patients with ocular BD and 2178 healthy controls. Genotyping analysis of 11 single nucleotide polymorphisms was carried out. The expression of PTPN2 in peripheral blood mononuclear cells (PBMCs) was quantified by real-time PCR and cytokine production was measured by ELISA. RESULTS The frequency of the GG genotype of PTPN2-rs7234029 was significantly lower in patients with ocular BD (p=1.94×10-5, pc=8.34×10-4, OR=0.466). Stratification according to gender showed that rs7234029 was significantly associated with BD in men. A stratified analysis according to the main clinical features showed that rs7234029 was significantly associated with genital ulcers, skin lesions and a positive pathergy test. No association could be detected between BD and CD122 gene polymorphisms. Functional studies showed that rs7234029 GG genotype carriers had a higher PNPT2 mRNA expression level than those which carrying the AA or AG genotype, and a decreased secretion of IL-17 and tumour necrosis factor-alpha was seen by PBMCs from GG carriers. No significant difference could be detected concerning IL-1β or IL-6 production by stimulated PBMCs between the different genotype groups. CONCLUSIONS This study shows that a PTPN2-rs7234029 polymorphism is associated with ocular BD and is strongly influenced by gender. In addition, our results suggest that the genetic association with PTPN2 may involve the regulation of PTPN2 mRNA expression and cytokine secretion.
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Affiliation(s)
- Qi Zhang
- Ophthalmology Department, The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology, Chongqing Eye Institute, Chongqing, People's Republic of China
| | - Hua Li
- Ophthalmology Department, Yongchuan Hospital, Chongqing Medical University, Chongqing, People's Republic of China
| | - Shengping Hou
- Ophthalmology Department, The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology, Chongqing Eye Institute, Chongqing, People's Republic of China
| | - Hongsong Yu
- Ophthalmology Department, The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology, Chongqing Eye Institute, Chongqing, People's Republic of China
| | - Guannan Su
- Ophthalmology Department, The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology, Chongqing Eye Institute, Chongqing, People's Republic of China
| | - Bolin Deng
- Ophthalmology Department, The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology, Chongqing Eye Institute, Chongqing, People's Republic of China
| | - Jian Qi
- Ophthalmology Department, The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology, Chongqing Eye Institute, Chongqing, People's Republic of China
| | - Chunjiang Zhou
- Ophthalmology Department, The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology, Chongqing Eye Institute, Chongqing, People's Republic of China
| | - Aize Kijlstra
- University Eye Clinic Maastricht, Maastricht, The Netherlands
| | - Peizeng Yang
- Ophthalmology Department, The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology, Chongqing Eye Institute, Chongqing, People's Republic of China
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87
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Na SJ, Kang MJ, Yu DS, Han KD, Lee JH, Park YG, Lee YB. Cancer risk in patients with Behçet disease: A nationwide population-based dynamic cohort study from Korea. J Am Acad Dermatol 2018; 78:464-470.e2. [DOI: 10.1016/j.jaad.2017.09.035] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 09/05/2017] [Accepted: 09/16/2017] [Indexed: 12/11/2022]
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88
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Watts RA, Robson J. Introduction, epidemiology and classification of vasculitis. Best Pract Res Clin Rheumatol 2018; 32:3-20. [DOI: 10.1016/j.berh.2018.10.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 06/18/2018] [Accepted: 07/20/2018] [Indexed: 12/12/2022]
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89
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90
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Fiorillo MT, Paladini F, Tedeschi V, Sorrentino R. HLA Class I or Class II and Disease Association: Catch the Difference If You Can. Front Immunol 2017; 8:1475. [PMID: 29163539 PMCID: PMC5681916 DOI: 10.3389/fimmu.2017.01475] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Accepted: 10/20/2017] [Indexed: 12/25/2022] Open
Affiliation(s)
- Maria Teresa Fiorillo
- Department of Biology and Biotechnology "Charles Darwin", Sapienza University of Rome, Rome, Italy
| | - Fabiana Paladini
- Department of Biology and Biotechnology "Charles Darwin", Sapienza University of Rome, Rome, Italy
| | - Valentina Tedeschi
- Department of Biology and Biotechnology "Charles Darwin", Sapienza University of Rome, Rome, Italy
| | - Rosa Sorrentino
- Department of Biology and Biotechnology "Charles Darwin", Sapienza University of Rome, Rome, Italy
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91
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Giza M, Koftori D, Chen L, Bowness P. Is Behçet's disease a 'class 1-opathy'? The role of HLA-B*51 in the pathogenesis of Behçet's disease. Clin Exp Immunol 2017; 191:11-18. [PMID: 28898393 DOI: 10.1111/cei.13049] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2017] [Indexed: 12/11/2022] Open
Abstract
The association between carriage of the human leucocyte antigen (HLA)-B*51 allele and development of Behçet's disease (BD) has been known since the early 1970s, but the exact mechanisms responsible for its role in pathogenesis remain much-debated. In an effort to explain the disease process, it has been suggested that BD constitutes one of a newly termed group of diseases, the 'MHC-I-opathies'. Other MHC-I-opathies include ankylosing spondylitis and HLA-B*27-associated spondyloarthropathies and HLA-C*0602-associated skin psoriasis. Recent work analysing the peptidome of HLA-B*51 suggests that altered peptide presentation by HLA-B*51 is vital to the disease process. In this review, we argue that immune receptor interactions with HLA-B*51 or the HLA-B*51-peptide complex could lead to development of inflammation in BD. The evidence for CD8+ T cell involvement is weak, and based on emerging studies it seems more likely that natural killer (NK) or other cell interactions, perhaps mediated by leucocyte immunoglobulin-like receptor (LILR) or killer immunoglobulin-like receptor (KIR) receptors, are culpable in pathogenesis. HLA misfolding leading directly to inflammation is another hypothesis for BD pathogenesis that deserves greater investigation. Ultimately, greater understanding of HLA-B*51's unique role in BD will probably lead to improved development of therapeutic strategies.
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Affiliation(s)
- M Giza
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - D Koftori
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - L Chen
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - P Bowness
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
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92
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Knitting the Threads of Silk through Time: Behçet's Disease-Past, Present, and Future. Int J Rheumatol 2017; 2017:2160610. [PMID: 29081805 PMCID: PMC5610876 DOI: 10.1155/2017/2160610] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 08/07/2017] [Indexed: 12/14/2022] Open
Abstract
Behçet's disease (BD) is a chronic relapsing vasculitis that affects vessels of all types and sizes with a broad spectrum of phenotypic heterogeneity and complex immunopathogenesis. Efforts by the scientific community to resolve the unmet needs of BD and gaps in our knowledge have been hampered by considerable challenges that primarily relate to the rare nature of the disease in many parts of the world and its heterogeneity. Controversies remain in many aspects of the disease including the diagnostic criteria, immunopathogenesis and biomarker discovery, geographical variation, and therapeutic considerations. In this review, we highlight recent advances in our scientific understanding of BD, shed new insights into diagnostic and treatment strategies, and discuss residual gaps in our knowledge that will serve as the basis for current and future research.
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93
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Mohammad-Ebrahim H, Kamali-Sarvestani E, Mahmoudi M, Beigy M, Karami J, Ahmadzadeh N, Shahram F. Association of killer cell immunoglobulin-like receptor (KIR) genes and their HLA ligands with susceptibility to Behçet's disease. Scand J Rheumatol 2017; 47:155-163. [PMID: 28862099 DOI: 10.1080/03009742.2017.1340510] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVES Behçet's disease (BD) is a systemic inflammatory disorder with remissions and exacerbations. It is thought that defects in the natural killer (NK) cell repertoire may be involved in BD through killer cell immunoglobulin-like receptors (KIRs). This study aimed to evaluate KIR and HLA genes, their interactions in BD patients, and their associations with clinical manifestations. METHOD The presence or absence of KIR and HLA alleles and genotypes was analysed by polymerase chain reaction sequence-specific primer on genomic DNA of 397 BD patients and 300 healthy controls. RESULTS None of the KIR genes showed significant effects on BD susceptibility. HLA-C1Asn80 showed a protective effect against BD, whereas HLA-C2Lys80, HLA-B-Bw4Ile80, HLA-B5, and HLA-B51 were associated with a susceptibility risk for BD. In the combination of KIR and HLA genes, the frequencies of HLA genotypes no. 2, 3, 5, and 8, and inhibitory KIR no. 4 were significantly higher in patients than in controls. The frequencies of KIR genotype no. 3 and HLA genotypes no. 1, 4, 6, 7, and 9 were significantly lower in patients than in controls. There were many associations between KIR and HLA genes with clinical features of BD. CONCLUSION Differences in the frequency of HLA genes, KIR-HLA interactions, and genotypes between BD and healthy controls and their associations with clinical manifestations indicate that NK cells are involved in BD pathogenesis. The observed differences indicated an NK cell activity imbalance in BD patients, and suggest a role of the KIR-HLA repertoire in the development of BD.
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Affiliation(s)
- H Mohammad-Ebrahim
- a Department of Immunology, School of Medicine , Shiraz University of Medical Sciences , Shiraz , Iran.,b Autoimmune Disease Research Centre , Shiraz University of Medical Sciences , Shiraz , Iran.,c Rheumatology Research Center , Tehran University of Medical Sciences , Tehran , Iran
| | - E Kamali-Sarvestani
- a Department of Immunology, School of Medicine , Shiraz University of Medical Sciences , Shiraz , Iran.,b Autoimmune Disease Research Centre , Shiraz University of Medical Sciences , Shiraz , Iran
| | - M Mahmoudi
- c Rheumatology Research Center , Tehran University of Medical Sciences , Tehran , Iran
| | - M Beigy
- c Rheumatology Research Center , Tehran University of Medical Sciences , Tehran , Iran.,d Students' Scientific Research Center (SSRC) , Tehran University of Medical Sciences , Tehran , Iran
| | - J Karami
- e Department of Immunology , School of Medicine, Iran University of Medical Sciences , Tehran , Iran
| | - N Ahmadzadeh
- c Rheumatology Research Center , Tehran University of Medical Sciences , Tehran , Iran
| | - F Shahram
- c Rheumatology Research Center , Tehran University of Medical Sciences , Tehran , Iran
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94
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van Laar JAM. Can epidemiological studies uncover the origin of Behçet’s disease? Rheumatology (Oxford) 2017. [DOI: 10.1093/rheumatology/kex231] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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95
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Koca SS, Kara M, Özgen M, Dayanan R, Demir CF, Aksoy K, İlhan N, Dönder E, Işık A. Low prevalence of obesity in Behçet's disease is associated with high obestatin level. Eur J Rheumatol 2017. [PMID: 28638683 DOI: 10.5152/eurjrheum.2017.160095] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE Chronic inflammatory diseases are associated with altered body composition. Ghrelin has anti-inflammatory effects, and its level is altered in obesity and inflammatory diseases. The aim of the study was to evaluate the prevalence of obesity and ghrelin and obestatin levels in patients with Behçet's disease (BD). MATERIAL AND METHODS One hundred and forty-three (143) patients with BD and 112 healthy controls (HC) were enrolled. Participants were subdivided according to the body mass index (BMI) as lean (<18.5 kg/m2), normal weight (18.5-24.9 kg/m2), overweight (25-29.9 kg/m2) and obese (≥30 kg/m2). In addition to the routine evaluations (fasting blood glucose, lipid profile, and kidney and liver function tests), serum acylated-ghrelin (AG), unacylated-ghrelin (UAG), total ghrelin (TG) and obestatin levels were analyzed. Student's t-test and chi-square test were used for statistical analysis. RESULTS The prevalence of obesity was relatively lower in the BD group than in the HC group (12.6% vs. 20.5%, p=0.089). Serum ghrelin levels were similar in the BD and HC groups (p>0.05 for all) although the obestatin level was higher in the BD group compared to the HC group (p<0.001). Serum UAG, TG and obestatin levels were lower in obese BD patients (n=18) than non-obese BD patients (p=0.027, p=0.014 and p=0.001, respectively). CONCLUSION The obestatin level was high and the prevalence of obesity was low in the BD group. Moreover, obese BD patients had low obestatin levels. These results suggest that obestatin may protect BD patients from obesity.
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Affiliation(s)
| | - Murat Kara
- Department of Medical Genetics, Sıtkı Koçman University School of Medicine, Muğla, Turkey
| | - Metin Özgen
- Department of Rheumatology, 19 Mayıs University School of Medicine, Samsun, Turkey
| | - Ramazan Dayanan
- Department of Internal Medicine, Fırat University School of Medicine, Elazığ, Turkey
| | - Caner Feyzi Demir
- Department of Neurology, Fırat University School of Medicine, Elazığ, Turkey
| | - Kader Aksoy
- Department of Endocrinology, Fırat University School of Medicine, Elazığ, Turkey
| | - Nevin İlhan
- Department of Biochemistry, Fırat University School of Medicine, Elazığ, Turkey
| | - Emir Dönder
- Department of Internal Medicine, Fırat University School of Medicine, Elazığ, Turkey
| | - Ahmet Işık
- Department of Rheumatology, Fırat University School of Medicine, Elazığ, Turkey
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96
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Blake T, Pickup L, Carruthers D, Damato EM, Denniston A, Hamburger J, Maxton C, Mitton D, Murray PI, Nightingale P, Poveda-Gallego A, Richards A, Whallett A, Situnayake D. Birmingham Behçet's service: classification of disease and application of the 2014 International Criteria for Behçet's Disease (ICBD) to a UK cohort. BMC Musculoskelet Disord 2017; 18:101. [PMID: 28283043 PMCID: PMC5346254 DOI: 10.1186/s12891-017-1463-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Accepted: 02/28/2017] [Indexed: 11/16/2022] Open
Abstract
Background This study reports on the analysis of the application and diagnostic predictability of the revised 2014 ICBD criteria in an unselected cohort of UK patients, and the ensuing organ associations and patterns of disease. Methods A retrospective cohort study was conducted using a database of electronic medical records. Three categories were recognised: clinically defined BD, incomplete BD and rejected diagnoses of BD. We applied the ISG 1990 and ICBD 2014 classification criteria to these subgroups to validate diagnostic accuracy against the multidisciplinary assessment. Results Between 2012 and 2015, 281 patients underwent initial assessment at an urban tertiary care centre: 190 patients with a confirmed diagnosis of BD, 7 with an incomplete diagnosis, and 84 with a rejected diagnosis. ICBD 2014 demonstrated an estimated sensitivity of 97.89% (95% CI: 94.70 to 99.42) and positive likelihood ratio of 1.21 (1.10 to 1.28). The strongest independent predictors were: Central nervous lesions (OR = 10.57, 95% CI: 1.34 to 83.30); Genital ulceration (OR = 9.05, 95% CI: 3.35 to 24.47); Erythema nodosum (OR = 6.59, 95% CI: 2.35 to 18.51); Retinal vasculitis (OR = 6.25, 95% CI: 1.47 to 26.60); Anterior uveitis (OR = 6.16, 95% CI: 2.37 to 16.02); Posterior uveitis (OR = 4.82, 95% CI: 1.25 to 18.59). Conclusions The ICBD 2014 criteria were more sensitive at picking up cases than ISG 1990 using the multidisciplinary assessment as the gold standard. ICBD may over-diagnose BD in a UK population. Patients who have an incomplete form of BD represent a distinct group that should not be given an early diagnostic label. Behçet’s disease is a complex disease that is best diagnosed by multidisciplinary clinical assessment. Patients in the UK differ in their clinical presentation and genetic susceptibility from the original descriptions. This study also highlights an incomplete group of Behçet’s patients that are less well defined by their clinical presentation.
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Affiliation(s)
- Tim Blake
- Rheumatology Department, Birmingham City Hospital, Sandwell and West Birmingham Hospitals NHS Trust, Dudley Rd, Birmingham, B18 7QH, UK.
| | - Luke Pickup
- Institute of Inflammation and Ageing, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
| | - David Carruthers
- Rheumatology, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
| | | | - Alastair Denniston
- Institute of Inflammation and Ageing, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK.,Ophthalmology, Birmingham and Midland Eye Centre, Birmingham, UK
| | - John Hamburger
- Oral Medicine, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
| | - Claire Maxton
- Rheumatology, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
| | - Debbie Mitton
- Rheumatology, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
| | - Philip I Murray
- Institute of Inflammation and Ageing, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK.,Ophthalmology, Birmingham and Midland Eye Centre, Birmingham, UK
| | - Peter Nightingale
- Wolfson Computer Laboratory, University Hospital Birmingham NHS Foundation Trust, Birmingham, UK
| | | | - Andrea Richards
- Oral Medicine, Birmingham Community Healthcare NHS Trust, Birmingham, UK
| | - Andrew Whallett
- Rheumatology, Dudley Group of Hospitals NHS Foundation Trust, Birmingham, UK
| | - Deva Situnayake
- Rheumatology, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
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97
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Kidd DP. Neurological complications of Behçet's syndrome. J Neurol 2017; 264:2178-2183. [PMID: 28283819 DOI: 10.1007/s00415-017-8436-9] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 02/22/2017] [Accepted: 02/24/2017] [Indexed: 12/14/2022]
Abstract
In this review of the neurological complications of Behçet's syndrome, the clinical features and epidemiology of the systemic disease are summarised before a discussion of the neurological syndromes which may develop is made. Neurological involvement occurs in 9% of cases, and is equally prevalent in each geographical area. Vascular complications occur in 14%, in whom thrombosis of the venous sinuses or cerebral veins occurs, and intracranial hypertension, venous infarction and parenchymal haemorrhage may develop. There is a correlation with the prevalence of peripheral venous thrombosis. Concurrent inflammatory disease of the brain is most uncommon. Inflammation may affect any part of the central nervous system, but most commonly involves a subacute meningoencephalitis of the brainstem and diencephalon. Inflammatory lesions elsewhere in the brain and in the spinal cord may occur, and tumefactive lesions may arise from the diencephalon. Cognitive dysfunction and affective symptoms, including psychosis, may occur, and there are high levels of anxiety and fatigue which are related to the severity of the systemic disease, all of which are more severe in those with neurological involvement. Imaging shows enhancing lesions which often disappear after treatment, but atrophy is common. The CSF is active when there is a meningoencephalitis, and oligoclonal bands do not occur. Treatment is with steroids and immunosuppression. Those with treatment resistant disease respond to biological agents, including TNF alpha, IL-1 and IL-6 antagonists.
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Affiliation(s)
- D P Kidd
- Behçet's Syndrome Centre of Excellence, Institute of Dentistry, Royal London Hospital, Whitechapel, London, E1 1BB, UK.
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98
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Othman K, Liza-Sharmini AT, Ibrahim M, Tharakan J, Yanai R, Zunaina E. Severe panuveitis in neuro-Behçet's disease in Malaysia: a case series. Int Med Case Rep J 2017; 10:35-40. [PMID: 28223848 PMCID: PMC5304997 DOI: 10.2147/imcrj.s121863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Behçet’s disease (BD) is a multisystemic disease that is very rare in Malaysia. About 5% of patients develop central nervous system involvement, termed neuro-Behçet’s. Neuro-Behçet’s is one of the most serious causes of long-term morbidity and mortality. We report two cases of neuro-Behçet’s associated with uveitis (ocular BD) highlighting the clinical presentation, diagnostic measurement, and therapeutic management of these cases.
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Affiliation(s)
| | | | | | - John Tharakan
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Ryoji Yanai
- Department of Ophthalmology, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan
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99
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Maldini C, Druce K, Basu N, LaValley MP, Mahr A. Exploring the variability in Behçet’s disease prevalence: a meta-analytical approach. Rheumatology (Oxford) 2017; 57:185-195. [DOI: 10.1093/rheumatology/kew486] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Indexed: 01/01/2023] Open
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100
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Takeuchi M, Mizuki N, Meguro A, Ombrello MJ, Kirino Y, Satorius C, Le J, Blake M, Erer B, Kawagoe T, Ustek D, Tugal-Tutkun I, Seyahi E, Ozyazgan Y, Sousa I, Davatchi F, Francisco V, Shahram F, Abdollahi BS, Nadji A, Shafiee NM, Ghaderibarmi F, Ohno S, Ueda A, Ishigatsubo Y, Gadina M, Oliveira SA, Gül A, Kastner DL, Remmers EF. Dense genotyping of immune-related loci implicates host responses to microbial exposure in Behçet's disease susceptibility. Nat Genet 2017; 49:438-443. [PMID: 28166214 PMCID: PMC5369770 DOI: 10.1038/ng.3786] [Citation(s) in RCA: 98] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Accepted: 01/12/2017] [Indexed: 12/14/2022]
Abstract
We analyzed 1,900 Turkish Behçet’s disease cases and 1,779 controls genotyped with the Immunochip. The most significantly associated single nucleotide polymorphism (SNP) was rs1050502, a tag SNP for HLA-B*51. In the Turkish discovery set, we identified three novel loci, IL1A-IL1B, IRF8, and CEBPB-PTPN1, with genome-wide significance (P<5×10−8) by direct genotyping, and ADO-EGR2 by imputation. ADO-EGR2, IRF8, and CEBPB-PTPN1 replicated by genotyping 969 Iranian cases and 826 controls. Imputed data in 608 Japanese cases and 737 controls replicated ADO-EGR2 and IRF8 and meta-analysis additionally identified RIPK2 and LACC1. The disease-associated allele of rs4402765, the lead marker of the IL1A-IL1B locus, was associated with both decreased interleukin-1α and increased interleukin-1β production. ABO non-secretor genotypes of two ancestry-specific FUT2 SNPs showed strong disease association (P=5.89×10−15). Our findings extend shared susceptibility genes with Crohn’s disease and leprosy, and implicate mucosal factors and the innate immune response to microbial exposure in Behçet’s disease susceptibility.
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Affiliation(s)
- Masaki Takeuchi
- Inflammatory Disease Section, National Human Genome Research Institute, US National Institutes of Health, Bethesda, Maryland, USA.,Department of Ophthalmology and Visual Science, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Nobuhisa Mizuki
- Department of Ophthalmology and Visual Science, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Akira Meguro
- Department of Ophthalmology and Visual Science, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Michael J Ombrello
- Translational Genetics and Genomics Unit, National Institute of Arthritis and Musculoskeletal and Skin Diseases, US National Institutes of Health, Bethesda, Maryland, USA
| | - Yohei Kirino
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Colleen Satorius
- Inflammatory Disease Section, National Human Genome Research Institute, US National Institutes of Health, Bethesda, Maryland, USA
| | - Julie Le
- Inflammatory Disease Section, National Human Genome Research Institute, US National Institutes of Health, Bethesda, Maryland, USA
| | - Mary Blake
- Translational Immunology Section, National Institute of Arthritis and Musculoskeletal and Skin Diseases, US National Institutes of Health, Bethesda, Maryland, USA
| | - Burak Erer
- Inflammatory Disease Section, National Human Genome Research Institute, US National Institutes of Health, Bethesda, Maryland, USA
| | - Tatsukata Kawagoe
- Department of Ophthalmology and Visual Science, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Duran Ustek
- Department of Genetics, Institute for Experimental Medicine, Istanbul University, Istanbul, Turkey
| | - Ilknur Tugal-Tutkun
- Department of Ophthalmology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Emire Seyahi
- Department of Internal Medicine, Division of Rheumatology, Cerrahpasş a Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Yilmaz Ozyazgan
- Department of Ophthalmology, Cerrahpaşa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Inês Sousa
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal.,Instituto Gulbenkian de Ciência, Oeiras, Portugal
| | - Fereydoun Davatchi
- Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Vânia Francisco
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal.,Instituto Gulbenkian de Ciência, Oeiras, Portugal
| | - Farhad Shahram
- Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Abdolhadi Nadji
- Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Fahmida Ghaderibarmi
- Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Shigeaki Ohno
- Department of Ophthalmology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Atsuhisa Ueda
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Yoshiaki Ishigatsubo
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Massimo Gadina
- Translational Immunology Section, National Institute of Arthritis and Musculoskeletal and Skin Diseases, US National Institutes of Health, Bethesda, Maryland, USA
| | - Sofia A Oliveira
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal.,Instituto Gulbenkian de Ciência, Oeiras, Portugal
| | - Ahmet Gül
- Department of Internal Medicine, Division of Rheumatology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Daniel L Kastner
- Inflammatory Disease Section, National Human Genome Research Institute, US National Institutes of Health, Bethesda, Maryland, USA
| | - Elaine F Remmers
- Inflammatory Disease Section, National Human Genome Research Institute, US National Institutes of Health, Bethesda, Maryland, USA
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