1
|
Hu D, Guan JL. The roles of immune cells in Behçet's disease. Adv Rheumatol 2023; 63:49. [PMID: 37814339 DOI: 10.1186/s42358-023-00328-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 09/21/2023] [Indexed: 10/11/2023] Open
Abstract
Behçet's disease (BD) is a systemic vasculitis that can affect multiple systems, including the skin, mucous membranes, joints, eyes, gastrointestinal and nervous. However, the pathogenesis of BD remains unclear, and it is believed that immune-inflammatory reactions play a crucial role in its development. Immune cells are a critical component of this process and contribute to the onset and progression of BD. By regulating the function of these immune cells, effective control over the occurrence and development of BD can be achieved, particularly with regards to monocyte activation and aggregation, macrophage differentiation and polarization, as well as T cell subset differentiation. This review provides a brief overview of immune cells and their role in regulating BD progression, which may serve as a theoretical foundation for preventing and treating this disease.
Collapse
Affiliation(s)
- Dan Hu
- Department of Rheumatology and Immunology, Huadong Hospital affiliated with Fudan University, #221 Yan'an West Road, Shanghai, 200040, P.R. China
| | - Jian-Long Guan
- Department of Rheumatology and Immunology, Huadong Hospital affiliated with Fudan University, #221 Yan'an West Road, Shanghai, 200040, P.R. China.
| |
Collapse
|
2
|
Hammami AS, Jellazi M, Arfa S, Daada S, Ben Hamda K, Achour A, Ouali S. Getting to the <em>heart</em> of the matter: diagnostic tools and therapeutic approach to cardiac involvement in Behçet syndrome A Tunisian case series. Reumatismo 2021; 73:32-43. [PMID: 33874645 DOI: 10.4081/reumatismo.2021.1369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 02/23/2021] [Indexed: 11/23/2022] Open
Abstract
The aim was to investigate the frequency and spectrum of cardiac involvement (CI) in patients with Behçet syndrome (BS) in the Tunisian context, and to assess the clinical and imaging features, treatment, and outcomes. We retrospectively retrieved the medical records of patients with CI among 220 BS patients admitted to the hospital internal medicine department between February 2006 and April 2019, who fulfilled the International Study Group diagnostic criteria for BS. Ten patients (8 men, 2 women) were eligible for the study. Mean age was 37.3 years. Three patients had 2 isolated episodes of cardiac BS. The different types of CI were coronary artery disease (5/10), intracardiac thrombus (4/10), pericarditis (1/10), myocarditis (1/10), and myocardial fibrosis (1/10). Five patients had associated vascular involvement (50%). Medical treatment was based on corticosteroids and colchicine in all patients (100%), anticoagulants in 8 (80%), and cyclophosphamide followed by azathioprine in 9 (90%). The clinical course was favorable in 9 patients; 1 patient died. CI remains an important feature of BS because of its association with increased risk of mortality and morbidity. Therefore, early screening and detection with imaging methods are paramount. Also, better cooperation between rheumatologists and cardiologists could improve outcomes.
Collapse
Affiliation(s)
- A S Hammami
- Department of Internal Medicine, Geriatric Unit, Hospital Fattouma Bourguiba of Monastir, Monastir, Tunisia; Biochemistry Laboratory, LR12ES05 LR-NAFS Nutrition - Functional Food and Vascular Health, Faculty of Medicine, University of Monastir, Monastir.
| | - M Jellazi
- Department of Internal Medicine, Geriatric Unit, Hospital Fattouma Bourguiba of Monastir, Monastir.
| | - S Arfa
- Department of Internal Medicine, Geriatric Unit, Hospital Fattouma Bourguiba of Monastir, Monastir.
| | - S Daada
- Department of Internal Medicine, Geriatric Unit, Hospital Fattouma Bourguiba of Monastir, Monastir.
| | - K Ben Hamda
- Department of Cardiology, Hospital Fattouma Bourguiba of Monastir, Monastir.
| | - A Achour
- Department of Radiology, Hospital Fattouma Bourguiba of Monastir, Monastir.
| | - S Ouali
- Department of Internal Medicine, Geriatric Unit, Hospital Fattouma Bourguiba of Monastir, Monastir, Tunisia; Biochemistry Laboratory, LR12ES05 LR-NAFS Nutrition - Functional Food and Vascular Health, Faculty of Medicine, University of Monastir, Monastir.
| |
Collapse
|
3
|
Cheng L, Li Y, Wu Z, Li L, Liu C, Liu J, Dai J, Zheng W, Zhang F, Tang L, Yu X, Li Y. Comprehensive analysis of immunoglobulin and clinical variables identifies functional linkages and diagnostic indicators associated with Behcet's disease patients receiving immunomodulatory treatment. BMC Immunol 2021; 22:16. [PMID: 33618671 PMCID: PMC7901184 DOI: 10.1186/s12865-021-00403-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 01/29/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Behcet's disease (BD) is a relapsing systemic vascular autoimmune/inflammatory disease. Despite much effort to investigate BD, there are virtually no unique laboratory markers identified to help in the diagnosis of BD, and the pathogenesis is largely unknown. The aim of this work is to explore interactions between different clinical variables by correlation analysis to determine associations between the functional linkages of different paired variables and potential diagnostic biomarkers of BD. METHODS We measured the immunoglobulin proteome (IgG, IgG1-4, IgA, IgA1-2) and 29 clinical variables in 66 healthy controls and 63 patients with BD. We performed a comprehensive clinical variable linkage analysis and defined the physiological, pathological and pharmacological linkages based on the correlations of all variables in healthy controls and BD patients without and with immunomodulatory therapy. We further calculated relative changes between variables derived from comprehensive linkage analysis for better indications in the clinic. The potential indicators were validated in a validation set with 76 patients with BD, 30 healthy controls, 18 patients with Takayasu arteritis and 18 patients with ANCA-associated vasculitis. RESULTS In this study, the variables identified were found to act in synergy rather than alone in BD patients under physiological, pathological and pharmacological conditions. Immunity and inflammation can be suppressed by corticosteroids and immunosuppressants, and integrative analysis of granulocytes, platelets and related variables is likely to provide a more comprehensive understanding of disease activity, thrombotic potential and ultimately potential tissue damage. We determined that total protein/mean corpuscular hemoglobin and total protein/mean corpuscular hemoglobin levels, total protein/mean corpuscular volume, and plateletcrit/monocyte counts were significantly increased in BD compared with controls (P < 0.05, in both the discovery and validation sets), which helped in distinguishing BD patients from healthy and vasculitis controls. Chronic anemia in BD combined with increased total protein contributed to higher levels of these biomarkers, and the interactions between platelets and monocytes may be linked to vascular involvement. CONCLUSIONS All these results demonstrate the utility of our approach in elucidating the pathogenesis and in identifying novel biomarkers for autoimmune diseases in the future.
Collapse
Affiliation(s)
- Linlin Cheng
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Yang Li
- State Key Laboratory of Proteomics, Beijing Proteome Research Center, National Center for Protein Sciences (Beijing), Beijing Institute of Lifeomics, No. 38, Life Science Park Road Changping District, Beijing, 102206, China
| | - Ziyan Wu
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, 100730, China
| | - Liubing Li
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Chenxi Liu
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Jianhua Liu
- Department of Laboratory Medicine, Shengjing Hospital of China Medical University, Shenyang, 110004, China
| | - Jiayu Dai
- State Key Laboratory of Proteomics, Beijing Proteome Research Center, National Center for Protein Sciences (Beijing), Beijing Institute of Lifeomics, No. 38, Life Science Park Road Changping District, Beijing, 102206, China
| | - Wenjie Zheng
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, 100730, China
| | - Fengchun Zhang
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, 100730, China
| | - Liujun Tang
- State Key Laboratory of Proteomics, Beijing Proteome Research Center, National Center for Protein Sciences (Beijing), Beijing Institute of Lifeomics, No. 38, Life Science Park Road Changping District, Beijing, 102206, China.
| | - Xiaobo Yu
- State Key Laboratory of Proteomics, Beijing Proteome Research Center, National Center for Protein Sciences (Beijing), Beijing Institute of Lifeomics, No. 38, Life Science Park Road Changping District, Beijing, 102206, China.
| | - Yongzhe Li
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China.
| |
Collapse
|
4
|
Correlation of clinical signs and symptoms of Behçet's disease with mean platelet volume (MPV) and red cell distribution width (RDW). Orphanet J Rare Dis 2020; 15:297. [PMID: 33087144 PMCID: PMC7579941 DOI: 10.1186/s13023-020-01588-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 10/13/2020] [Indexed: 01/22/2023] Open
Abstract
Background A strong correlation was previously found between mean platelet volume (MPV), red blood cell distribution width (RDW), and the severity of signs and symptoms in patients suffering from inflammatory and autoimmune diseases. The current study evaluated these correlations in patients with Behçet’s disease (BD) as well the relationship between MPV and RDW and disease activity score on the Iranian Behçet’s Disease Dynamic Activity Measurement (IBDDAM). Methods This cross-sectional study included 319 patients with BD for whom demographic and epidemiological data, IBDDAM scores, and duration of illness was recorded. Blood samples were then obtained and the relationships between their disease status and manifestations and their laboratory parameters were evaluated with statistical models to find possible correlations. Results Our analysis showed a significantly higher RDW in patients with BD who had ocular manifestations (p < 0.001) and oral aphthae (p = 0.004). Patients with active BD had higher RDW (p < 0.001) and MPV (p < 0.001) in comparison to those with currently inactive BD. Similarly, patients who had any type of ocular manifestation had higher RDW (p < 0.001) and MPV (p < 0.001). Regression analyses identified a statistically significant model for the effect of RDW and MPV in predicting active BD status (p < 0.001), as well as its significant relationship with active ocular manifestations (p < 0.001). Conclusion BD was found to be associated with an increase in MPV and RDW, particularly during active phases. RDW and MPV were also found to have predictive value for screening to detect BD activity and its ocular complications.
Collapse
|
5
|
Takeda Y, Marumo M, Nara H, Feng ZG, Asao H, Wakabayashi I. Selective induction of anti-inflammatory monocyte-platelet aggregates in a model of pulsatile blood flow at low shear rates. Platelets 2016; 27:583-92. [PMID: 27078265 DOI: 10.3109/09537104.2016.1153616] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
In patients with cardiovascular abnormalities or immunological disorders, an increased number of circulating leukocyte-platelet aggregates is observed. Leukocyte-platelet aggregates play an essential role in linking the hemostatic and immune systems. High shear stress and pro-coagulant and pro-inflammatory stimulants are known to activate platelets and promote the formation of aggregates. Pulsatile blood flow under low shear stress can also induce platelet activation in comparatively mild conditions. However, the effect of such events on leukocyte-platelet aggregates has not yet been investigated. To determine whether low shear stress affects the formation of aggregates, we established a simple "inverting rotation" method of inducing periodic changes in the direction of blood flow in combination with low shear stress. We demonstrated that after the inverting rotation treatment for 10-20 min more than 70% of monocytes selectively aggregated with platelets. The formation of monocyte-platelet complexes was inhibited by an anti-CD162 (PSGL-1) monoclonal antibody or a Ca(2+) chelator. The phagocytic activity of monocytes was augmented by inverting rotation, whereas phagocytosis mediated by granulocytes remained unaffected. Interestingly, the formation of monocyte-platelet complexes suppressed the production of pro-inflammatory cytokines such as interleukin (IL)-1β. At the same time, monocyte-platelet complexes augmented the expression of the anti-inflammatory cytokine IL-10. Our results suggest that platelet-bound monocytes show an anti-inflammatory phenotype under low shear stress conditions. Thus, our method provided new insights into the mechanisms of monocyte-platelet aggregate formation and regulation.
Collapse
Affiliation(s)
- Yuji Takeda
- a Department of Environmental and Preventive Medicine , Hyogo College of Medicine , Nishinomiya , Japan.,b Department of Immunology, Faculty of Medicine , Yamagata University , Yamagata , Japan
| | - Mikio Marumo
- a Department of Environmental and Preventive Medicine , Hyogo College of Medicine , Nishinomiya , Japan
| | - Hidetoshi Nara
- b Department of Immunology, Faculty of Medicine , Yamagata University , Yamagata , Japan
| | - Zhong-Gang Feng
- c Department of Bio-Systems Engineering , Graduate School of Science and Engineering, Yamagata University , Yamagata , Japan
| | - Hironobu Asao
- b Department of Immunology, Faculty of Medicine , Yamagata University , Yamagata , Japan
| | - Ichiro Wakabayashi
- a Department of Environmental and Preventive Medicine , Hyogo College of Medicine , Nishinomiya , Japan
| |
Collapse
|
6
|
|
7
|
Ekiz O, Balta I, Sen BB, Rifaioglu EN, Ergin C, Balta S, Demirkol S. Mean Platelet Volume in Recurrent Aphthous Stomatitis and Behçet Disease. Angiology 2013; 65:161-5. [PMID: 23766348 DOI: 10.1177/0003319713492375] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Behcet disease (BD) and recurrent aphthous stomatitis (RAS) are systemic inflammatory diseases, but the exact pathogenesis of both the diseases is unknown. Mean platelet volume (MPV) is an indicator of platelet activation. The aim of this study was to investigate the MPV levels in patients with BD, RAS, and healthy participants. A total of 61 patients with BD, 60 patients with RAS, and 60 healthy controls were included in this study. The MPV levels and erythrocyte sedimentation rate in patients with BD and RAS groups were significantly higher than the control groups ( P < .001). In the BD group as well as in the RAS group, the disease activity does not affect the levels of MPV. The MPV levels may be used as a cheap and feasible diagnostic marker in patients with BD and RAS. Nevertheless, the MPV does not have a predictive value in differentiating the diagnosis of BD and RAS.
Collapse
Affiliation(s)
- Ozlem Ekiz
- Department of Dermatology, School of Medicine, Mustafa Kemal University, Hatay, Turkey
| | - Ilknur Balta
- Department of Dermatology, Ankara Kecioren Training and Research Hospital, Ankara, Turkey
| | - Bilge Bulbul Sen
- Department of Dermatology, School of Medicine, Mustafa Kemal University, Hatay, Turkey
| | - Emine Nur Rifaioglu
- Department of Dermatology, School of Medicine, Mustafa Kemal University, Hatay, Turkey
| | - Can Ergin
- Department of Dernatology, Ankara Dıskapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Sevket Balta
- Department of Cardiology, Gulhane Medical Academy, Ankara, Turkey
| | - Sait Demirkol
- Department of Cardiology, Gulhane Medical Academy, Ankara, Turkey
| |
Collapse
|
8
|
Owlia MB, Mehrpoor G. Behcet's Disease: New Concepts in Cardiovascular Involvements and Future Direction for Treatment. ISRN PHARMACOLOGY 2012; 2012:760484. [PMID: 22530146 PMCID: PMC3317002 DOI: 10.5402/2012/760484] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2011] [Accepted: 12/15/2011] [Indexed: 01/02/2023]
Abstract
Behcet's disease (BD) is the only systemic vasculitis involving both arteries and vein in any sizes. It frequently encounters in rheumatology clinics. It has some major morbidities and even fatal outcomes in some cases. The aim of this paper is to analyze the main concepts on pathophysiology and treatment options in BD, focusing on cardiovascular aspects, thrombosis, and potential future treatment.
Collapse
Affiliation(s)
- M. B. Owlia
- Division of Rheumatology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - G. Mehrpoor
- Division of Rheumatology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| |
Collapse
|
9
|
Kim JW, Lee SH, Song R, Lee YA, Hong SJ, Yang HI. A Case of Behçet's Disease Associated with Myelofibrosis. JOURNAL OF RHEUMATIC DISEASES 2012. [DOI: 10.4078/jrd.2012.19.1.55] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Jung-Wook Kim
- Department of Rheumatology, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Sang-Hoon Lee
- Department of Rheumatology, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Ran Song
- Department of Rheumatology, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Yeon-Ah Lee
- Department of Rheumatology, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Seung-Jae Hong
- Department of Rheumatology, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Hyung-In Yang
- Department of Rheumatology, School of Medicine, Kyung Hee University, Seoul, Korea
| |
Collapse
|
10
|
Kotsis T, Moulakakis KG, Mylonas S, Andrikopoulos V. Vascular manifestations of Behcet's disease: report of a case and review of the literature. Phlebology 2011; 26:249-53. [PMID: 21478143 DOI: 10.1258/phleb.2010.010024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Adamantiades-Behçet's disease (ABD) is a relapsing vasculitis of unknown aetiology and variable clinical manifestations. The syndrome can be presented in a myriad of ways and can involve nearly every organ. Although vascular involvement is not included among the ABD diagnostic criteria, it is a unique clinical manifestation in adults with a potentially devastating outcome. We report an ABD case, presenting with a thrombotic occlusion of the inferior vena cava. The authors review the recent literature, emphasizing the spectrum of vascular manifestations accompanying Behçet's disease.
Collapse
Affiliation(s)
- T Kotsis
- Department of Vascular Surgery, 'Red Cross' General Hospital, Andrea Papandreou 132 Street, Glyfada, Athens 16561, Greece
| | | | | | | |
Collapse
|
11
|
Messedi M, Jamoussi K, Frigui M, Laporte F, Turki M, Chaabouni K, Mnif E, Jaloulli M, Kaddour N, Bahloul Z, Ayedi F. Atherogenic Lipid Profile in Behçet’s Disease: Evidence of Alteration of HDL Subclasses. Arch Med Res 2011; 42:211-8. [DOI: 10.1016/j.arcmed.2011.05.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2010] [Accepted: 04/18/2011] [Indexed: 01/06/2023]
|
12
|
Current world literature. Curr Opin Rheumatol 2010; 23:125-30. [PMID: 21124095 DOI: 10.1097/bor.0b013e3283422cce] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|