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Arbrile M, Radin M, Medica D, Miraglia P, Rilat L, Cecchi I, Foddai SG, Barinotti A, Menegatti E, Roccatello D, Sciascia S. Finding the Needle in the Haystack: Serological and Urinary Biomarkers in Behçet's Disease: A Systematic Review. Int J Mol Sci 2023; 24:ijms24033041. [PMID: 36769366 PMCID: PMC9917563 DOI: 10.3390/ijms24033041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 01/16/2023] [Accepted: 01/17/2023] [Indexed: 02/08/2023] Open
Abstract
Urinary and serological markers play an essential role in the diagnostic process of autoimmune diseases. However, to date, specific and reliable biomarkers for diagnosing Behçet's disease (BD) are still lacking, negatively affecting the management of these patients. To analyze the currently available literature on serological and urinary BD biomarkers investigated in the last 25 years, we performed a systematic literature review using the Population, Intervention, Comparison, and Outcomes (PICO) strategy. One hundred eleven studies met the eligibility criteria (6301 BD patients, 5163 controls). Most of them were retrospective, while five (5%) were prospective. One hundred ten studies (99%) investigated serological biomarkers and only two (2%) focused on urinary biomarkers. One hundred three studies (93%) explored the diagnostic potential of the biomolecules, whereas sixty-two (56%) tested their effect on disease activity monitoring. Most articles reported an increase in inflammatory markers and pro-oxidant molecules, with a decrease in antioxidants. Promising results have been shown by the omics sciences, offering a more holistic approach. Despite the vast number of investigated markers, existing evidence indicates a persistent gap in BD diagnostic/prognostic indices. While new steps have been taken in the direction of pathogenesis and disease monitoring, international efforts for the search of a diagnostic marker for BD are still needed.
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Affiliation(s)
- Marta Arbrile
- Department of Clinical and Biological Sciences, School of Specialization of Clinical Pathology, University of Turin, 10124 Turin, Italy
| | - Massimo Radin
- Department of Clinical and Biological Sciences, School of Specialization of Clinical Pathology, University of Turin, 10124 Turin, Italy
- Center of Excellence on Nephrologic, Rheumatologic and Rare Diseases (ERK-Net, ERN-Reconnect and RITA-ERN Member) with Nephrology and Dialysis Unit, San Giovanni Bosco Hub Hospital, University of Turin, 10124 Turin, Italy
- Correspondence: ; Tel.: +39-3923741973
| | - Davide Medica
- Department of Clinical and Biological Sciences, School of Specialization of Clinical Pathology, University of Turin, 10124 Turin, Italy
| | - Paolo Miraglia
- Department of Clinical and Biological Sciences, School of Specialization of Clinical Pathology, University of Turin, 10124 Turin, Italy
| | - Letizia Rilat
- Department of Clinical and Biological Sciences, School of Specialization of Clinical Pathology, University of Turin, 10124 Turin, Italy
| | - Irene Cecchi
- Center of Excellence on Nephrologic, Rheumatologic and Rare Diseases (ERK-Net, ERN-Reconnect and RITA-ERN Member) with Nephrology and Dialysis Unit, San Giovanni Bosco Hub Hospital, University of Turin, 10124 Turin, Italy
| | - Silvia Grazietta Foddai
- Center of Excellence on Nephrologic, Rheumatologic and Rare Diseases (ERK-Net, ERN-Reconnect and RITA-ERN Member) with Nephrology and Dialysis Unit, San Giovanni Bosco Hub Hospital, University of Turin, 10124 Turin, Italy
| | - Alice Barinotti
- Department of Clinical and Biological Sciences, School of Specialization of Clinical Pathology, University of Turin, 10124 Turin, Italy
| | - Elisa Menegatti
- Department of Clinical and Biological Sciences, School of Specialization of Clinical Pathology, University of Turin, 10124 Turin, Italy
- Center of Excellence on Nephrologic, Rheumatologic and Rare Diseases (ERK-Net, ERN-Reconnect and RITA-ERN Member) with Nephrology and Dialysis Unit, San Giovanni Bosco Hub Hospital, University of Turin, 10124 Turin, Italy
| | - Dario Roccatello
- Department of Clinical and Biological Sciences, School of Specialization of Clinical Pathology, University of Turin, 10124 Turin, Italy
- Center of Excellence on Nephrologic, Rheumatologic and Rare Diseases (ERK-Net, ERN-Reconnect and RITA-ERN Member) with Nephrology and Dialysis Unit, San Giovanni Bosco Hub Hospital, University of Turin, 10124 Turin, Italy
| | - Savino Sciascia
- Department of Clinical and Biological Sciences, School of Specialization of Clinical Pathology, University of Turin, 10124 Turin, Italy
- Center of Excellence on Nephrologic, Rheumatologic and Rare Diseases (ERK-Net, ERN-Reconnect and RITA-ERN Member) with Nephrology and Dialysis Unit, San Giovanni Bosco Hub Hospital, University of Turin, 10124 Turin, Italy
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Merashli M, Bucci T, Pastori D, Pignatelli P, Arcaro A, Gentile F, Marottoli V, Ames PRJ. Plasma Homocysteine in Behcet's Disease: A Systematic Review and Meta-Analysis. Thromb Haemost 2022; 122:1209-1220. [PMID: 34996122 DOI: 10.1055/s-0041-1740637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
AIM To evaluate the relevance of plasma homocysteine (HC) in Behcet's disease (BD) and its clinical manifestations. METHODS Systematic review of EMBASE and PubMed databases according to PRISMA guidelines from inception to July 2021; random-effects meta-analyses for continuous outcomes. RESULTS The search strategy retrieved 48 case-control (2,669 BD and 2,245 control participants) and 5 cohort studies (708 BD participants). Plasma HC was higher in BD than in controls (p < 0.0001) with wide heterogeneity (I2 = 89.7%) that remained unchanged after sensitivity analysis according to year of article publication, age of BD participants, study size, study quality, method of HC determination, and male/female ratio >1.5; some pooled ethnicities explained a small part of the heterogeneity (I2 = 16.3%). Active BD participants had higher HC than inactive ones (p < 0.0001), with moderate heterogeneity (I2 = 49.2%) that disappeared after removal of an outlier study with very high disease activity. BD participants with any vascular involvement had higher HC than those without (p < 0.0001) with wide heterogeneity (I2 = 89.7%); subgroup analysis on venous thrombosis only changed neither effect size (p < 0.0001) nor heterogeneity (I2 = 72.7%). BD participants with ocular involvement had higher HC than those without (p < 0.0001) with moderate heterogeneity (I2 = 40.3%). CONCLUSION Although causality cannot be inferred, the consistency of the elevation of plasma HC in BD, particularly in patients with active disease, with vascular and ocular involvement suggests an intrinsic involvement of HC in these clinical manifestations.
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Affiliation(s)
- Mira Merashli
- Department of Rheumatology, American University of Beirut, Bliss, Beirut, Lebanon
| | - Tommaso Bucci
- Department of General Surgery, Surgical Specialties and Organ Transplantation "Paride Stefanini," Sapienza University of Rome, Rome, Italy
| | - Daniele Pastori
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Pasquale Pignatelli
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Alessia Arcaro
- Department of Medicine and Health Sciences 'V. Tiberio', Università del Molise, Campobasso, Italy
| | - Fabrizio Gentile
- Department of Medicine and Health Sciences 'V. Tiberio', Università del Molise, Campobasso, Italy
| | | | - Paul R J Ames
- Immune Response and Vascular Disease Unit, CEDOC, Nova University Lisbon, Rua Camara Pestana, Lisbon Portugal.,Department of Haematology, Dumfries Royal Infirmary, Cargenbridge, Dumfries, United Kingdom
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Miskin A, Kurumkattil R, Gupta A, Trehan HS, Dudeja P, Dhar SK, Sharma VK. To Study the Role of Serum Homocysteine Levels and Ocular Involvement in Retinal Vasculitis. Indian J Clin Biochem 2021; 37:212-217. [PMID: 35463114 PMCID: PMC8993952 DOI: 10.1007/s12291-021-00976-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 04/03/2021] [Indexed: 11/29/2022]
Abstract
Idiopathic retinal vasculitis is a chronic disease of unknown aetiology which results in ocular morbidity in patients of productive age group. Homocysteine has been implicated in various ocular conditions like age-related macular degeneration, retinal vein occlusions, diabetic retinopathy, and optic nerve diseases. We conducted a study to investigate the relation between serum homocysteine levels and retinal vasculitis at a tertiary care centre in North India. In this case-control study, 32 cases and 64 controls were included and the duration was from June 2017 to March 2019. Serum homocysteine of cases and controls was detected by reflectance photometry using VITROS Chemistry Products HCY 2 (Homocysteine) and the normal range of serum homocysteine as per this method was 6.60 to 14.80 micro mol per litre. Our study found that of the total 32 retinal vasculitis patients, serum homocysteine was raised in 65.62% (21 cases out of 32) and in 70.31% of control group (45 out of 64). Chi square test results showed that there was no significant association found between S. homocysteine levels and Reticular vasculitis (P: 0.64). The two groups were comparable in terms of the age with mean ± SD in cases being 33.47 ± 8.336 years and controls being 35.16 ± 8.568 years with a P value of 0.37 being statistically insignificant. The data collected was analysed using SSPS-16 (Statistical Package for Social Sciences Version 16) software and test of association was Odd's ratio. Power of study was 80% and P < 0.05 is considered statistically significant. We found that there is no significant association between raised serum homocysteine and retinal vasculitis (with P < 0.64). Odds ratio was 0.80(0.33-1.99) implying that the cases and controls were statistically significantly different with respect to homocysteine levels.
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Affiliation(s)
- Angad Miskin
- Department of Ophthalmology, Army Hospital (Research and Referral), Delhi Cantt, New Delhi, 110010 India
| | - Raji Kurumkattil
- Department of Ophthalmology, Army Hospital (Research and Referral), Delhi Cantt, New Delhi, 110010 India
| | - Anurodh Gupta
- Department of Biochemistry, Army Hospital (Research and Referral), New Delhi, India
| | - Hemant Singh Trehan
- Department of Ophthalmology, Army Hospital (Research and Referral), Delhi Cantt, New Delhi, 110010 India
| | - Puja Dudeja
- Department of Preventive and Social Medicine, Armed Forces Medical College, Pune, India
| | - Sanjay Kumar Dhar
- Department of Ophthalmology, Army Hospital (Research and Referral), Delhi Cantt, New Delhi, 110010 India
| | - Vijay Kumar Sharma
- Department of Ophthalmology, Army Hospital (Research and Referral), Delhi Cantt, New Delhi, 110010 India
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Powierza K, Sawicka-Powierza J, Urban B, Żelazowska-Rutkowska B, Cylwik B, Mikołuć B, Kowalewska O, Bakunowicz-Łazarczyk A. Endothelin-1 Serum Concentration in Pediatric Chronic Idiopathic Uveitis. Clin Ophthalmol 2021; 15:157-164. [PMID: 33469261 PMCID: PMC7811460 DOI: 10.2147/opth.s276109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 11/13/2020] [Indexed: 12/14/2022] Open
Abstract
Purpose The aim of our study was to determine endothelin-1 (ET-1) concentration in chronic idiopathic uveitis in children and adolescents depending on anatomical location and grade of inflammation. Methods The cross-sectional study was conducted among 17 patients with chronic idiopathic uveitis and 22 healthy controls. Concentration of ET-1 in serum was determined using a commercially available ELISA kit. The concentration of C reactive protein (CRP) in serum was determined by immunoturbidimetric method using CRP4 reagent kit (Roche Diagnostics GmbH, Mannheim, Germany). Results Statistically significant difference between ET-1 concentration in patients with chronic idiopathic uveitis and controls was found 1.33 (1.22; 1.48) vs 1.93 (1.1; 3.11), p = 0.008). No correlations were found between ET-1 concentration and age, either in chronic idiopathic uveitis patients or controls. Nine out of 17 patients presented with anterior uveitis, 5 with posterior and 3 with panuveitis. There were no differences in ET-1 concentration between anterior, posterior and panuveitis (p = 0.634), and in terms of grade of inflammation. Conclusion ET-1 expression is disturbed in pediatric chronic idiopathic uveitis irrespective of the anatomical location and grade of inflammation. Lower expression of ET-1 plays a crucial role in disturbed vascular tone control and can result in permanent visual impairment in chronic non-infectious uveitis.
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Affiliation(s)
- Katarzyna Powierza
- University Clinical Hospital in Bialystok, Medical University of Bialystok, Bialystok 15-276, Poland
| | | | - Beata Urban
- Department of Pediatric Ophthalmology and Strabismus, Medical University of Bialystok, Bialystok 15-274, Poland
| | - Beata Żelazowska-Rutkowska
- Department of Pediatric Laboratory Diagnostics, Medical University of Bialystok, Bialystok 15-274, Poland
| | - Bogdan Cylwik
- Department of Pediatric Laboratory Diagnostics, Medical University of Bialystok, Bialystok 15-274, Poland
| | - Bożena Mikołuć
- Department of Pediatrics, Rheumatology, Immunology and Metabolic Bone Diseases, Medical University of Bialystok, Bialystok 15-274, Poland
| | - Olga Kowalewska
- Psychiatric Clinic, Lund, Division of Psychiatry, Lund 222 40, Sweden
| | - Alina Bakunowicz-Łazarczyk
- Department of Pediatric Ophthalmology and Strabismus, Medical University of Bialystok, Bialystok 15-274, Poland
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Zhang W, Zhang H, Wang M, Li P, Ding C, Zhang W, Wang H, Tang B. Copolymer-Based Fluorescence Nanosensor for In Situ Imaging of Homocysteine in the Liver and Kidney of Diabetic Mice. Anal Chem 2020; 92:16221-16228. [PMID: 33210902 DOI: 10.1021/acs.analchem.0c04068] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Homocysteine (Hcy) is one of the important biomarkers of clinical diagnosis, which is closely related to the occurrence and development of many diseases. Current analysis methods have difficulties in detecting Hcy in cells and living organisms. As a powerful technique, fluorescence methods combined the laser confocal imaging technology can achieve real-time visual tracking in cells and in vivo. Herein, we establish a conjugated copolymer-based fluorescence nanosensor (DPA-PFNP-Cu(II)) using the connected 2,7-dibromofluorene and 4,7-bis (2-bromothiophen-5-yl)-2-1-3-benzothiadiazole as the main chain. The competitive coordination between Hcy and Cu(II) allows the fluorescence of the polymer off to on. Finally, the nanosensor is applied for in situ imaging of Hcy levels in the kidney and liver of diabetic mice and is found that Hcy levels were positively correlated with the degree of diabetes. Notably, the depth of tissue penetration of the nanosensor enables Hcy detection of the liver and kidney through in vivo imaging without damage. Two-photon imaging and in vivo imaging achieve consistent results, which correct each other, improving the accuracy of the test result. The present works provide a new imaging technique for studying the occurrence and development of diabetes and screening of new drugs for treatment at the living level.
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Affiliation(s)
- Wei Zhang
- College of Chemistry, Chemical Engineering and Materials Science, Collaborative Innovation Center of Functionalized Probes for Chemical Imaging in Universities of Shandong, Key Laboratory of Molecular and Nano Probes, Ministry of Education, Institute of Biomedical Sciences, Shandong Normal University, Jinan 250014, P. R. China
| | - Hui Zhang
- College of Chemistry, Chemical Engineering and Materials Science, Collaborative Innovation Center of Functionalized Probes for Chemical Imaging in Universities of Shandong, Key Laboratory of Molecular and Nano Probes, Ministry of Education, Institute of Biomedical Sciences, Shandong Normal University, Jinan 250014, P. R. China
| | - Mengqi Wang
- College of Chemistry, Chemical Engineering and Materials Science, Collaborative Innovation Center of Functionalized Probes for Chemical Imaging in Universities of Shandong, Key Laboratory of Molecular and Nano Probes, Ministry of Education, Institute of Biomedical Sciences, Shandong Normal University, Jinan 250014, P. R. China
| | - Ping Li
- College of Chemistry, Chemical Engineering and Materials Science, Collaborative Innovation Center of Functionalized Probes for Chemical Imaging in Universities of Shandong, Key Laboratory of Molecular and Nano Probes, Ministry of Education, Institute of Biomedical Sciences, Shandong Normal University, Jinan 250014, P. R. China
| | - Caifeng Ding
- Key Laboratory of Sensor Analysis of Tumor Marker, Ministry of Education, College of Chemistry and Molecular Engineering, Qingdao University of Science and Technology, Qingdao 266042, China
| | - Wen Zhang
- College of Chemistry, Chemical Engineering and Materials Science, Collaborative Innovation Center of Functionalized Probes for Chemical Imaging in Universities of Shandong, Key Laboratory of Molecular and Nano Probes, Ministry of Education, Institute of Biomedical Sciences, Shandong Normal University, Jinan 250014, P. R. China
| | - Hui Wang
- College of Chemistry, Chemical Engineering and Materials Science, Collaborative Innovation Center of Functionalized Probes for Chemical Imaging in Universities of Shandong, Key Laboratory of Molecular and Nano Probes, Ministry of Education, Institute of Biomedical Sciences, Shandong Normal University, Jinan 250014, P. R. China
| | - Bo Tang
- College of Chemistry, Chemical Engineering and Materials Science, Collaborative Innovation Center of Functionalized Probes for Chemical Imaging in Universities of Shandong, Key Laboratory of Molecular and Nano Probes, Ministry of Education, Institute of Biomedical Sciences, Shandong Normal University, Jinan 250014, P. R. China
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Assessment of Cytokine Release against Oral Mucosal Cell Line Culture (TR146) Stimulated by Neutrophil Elastase Associated with Behcet's Disease. Int J Dent 2019; 2019:6095628. [PMID: 31263499 PMCID: PMC6556314 DOI: 10.1155/2019/6095628] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 04/10/2019] [Accepted: 05/06/2019] [Indexed: 12/14/2022] Open
Abstract
Aim Cytokines and chemokines may be involved in the onset of oral ulcer in Behcet's disease. The aim of our study is to assess the cytotoxic effects of proinflammatory cytokines and chemokines on reconstructed oral mucosal cell line (TR146) when treated with different concentrations of neutrophil elastase (NE). Objective For this purpose, a culture of the oral mucosal model (OMM) prepared from a cell line derived from an oral squamous cell carcinoma of buccal mucosa (TR146) is treated with different concentrations of neutrophil elastase. The cultures were incubated for 4- and 24-hour intervals and designed as follows: culture + artificial saliva served as the negative control; culture + 0.01% SLS (sodium lauryl sulphate) served as the positive control; and culture + NE (10, 50, 100, and 200 nM) served as the treated group. Materials and Methods We used sandwich ELISA technique to isolate IL-1β (interleukin 1β), IL-8, and TNF-α (tumor necrosis factor). Results We found no significant level of IL-8 and TNF-α when treated with different concentrations of neutrophil elastase after 4- and 24-hour incubation. The IL-1β level was slightly higher when treated with 100 and 200 nM NE after 24 hours of incubation although a significantly high level was observed at 100 nM NE after 4 hours of incubation. Hence, we found an increase in the level of IL-1β when stimulating the reconstructed oral mucosal model (OMM) with different concentrations of NE. This is a preliminary in vitro study; however, further research is required to evaluate the cytotoxic effects of cytokines and chemokines released when treated with NE. Moreover, high concentrations of NE are recommended to stimulate the release of cytokines and chemokines against the OMM.
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Chiang CP, Wu YH, Chang JYF, Wang YP, Wu YC, Sun A. Hematinic deficiencies and hyperhomocysteinemia in gastric parietal cell antibody-positive or gastric and thyroid autoantibodies-negative Behcet's disease patients. J Formos Med Assoc 2019; 118:347-353. [DOI: 10.1016/j.jfma.2018.05.017] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 05/16/2018] [Accepted: 05/24/2018] [Indexed: 12/31/2022] Open
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Kuo YS, Chang JYF, Wang YP, Wu YC, Wu YH, Sun A. Significantly higher frequencies of hemoglobin, iron, vitamin B12, and folic acid deficiencies and of hyperhomocysteinemia in patients with Behcet's disease. J Formos Med Assoc 2018; 117:932-938. [DOI: 10.1016/j.jfma.2018.04.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 04/11/2018] [Accepted: 04/13/2018] [Indexed: 01/16/2023] Open
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Wu YH, Yu-Fong Chang J, Wang YP, Wu YC, Chen HM, Sun A. Hemoglobin, iron, vitamin B12, and folic acid deficiencies and hyperhomocysteinemia in Behcet's disease patients with atrophic glossitis. J Formos Med Assoc 2018; 117:559-565. [DOI: 10.1016/j.jfma.2018.03.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 03/06/2018] [Accepted: 03/08/2018] [Indexed: 01/17/2023] Open
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Alami A, Kriet M, Reda K, Laktaoui A, Oubaaz A. [Ocular Behçet]. Pan Afr Med J 2017; 26:237. [PMID: 28690751 PMCID: PMC5491746 DOI: 10.11604/pamj.2017.26.237.1175] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2011] [Accepted: 04/03/2017] [Indexed: 11/11/2022] Open
Abstract
Our study aimed to determine the clinical, therapeutic and prognostic features of ocular involvement in patients with Behçet's disease treated in our Department of ophthalmology. We conducted a retrospective data collection from medical records of 20 patients treated at the military hospital in Laayoune. All patients underwent complete ophthalmological examination and fluorescein angiography if necessary. OCT exam was performed in two patients. Ten patients had anterior uveitis, complicated in one case by ocular hypertonia; two patients had intermediate uveitis; eight patients had posterior segment involvement complicated in one case by intravitreal hemorrhage. Behcet's Disease (BD) is an systemic idiopathic inflammatory disease currently classified within primary non-necrotizing vasculitis. Ocular involvement is common and severe in Behçet's disease, with the potential to compromise the visual prognosis. Behcet's disease is common in Morocco. It can compromise patient's visual prognosis making the collaboration between ophthalmologists and internists particularly important.
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Affiliation(s)
- Ahmed Alami
- Service d'Ophtalmologie, 3 Hôpital Militaire de Laâyoune, Maroc
| | - Mohamed Kriet
- Service d'Ophtalmologie, Hôpital Militaire Avicenne de Marrakech, Maroc
| | - Karim Reda
- Service d'Ophtalmologie, Hôpital Militaire d'Instruction Mohamed V de Rabat, Maroc
| | | | - Abdelbaare Oubaaz
- Service d'Ophtalmologie, Hôpital Militaire d'Instruction Mohamed V de Rabat, Maroc
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Hyperhomocysteinemia impairs regional blood flow: involvements of endothelial and neuronal nitric oxide. Pflugers Arch 2016; 468:1517-25. [PMID: 27417104 DOI: 10.1007/s00424-016-1849-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 06/06/2016] [Accepted: 06/08/2016] [Indexed: 12/13/2022]
Abstract
Increasing evidence support the idea that hyperhomocysteinemia (HHcy) is responsible for pathogenesis underlying cerebral, coronary, renal, and other vascular circulatory disorders and for hypertension. Impaired synthesis of nitric oxide (NO) in the endothelium or increased production of asymmetric dimethylarginine and activated oxygen species are involved in the impairment of vasodilator effects of NO. Impaired circulation in the brain derived from reduced synthesis and actions of NO would be an important triggering factor to dementia and Alzheimer's disease. Reduced actions of NO and brain hypoperfusion trigger increased production of amyloid-β that inhibits endothelial function, thus establishing a vicious cycle for impairing brain circulation. HHcy is involved in the genesis of anginal attack and coronary myocardial infarction. HHcy is also involved in renal circulatory diseases. The homocysteine (Hcy)-induced circulatory failure is promoted by methionine and is prevented by increased folic acid and vitamin B6/B12. Eliminating poor life styles, such as smoking and being sedentary; keeping favorable dietary habits; and early treatment maintaining constitutive NOS functions healthy, reducing oxidative stresses would be beneficial in protecting HHcy-induced circulatory failures.
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Lazzerini P, Capecchi P, Selvi E, Lorenzini S, Bisogno S, Galeazzi M, Laghi Pasini F. Hyperhomocysteinemia: a cardiovascular risk factor in autoimmune diseases? Lupus 2016; 16:852-62. [DOI: 10.1177/0961203307084176] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Epidemiological studies conducted over the past 25 years have provided ample support for the association of mild hyperhomocysteinemia (HHcy) with an elevated risk of atherothrombosis. Since autoimmune disorders (AD) are frequently associated with relevant and early signs of atherothrombotic damage not adequately explained by the traditional risk factors involved in the onset of cardiovascular disease (CVD), a large interest has been shown to the putative role of mild HHcy in this setting. On the basis of such considerations, we focused the attention on the relationship between homocysteine (Hcy) and CVD in patients affected with autoimmune diseases, reviewing the most recent literature data and also providing our original experience. Although the large amount of available studies clearly shows that HHcy represents a common finding in patients affected with several autoimmune diseases, the actual role of Hcy in the development of CVD in the course of AD is not clear yet, perhaps, with the only exception of the systemic lupus erythematosus. In the other conditions, the role of Hcy in the pathogenesis of vascular complications is still a matter of debate, as the result of conflicting reports and/or lack of an adequate body of investigation. Lupus (2007) 16, 852—862.
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Affiliation(s)
- P.E. Lazzerini
- Divisions of Clinical Immunology, University of Siena, Siena, Italy
| | - P.L. Capecchi
- Divisions of Clinical Immunology, University of Siena, Siena, Italy
| | - E. Selvi
- Rheumatology, Department of Clinical Medicine and Immunological Sciences, University of Siena, Siena, Italy
| | - S. Lorenzini
- Rheumatology, Department of Clinical Medicine and Immunological Sciences, University of Siena, Siena, Italy
| | - S. Bisogno
- Rheumatology, Department of Clinical Medicine and Immunological Sciences, University of Siena, Siena, Italy
| | - M. Galeazzi
- Rheumatology, Department of Clinical Medicine and Immunological Sciences, University of Siena, Siena, Italy
| | - F. Laghi Pasini
- Divisions of Clinical Immunology, University of Siena, Siena, Italy
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Elbay AE, Topalkara A, Elbay A, Erdoğan H, Vural A, Bahadır Çetin A. Evaluation of Serum Homocysteine and Leptin Levels in Patients with Uveitis. Turk J Ophthalmol 2015; 45:146-151. [PMID: 27800222 PMCID: PMC5082272 DOI: 10.4274/tjo.26539] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Accepted: 12/02/2014] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVES To evaluate the serum homocysteine (Hcy) and leptin levels in patients with uveitis. MATERIALS AND METHODS The 70 cases included in the study comprised 3 groups: patients with Behçet's uveitis (BU), patients with non-Behçet's uveitis (NBU) and healthy controls. Body mass index was calculated for each subject. Serum Hcy and leptin levels were measured. Furthermore, acute-phase reactants including erythrocyte sedimentation rate (ESR), C-reactive protein and neutrophil count were measured. RESULTS Serum Hcy levels were 15.04±4.59 µmol/L in the BU group, 15.4±6.87 µmol/L in the NBU group and 13.64±4.72 µmol/L in the control group (p>0.05). The serum leptin levels of male patients in the BU group, NBU group and control group were 4.76±3.54 ng/ml, 6.33±3.74 ng/ml and 5.47±6.33 ng/ml, respectively (p>0.05). When we compared serum leptin levels in female patients and controls, the mean serum leptin concentrations were significantly higher in female BU and NBU patients (24.83±17.62 ng/ml and 28.46±13.90 ng/ml, respectively) than in healthy control volunteers (9.62±6.36 ng/ml, p<0.05). In addition, the ESR value differences between groups were statistically significant (p<0.05). CONCLUSION A larger case series is necessary to investigate serum Hcy and leptin concentrations in uveitis patients.
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Affiliation(s)
- Arif Emre Elbay
- Gazi State Hospital, Clinic of Ophthalmology, Samsun, Turkey
| | - Ayşen Topalkara
- Cumhuriyet University Faculty of Medicine, Department of Ophthalmology, Sivas, Turkey
| | - Ahmet Elbay
- Pendik State Hospital, Clinic of Ophthalmology, İstanbul, Turkey
| | - Haydar Erdoğan
- Cumhuriyet University Faculty of Medicine, Department of Ophthalmology, Sivas, Turkey
| | - Ayşe Vural
- Cumhuriyet University Faculty of Medicine, Department of Ophthalmology, Sivas, Turkey
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Dyer LA. Hypercysteinemia hypes up the inflammasome. J Mol Cell Cardiol 2015; 82:33-5. [PMID: 25758430 DOI: 10.1016/j.yjmcc.2015.02.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Revised: 02/26/2015] [Accepted: 02/27/2015] [Indexed: 10/23/2022]
Affiliation(s)
- Laura A Dyer
- Department of Natural Sciences, Middle Georgia State College, Macon, GA 31206, USA.
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15
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Yildirim M, Baysal V, Inaloz HS, Doguc D. The Significance of Serum Nitric Oxide Levels in Behçet's Disease and Recurrent Aphthous Stomatitis. J Dermatol 2014; 31:983-8. [PMID: 15801262 DOI: 10.1111/j.1346-8138.2004.tb00641.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Behçet's disease (BD) is an inflammatory multisystem disorder characterized by recurrent oral and genital aphthous ulcers, arthritis, uveitis, and thrombophlebitis; it can involve several organs. However, recurrent aphthous stomatitis (RAS) can be seen without a confirmed diagnosis of BD. Moreover, there is no way of predicting whether a patient with RAS will develop BD. Nitric oxide (NO) is a free radical synthesized from L-arginine by one of the family of nitric oxide synthase (NOS) enzymes. Increased production of NO during several inflammatory and infectious processes has been recently postulated. Our aim was to investigate the serum NO levels in patients with active and inactive BD and RAS. Forty-six patients with BD, 30 patients with RAS and 30 healthy controls were enrolled in the study. The patients with BD were separated into two groups: clinically active (n = 24) and inactive (n = 22). A blood sample was collected from all subjects in order to determine their serum NO levels. In patients with active BD, higher serum levels of NO metabolite were found in comparison with patients with inactive BD, in patients with RAS, or healthy controls (p < 0.05). We also found higher serum NO metabolite levels in patients with RAS than in healthy controls (p < 0.05). In patients with inactive BD, statistically significant higher levels of serum NO levels were found in comparison with the control group (p < 0.05). However, we found no statistically significant difference between the patients with inactive BD and RAS, which indicated that inactive BD cannot be distinguished from RAS by serum NO levels. We conclude that serum NO levels may be an important marker for estimating the severity of BD. However, further studies are needed to confirm our findings.
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Affiliation(s)
- Mehmet Yildirim
- University of Suleyman Demirel, School of Medicine, Department of Dermatology, Isparta, Turkey
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Tugal-Tutkun I, Onal S, Ozyazgan Y, Soylu M, Akman M. Validity and agreement of uveitis experts in interpretation of ocular photographs for diagnosis of Behçet uveitis. Ocul Immunol Inflamm 2013; 22:461-8. [PMID: 24329561 DOI: 10.3109/09273948.2013.854393] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
UNLABELLED Abstract Purpose: To evaluate agreement and estimate sensitivity and specificity of uveitis specialists' interpretation of ocular photographs in diagnosing Behçet uveitis. METHODS Fourteen Turkish uveitis specialists, masked to demographic and clinical features of patients, independently labeled ocular photographs (29 Behçet/30 other diagnoses) as "Behçet uveitis" or "non-Behçet." Level of agreement was evaluated using kappa statistics. Photographs were categorized based on ocular signs captured and performance of observers. RESULTS Exact agreement with the correct diagnosis was 56-81%. Seven reviewers correctly labeled more than 70% of photographs. Interobserver agreement among those 7 reviewers revealed moderate (κ = 0.41-0.60) or substantial (κ = 0.61-0.80) agreement in 76% of pairs. Smooth layered hypopyon, superficial retinal infiltrate with retinal hemorrhages, and branch retinal vein occlusion with vitreous haze were correctly recognized as Behçet uveitis by majority of reviewers. CONCLUSIONS There are ocular signs of Behçet disease that can be considered diagnostic even in the absence of any other clinical information.
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Affiliation(s)
- Ilknur Tugal-Tutkun
- Department of Ophthalmology, Istanbul University, Istanbul Medical Faculty , Istanbul , Turkey
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Kim SJ, Lee S, Park C, Seo JS, Kim JI, Yu HG. Targeted resequencing of candidate genes reveals novel variants associated with severe Behçet's uveitis. Exp Mol Med 2013; 45:e49. [PMID: 24136464 PMCID: PMC3809359 DOI: 10.1038/emm.2013.101] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2013] [Accepted: 07/29/2013] [Indexed: 11/09/2022] Open
Abstract
Behçet's disease (BD) is a chronic systemic inflammatory disorder characterized by four major manifestations: recurrent uveitis, oral and genital ulcers and skin lesions. To identify some pathogenic variants associated with severe Behçet's uveitis, we used targeted and massively parallel sequencing methods to explore the genetic diversity of target regions. A solution-based target enrichment kit was designed to capture whole-exonic regions of 132 candidate genes. Using a multiplexing strategy, 32 samples from patients with a severe type of Behçet's uveitis were sequenced with a Genome Analyzer IIx. We compared the frequency of each variant with that of 59 normal Korean controls, and selected five rare and eight common single-nucleotide variants as the candidates for a replication study. The selected variants were genotyped in 61 cases and 320 controls and, as a result, two rare and seven common variants showed significant associations with severe Behçet's uveitis (P<0.05). Some of these, including rs199955684 in KIR3DL3, rs1801133 in MTHFR, rs1051790 in MICA and rs1051456 in KIR2DL4, were predicted to be damaging by either the PolyPhen-2 or SIFT prediction program. Variants on FCGR3A (rs396991) and ICAM1 (rs5498) have been previously reported as susceptibility loci of this disease, and those on IFNAR1, MTFHR and MICA also replicated the previous reports at the gene level. The KIR3DL3 and KIR2DL4 genes are novel susceptibility genes that have not been reported in association with BD. In conclusion, this study showed that target enrichment and next-generation sequencing technologies can provide valuable information on the genetic predisposition for Behçet's uveitis.
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Affiliation(s)
- Sang Jin Kim
- 1] Department of Ophthalmology, Seoul National University College of Medicine, Seoul, South Korea [2] Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
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Abstract
The diagnosis of Behçet disease is clinical and based on the presence of characteristic ocular and systemic inflammatory manifestations. Patients may present with anterior, posterior, or panuveitis in one or both eyes. The differential diagnosis includes a variety of infectious and noninfectious causes of acute nongranulomatous anterior uveitis, intermediate uveitis, occlusive retinal vasculitis, focal or multifocal retinitis, and necrotizing retinitis. A course characterized by sudden onset with improvement followed by recurrence of inflammatory signs is most typical for Behçet uveitis.
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Affiliation(s)
- Ilknur Tugal-Tutkun
- Department of Ophthalmology, Istanbul Faculty of Medicine, Istanbul University , Istanbul , Turkey
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Inanir A, Yigit S, Tekcan A, Tural S, Kismali G. IL-4 and MTHFR gene polymorphism in rheumatoid arthritis and their effects. Immunol Lett 2013; 152:104-8. [PMID: 23685257 DOI: 10.1016/j.imlet.2013.05.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Revised: 04/13/2013] [Accepted: 05/06/2013] [Indexed: 12/30/2022]
Abstract
Rheumatoid arthritis (RA) is a chronic, systemic inflammatory disease that mainly affects the joints. Polymorphic variations of the cytokine genes and MTHFR gene have received attention as potential markers of susceptibility, severity, and/or protection in RA. The aim of this study was to investigate the MTHFR C677T and IL-4 70bp VNTR variation in Turkish patients with RA and evaluate if there was an association with clinical features, especially ocular involvement, in RA patients. The study included 297 persons (147 patients with RA and 150 healthy controls). Genomic DNA was isolated and genotyped using PCR assay for the MTHFR gene C677T and IL-4 gene 70bp VNTR polymorphisms. Our results show that there was statistically significant difference between the groups with respect to IL-4 genotype (p=0.01) and allele frequencies (p<0.002). There was no statistical significant difference in the genotype frequencies MTHFR gene, but allele frequencies showed statistically significant association (p=0.01). When we examined MTHFR and IL-4 genotype frequencies according to the clinical characteristics, we found that there was a difference between MTHFR genotypes and ocular involvement but it is not to a statistical significant degree (p=0.09). In the combined genotype analysis, MTHFR/IL-4 CCP2P2 combine genotype was estimated to have protective effect against RA, CTP1P2 combine genotype was found to be risk for RA. Our findings suggest that there is an association of IL-4 gene 70bp VNTR polymorphism and MTHFR C677T polymorphism with susceptibility of a person for development of RA.
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Affiliation(s)
- Ahmet Inanir
- Department of Physical Therapy and Rehabilitation, Faculty of Medicine, Gaziosmanpasa University, Tokat, 60100, Turkey.
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20
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Karakus N, Yigit S, Kalkan G, Rustemoglu A, Inanir A, Gul U, Pancar GS, Akkanet S, Ates O. Association between the methylene tetrahydrofolate reductase gene C677T mutation and colchicine unresponsiveness in Behcet's disease. Mol Vis 2012; 18:1696-700. [PMID: 22773907 PMCID: PMC3388981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2012] [Accepted: 06/19/2012] [Indexed: 11/16/2022] Open
Abstract
PURPOSE Behcet's disease (BD) is a multisystemic immunoinflammatory disorder characterized by mucocutaneous, ocular, vascular, and central nervous system manifestations. The common methylene tetrahydrofolate reductase (MTHFR) gene C677T mutation is a known risk factor for thrombosis. The aim of this study was to investigate the MTHFR gene C677 mutation in patients with BD and evaluate if there was an association with clinical features, especially thrombosis, in a relatively large cohort of patients with BD. METHODS The study included 318 patients with BD and 207 healthy controls. Genomic DNA was isolated and genotyped using PCR-based restriction fragment length polymorphism assay for the MTHFR gene C677T mutation. RESULTS The genotype and allele frequencies of the C677T mutation showed a statistically significant difference between BD patients and controls (p=0.003 and p=0.001, respectively). There was also a significant association between C677T alteration and response to colchicine in BD patients (p=0.046). CONCLUSIONS The results of this study showed that there was a high association between the MTHFR gene C677T mutation and BD. Stratification analysis according to clinical features for this disease did not reveal an association except response to colchicine that was shown to be influenced by the MTHFR C677T mutation.
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Affiliation(s)
- Nevin Karakus
- Ondokuz Mayis University, Faculty of Medicine, Department of Medical Biology, Samsun, Turkey,Gaziosmanpasa University, Faculty of Medicine, Department of Medical Biology, Tokat, Turkey
| | - Serbulent Yigit
- Gaziosmanpasa University, Faculty of Medicine, Department of Medical Biology, Tokat, Turkey
| | | | - Aydin Rustemoglu
- Gaziosmanpasa University, Faculty of Medicine, Department of Medical Biology, Tokat, Turkey
| | - Ahmet Inanir
- Department of Physical Therapy and Rehabilitation, Tokat, Turkey
| | - Ulker Gul
- Ankara Numune Training and Research Hospital, Second Dermatology Clinics, Ankara, Turkey
| | | | - Songul Akkanet
- Gaziosmanpasa University, Faculty of Medicine, Department of Medical Biology, Tokat, Turkey
| | - Omer Ates
- Gaziosmanpasa University, Faculty of Medicine, Department of Medical Biology, Tokat, Turkey
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Abstract
PURPOSE OF REVIEW To alert physician to timely recognition and current treatment of recurrent hypopyon iridocyclitis or panuveitis in ocular Behçet disease (OBD). RECENT FINDINGS Interferon-α, rituximab, intravitreal triamcinolone, and biological response modifiers by tumor necrosis factor inhibitors such as infliximab and adalimumab are being used increasingly for the treatment of severe sight-threatening ocular inflammation including retinal vasculitis and cystoid macular edema (CME). SUMMARY Biological agents offer tremendous potential in the treatment of OBD. Given that OBD predominantly afflicts the younger adults in their most productive years, dermatologist, rheumatologist, internist, or general practitioners supervising patients with oculo-articulo-oromucocutaneous syndromes should be aware of systemic Behçet disease. Early recognition of ocular involvement is important and such patients should strongly be instructed to visit immediately an ophthalmologist, as uveitis management differs from extraocular involvements with high ocular morbidity from sight-threatening complications due to relapsing inflammatory attacks in the posterior segment of the eye. A single infliximab infusion should be considered for the control of acute panuveitis, whereas repeated long-term infliximab infusions were proved to be more effective in reducing the number of episodes in refractory uveoretinitis with faster regression and complete remission of CME.
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22
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Abstract
PURPOSE OF REVIEW To alert physician to timely recognition and current treatment of recurrent hypopyon iridocyclitis or panuveitis in ocular Behçet disease (OBD). RECENT FINDINGS Interferon-α, rituximab, intravitreal triamcinolone, and biological response modifiers by tumor necrosis factor inhibitors such as infliximab and adalimumab are being used increasingly for the treatment of severe sight-threatening ocular inflammation including retinal vasculitis and cystoid macular edema (CME). SUMMARY Biological agents offer tremendous potential in the treatment of OBD. Given that OBD predominantly afflicts the younger adults in their most productive years, dermatologist, rheumatologist, internist, or general practitioners supervising patients with oculo-articulo-oromucocutaneous syndromes should be aware of systemic Behçet disease. Early recognition of ocular involvement is important and such patients should strongly be instructed to visit immediately an ophthalmologist, as uveitis management differs from extraocular involvements with high ocular morbidity from sight-threatening complications due to relapsing inflammatory attacks in the posterior segment of the eye. A single infliximab infusion should be considered for the control of acute panuveitis, whereas repeated long-term infliximab infusions were proved to be more effective in reducing the number of episodes in refractory uveoretinitis with faster regression and complete remission of CME.
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Affiliation(s)
- Cem Evereklioglu
- Department of Ophthalmology, Erciyes University Medical Faculty, Kayseri, Turkey
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Pineton de Chambrun M, Wechsler B, Geri G, Cacoub P, Saadoun D. New insights into the pathogenesis of Behçet's disease. Autoimmun Rev 2011; 11:687-98. [PMID: 22197900 DOI: 10.1016/j.autrev.2011.11.026] [Citation(s) in RCA: 198] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2011] [Accepted: 11/27/2011] [Indexed: 01/01/2023]
Abstract
Behçet's disease (BD) is a recurrent systemic inflammatory disorder of unknown origin characterized by oral and genital mucous ulcer, uveitis, and skin lesions. Involvement of large vessels, central nervous system (CNS), gastrointestinal tract and thrombotic events are less frequent but can be life threatening. The aim of this review is to provide new insights into the pathogenesis of BD. Over the past year substantial advances have been done in the understanding of the genetic [1,2] and immunology [3] of BD. BD is at the crossroad between autoimmune and autoinflammatory syndromes. In common with autoimmune diseases BD shares class I MHC association. However, in contrast to autoimmune disorders, BD has clinical features that seem to be mostly autoinflammatory. The pathogenesis of BD is still unknown, but major determinants of the genetic and immune system abnormalities have been reported recently. Triggering infectious factors are supposed to participate in the outbreak of BD in genetically predisposed patients. Two recent large genome-wide association study (GWAS) conducted in Turkey and Japan reported association between single nucleotide polymorphism (SNP) of interleukin (IL)-10 and IL-23R/IL-12RB2 genes and BD. New insights into the perturbations of T cell homeostasis of BD recently emerged. We have recently demonstrated the promotion of Th17 responses and the suppression of regulatory T cells (Tregs) that were driven by interleukin (IL)-21 production and that correlates with BD activity. Inflammatory cells within BD inflammatory lesions included mostly neutrophils, Th1 and Th17 cells, and cytotoxic CD8+ and γδ T cells. Altogether, the recent progresses in the knowledge of BD pathogenesis pave the way for innovative therapy.
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Affiliation(s)
- Marc Pineton de Chambrun
- Department of Internal Medicine and Laboratory I3 Immunology, Immunopathology, Immunotherapy, UMR CNRS 7211, INSERM U959, Groupe Hospitalier La Pitié-Salpetrière, Université Pierre et Marie Curie, Paris 6, Paris, France
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Pathophysiology of the Behçet's Disease. PATHOLOGY RESEARCH INTERNATIONAL 2011; 2012:493015. [PMID: 21977335 PMCID: PMC3184427 DOI: 10.1155/2012/493015] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2011] [Revised: 07/21/2011] [Accepted: 07/23/2011] [Indexed: 01/05/2023]
Abstract
Behçet's disease (BD) is a multisystemic disease of unknown etiology characterized by chronic relapsing oral-genital ulcers and uveitis. Multiple systemic associations including articular, gastrointestinal, cardiopulmonary, neurologic, and vascular involvement are also observed in BD. Although the etiopathogenesis of the disease remains unknown, increased neutrophil functions such as chemotaxis, phagocytosis, and excessive production of reactive oxygen species (ROS), including superoxide anion, which may be responsible for oxidative tissue damage seen in BD, and also immunological alterations, T lymphocyte abnormalities in both subpopulation and function have been considered to be correlated with the etiopathogenesis of BD. There is some clinical evidence suggesting that emotional stress and hormonal alterations can influence the course and disease activity of BD.
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The association of receptor of advanced glycated end products and inflammatory mediators contributes to endothelial dysfunction in a prospective study of acute kidney injury patients with sepsis. Mol Cell Biochem 2011; 359:73-81. [PMID: 21811803 DOI: 10.1007/s11010-011-1001-4] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2011] [Accepted: 07/19/2011] [Indexed: 02/01/2023]
Abstract
The pathogenesis of acute kidney injury (AKI) occurring due to sepsis is incompletely understood. Endothelial activation, defined as up-regulation of adhesion molecules by proinflammatory cytokines, may be central to the development of sepsis-induced AKI. Our aim was to determine levels of circulating adhesion molecules endothelial (E)-selectin, intercellular adhesion molecule (ICAM), and vascular cell adhesion molecule (VCAM), inflammatory mediators; tumor necrosis factor-α (TNF-α) and transforming growth factor-β (TGF-β), vasoactive mediators; endothelin-1 (ET-1) and nitric oxide (NO), soluble receptor for advanced glycated end products (sRAGE) and serum fetuin-A in septic AKI patients before and after antibiotic therapy. Nineteen AKI patients with sepsis and fifteen healthy controls were enrolled in this prospective study. Results revealed that 12 weeks of therapy caused amelioration of endothelial and inflammatory injuries as well as renal function markers. Moreover, the positive correlations between levels of RAGE and E-selectin (r=0.88), ET-1 (r=0.90), and TNF-α (r=0.94) and negative with NO (r=-0.75-0.95) suggest that possible interaction of RAGE and inflammation may contribute to endothelial dysfunction in septic AKI patients.
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Onur E, Kabaroglu C, Inanir I, Var A, Guvenc Y, Gunay O, Gunduz K. Oxidative stress impairs endothelial nitric oxide levels in Behçets' disease. Cutan Ocul Toxicol 2011; 30:217-20. [PMID: 21345164 DOI: 10.3109/15569527.2011.554480] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Behçet's disease (BD) is an inflammatory vasculitis. Endogenous nitric oxide (NO), produced by endothelial cells, has pleiotropic effects such as vasodilatator, antiplatelet, antiproliferative. Reactive oxygen species (ROS) are produced at sites of endothelial inflammation. ROS target polyunsaturated lipids, which results in malondialdehyde (MDA) production. OBJECTIVE The aim was to investigate the oxidative stress in BD patients by measuring MDA and total antioxidant status (TAS) levels and to establish a possible relationship with respect to NO levels regarding disease activity. MATERIALS AND METHODS 55 BD patients (30 active/25 inactive) and 20 healthy volunteers were included in the study. Blood samples were drawn following an overnight fasting. TAS and MDA levels were determined spectrophotometrically. Serum nitrite (NO(2-)) and nitrate (NO(3-)) levels were measured to estimate NO production. Data were expressed as mean ± SD. RESULTS TAS levels were significantly lower in BD patients than the controls (1.19 ± 0.34 vs. 3.29 ± 0.89 mmol/L). In the active BD group, MDA levels (0.36 ± 0.19 nmol/mL) were significantly higher than both the inactive BD group (0.25 ± 0.18 nmol/mL) and controls (0.18 ± 0.41 nmol/mL). NO levels were significantly lower in the active group compared to the inactive group (18.0 ± 2.80 vs. 19.40 ± 2.70 µmol/L). MDA levels correlated negatively with NO levels in the active group. CONCLUSION Decreased NO levels mediated by increased oxidative stress significantly contribute to endothelial dysfunction observed in BD.
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Affiliation(s)
- Ece Onur
- Celal Bayar University School of Medicine, Department of Biochemistry, Manisa, Turkey.
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A case of anterior ischemic optic neuropathy associated with Behcet's disease. Eye (Lond) 2011; 25:395-6. [PMID: 21212799 DOI: 10.1038/eye.2010.208] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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Hyperhomocysteinaemia in Behçet's Disease. Biochem Res Int 2010; 2010:361387. [PMID: 21188071 PMCID: PMC3005829 DOI: 10.1155/2010/361387] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2010] [Accepted: 02/15/2010] [Indexed: 11/17/2022] Open
Abstract
Objectives. The aim of this study was to investigate if hyperhomocysteinaemia is a contributive risk factor for the pathogenesis and the activity of Behçet's disease (BD). Design and Methods. Fifty four patients fullfiling the criteria of the International Study Group for BD were enrolled. Fifty healthy volunteers matched for age and sex with the BD group were included as a negative control group. Patients, with any condition that might affect plasma homocysteine concentration, were excluded. Results. Mean serum homocysteine concentration was significantly higher in patients with BD than in the healthy controls (P < .001), in patients with active disease (P = .04), and in masculine gender (P = .05). There was no significant difference between homocysteine level and clinical involvement. Conclusions. We demonstrated that plasma total homocysteine level (tHcy) is increased in BD and correlated with disease activity. No association was found between homocysteine levels and clinical involvement.
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Yang RX, Huang SY, Yan FF, Lu XT, Xing YF, Liu Y, Liu YF, Zhao YX. Danshensu protects vascular endothelia in a rat model of hyperhomocysteinemia. Acta Pharmacol Sin 2010; 31:1395-400. [PMID: 20871618 DOI: 10.1038/aps.2010.167] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
AIM To examine whether danshensu could protect vascular endothelia in a rat model of hyperhomocysteinemia. METHODS The model was established by feeding rats with a methionine-rich diet (1 g·kg⁻¹·d⁻¹) for 3 months. Immediately following the discontinuation of methionine-rich diet, rats were treated with danshensu (67.5 mg·kg⁻¹·d⁻¹, po) or saline for 3 additional months. One group of rats receiving vitamin mixture (folic acid, vitamin B12 and vitamin B6) was included as a positive control. One group of rats not exposed to methionine-rich diet was also included as a blank control. The expression of tumor necrosis factor-alpha (TNF-alpha) and intercellular adhesion molecule-1 (ICAM-1) protein in the descending aorta was examined using immunohistochemistry and Western blot. Homocysteine and blood concentration of endothelin and nitric oxide (NO) was also examined. RESULTS Methionine-rich diet resulted in accumulation of "foam cells", up-regulated expression of TNF-alpha and ICAM-1 in the descending aorta, and significantly increased serum homocysteine. Plasma endothelin concentration was significantly increased; NO was decreased. Danshensu treatment, either simultaneous to methionine-rich diet or afterwards, attenuated the above mentioned changes. CONCLUSION Chronic treatment with danshensu could prevent/attenuate the formation of atherosclerosis. Potential mechanisms include inhibited expression of representative proinflammatory cytokines and adhesion molecules in arterial endothelia. Changes in homocysteine and circulating molecules that control vascular contraction/relaxation via endothelial cells (eg, endothelin and NO) were also implicated.
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Hodeib AA, Elsharawy TA, Fawzi HA. Assessment of serum homocysteine, endothelin-1, and nitric oxide levels in behçet's disease. Indian J Dermatol 2010; 55:215-20. [PMID: 21063509 PMCID: PMC2965903 DOI: 10.4103/0019-5154.70667] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Some prominent features of Behçet's disease (BD) are arterial and venous thromboses as a result of endothelial dysfunction. Hyperhomocysteinemia is responsible for vascular endothelial injury due to an increased frequency of thrombogenesis. Endothelin-1 (ET-1) is a vasoconstrictor whereas nitric oxide (NO) is an endothelial vasorelaxing peptide that is responsible for the inhibition of platelet adhesion. AIM To evaluate serum levels of homocysteine (Hcy) and determine whether hyperhomocysteinemia is considered as a contributing risk factor for venous and arterial thromboses of BD, and to correlate serum levels of ET-1 and NO with disease activity. MATERIALS AND METHODS We measured serum levels of Hcy, ET-1, and nitrite (NO(2) (-)) in 25 patients who fulfilled the criteria of the International Study Group for BD, and compared them to those of 15 healthy control subjects. Levels of Hcy and ET-1 were measured by using enzyme-linked immunosorbent assay (ELISA), whereas serum nitrite (NO(2) (-)) levels were measured by using Griess reaction as an indicator for NO production. All the patients were screened for a history of venous thrombosis and subdivided into thrombotic and nonthrombotic subgroups according to their thrombotic history. Patients with BD were divided into two subgroups, active and inactive, according to their clinical and laboratory findings. RESULTS There were significant increases in serum levels of Hcy, ET-1, and nitrite in BD patients compared to those in controls. There was a significant increase in serum Hcy levels in thrombotic compared to nonthrombotic subgroups. Positive correlations were detected between the serum ET-1 and nitrite levels with disease activity in BD patients. CONCLUSION Hyperhomocysteinemia may play some role in the development of venous and arterial thromboses in BD. Increased NO production might ave critical biological activities that are relevant to pathological events in the active period of the disease.
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Affiliation(s)
- Abeer A Hodeib
- From the Assistant Professor of Dermatology and Venereology, Tanta University, Egypt
| | | | - Hisham A Fawzi
- From the Assistant Professor of Clinical Pathology Department, Alazhar University (males), Egypt
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Caramaschi P, Poli G, Bonora A, Volpe A, Tinazzi I, Pieropan S, Bambara LM, Biasi D. A study on thrombophilic factors in Italian Behcet's patients. Joint Bone Spine 2010; 77:330-4. [PMID: 20452800 DOI: 10.1016/j.jbspin.2010.02.022] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2009] [Accepted: 02/03/2010] [Indexed: 11/30/2022]
Abstract
BACKGROUND Behcet's disease (BD) may complicate with arterial and venous thrombosis. The purpose of this work is to evaluate in an Italian group of BD patients with thrombotic events a large panel of inherited and acquired thrombophilic factors. METHODS Thirty BD patients, of which nine with previously arterial or venous thrombosis and 21 without, underwent the following investigations: plasma antithrombin activity, protein C activity, free protein S level, sensitivity to APC, total plasma homocysteine concentration, serum folate level, determination of anti-phospholipid antibodies, serum Lp(a) levels, tests for gene polymorphisms of factor V Leiden, prothrombin and methylenetetrahydrofolate reductase genes. Tests for the gene polymorphisms were also performed in a group of healthy control subjects. RESULTS All the six patients with arterial or deep venous thrombosis showed thrombophilic conditions such as protein C or protein S deficiency (one case each), hyperhomocysteinemia (two cases), positivity of anti-phospholipid antibodies associated with APC resistance or hyperhomocysteinemia (one case each). Among three subjects with superficial thrombophlebitis only one showed a mild hyperhomocysteinemia. No differences were found between BD patients and control subjects concerning polymorphisms of the genes considered. Among BD patients the Factor V H1299R mutation showed a weak association with venous thrombosis (P=0.048). CONCLUSION In BD patients different concomitant significant thrombophilic risk factors may contribute to the development of thrombotic events. Patients affected by vasculo-Behcet should be evaluated for the presence of coexisting major thrombophilic conditions.
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Affiliation(s)
- Paola Caramaschi
- Dipartimento di Medicina Clinica Sperimentale, Policlinico G.B. Rossi, Piazzale Scuro, 37134 Verona, Italy.
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La Regina M, Gasparyan AY, Orlandini F, Prisco D. Behçet's Disease as a Model of Venous Thrombosis. Open Cardiovasc Med J 2010; 4:71-7. [PMID: 20360979 PMCID: PMC2847254 DOI: 10.2174/1874192401004020071] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2009] [Revised: 11/23/2009] [Accepted: 12/12/2009] [Indexed: 01/11/2023] Open
Abstract
Behçet's disease (BD) is a chronic inflammatory disease of unknown aetiology characterized by recurrent oral, genital aphthous ulcerations, uveitis, skin lesions and other multisystem affections associated with vasculitis. Different types of vessels, predominantly veins, can be affected in BD. The frequency of vascular lesions in BD, such as superficial and deep venous thromboses, arterial aneurysms and occlusions, ranges between 7-29%. In this review, various factors of thrombogenesis in BD, particularly pro- and antithrombotic endothelial and non-endothelial factors, factors of coagulation, platelet activation and rheological changes are presented and discussed from positions of Virchow's triad of venous thrombosis. Despite advances in understanding of thrombogenesis in BD, still many issues of diagnosis and targeted preventive and therapeutic measures remain unresolved. Further studies are needed to clarify the pathobiology of BD-related thrombosis and to provide the clinicians with recommendations over the utility, safety and effectiveness of the antithrombotic therapy in BD.
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Affiliation(s)
- Micaela La Regina
- Department of Internal Medicine, Periodic Fevers Research Centre, Catholic University, Rome, Italy
| | | | | | - Domenico Prisco
- Department of Medical and Surgical Critical Care, University of Florence, Florence, Italy
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Regina ML, Gasparyan AY, Orlandini F, Prisco D. Behçet’s Disease as a Model of Venous Thrombosis. Open Cardiovasc Med J 2010. [DOI: 10.2174/1874192401004010071] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Behçet’s disease (BD) is a chronic inflammatory disease of unknown aetiology characterized by recurrent oral, genital aphthous ulcerations, uveitis, skin lesions and other multisystem affections associated with vasculitis. Different types of vessels, predominantly veins, can be affected in BD. The frequency of vascular lesions in BD, such as superficial and deep venous thromboses, arterial aneurysms and occlusions, ranges between 7-29%.
In this review, various factors of thrombogenesis in BD, particularly pro- and antithrombotic endothelial and non-endothelial factors, factors of coagulation, platelet activation and rheological changes are presented and discussed from positions of Virchow’s triad of venous thrombosis.
Despite advances in understanding of thrombogenesis in BD, still many issues of diagnosis and targeted preventive and therapeutic measures remain unresolved. Further studies are needed to clarify the pathobiology of BD-related thrombosis and to provide the clinicians with recommendations over the utility, safety and effectiveness of the antithrombotic therapy in BD.
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Kartal Durmazlar SP, Akgul A, Eskioglu F. Hyperhomocysteinemia in patients with stasis dermatitis and ulcer: A novel finding with important therapeutic implications. J DERMATOL TREAT 2009; 20:336-9. [DOI: 10.3109/09546630902775069] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Arabaci T, Kara C, Çiçek Y. Relationship between periodontal parameters and Behçet’s disease and evaluation of different treatments for oral recurrent aphthous stomatitis. J Periodontal Res 2009; 44:718-25. [DOI: 10.1111/j.1600-0765.2008.01183.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Gönül M, Gül U, Kilinç C, Cakmak SK, Soylu S, Kiliç A. Homocysteine levels in patients with Behçet's disease and patients with recurrent aphthous stomatitis. Clin Rheumatol 2009; 28:1153-6. [PMID: 19575262 DOI: 10.1007/s10067-009-1214-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2009] [Revised: 05/25/2009] [Accepted: 06/03/2009] [Indexed: 11/26/2022]
Abstract
The mechanism for vascular involvement of Behçet disease (BD) includes arterial and venous thrombosis. Although the exact etiology of systemic vasculitis and thrombosis is still unknown, many hypotheses have been suggested. One of these hypotheses is that hyperhomocysteinemia causes vascular disease and thrombosis. The aim of this study was to compare the levels of homocysteine, vitamin B(12), and folic acid of BD patients with those of recurrent aphthous stomatitis (RAS) patients and healthy controls. Forty-five BD patients, 47 RAS patients, and 69 healty control subjects were included in this study. Vitamin B(12), folic acid, and homocysteine levels of the patients and controls were measured, and statistical differences among the groups were determined. BD patients had mostly cutaneous symptoms. Arthritis and ocular and vascular involvement were seen in 24.4%, 22%, and 11% of BD patients, respectively. No significant difference was detected among the groups in the levels of vitamin B(12), folic acid, and homocysteine. There was no significant difference in any parameters according to sex and age of the patients and activity of BD and if the patients with BD were treated or not. Homocysteine level inversely correlated with vitamin B(12) and folic acid levels in the BD group. We could not find any differences in homocysteine, vitamin B(12), and folic acid levels between BD and RAS patients and controls. This may be due to the fact that our patients mostly had cutaneous symptoms rather than vascular involvement.
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Affiliation(s)
- Müzeyyen Gönül
- 2nd Dermatology Clinic, Ankara Numune Education and Research Hospital, Ankara, Turkey.
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Homocysteine may involve in the pathogenesis of Behcet's disease by inducing inflammation. Mediators Inflamm 2009; 2008:407972. [PMID: 19197380 PMCID: PMC2633607 DOI: 10.1155/2008/407972] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2008] [Revised: 11/02/2008] [Accepted: 11/17/2008] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE Our aim was to evaluate the significance of homocysteine (Hcy) in Behcet's disease (BD) and the association of elevated Hcy levels associated with the indices of inflammation in BD. METHODS Untreated 70 patients with BD and 33 healthy individuals were included into the study. Hcy, tumor necrosis alpha (TNF-alpha), C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) were evaluated with respect to activity and specific individual clinical manifestations of the disease. RESULTS Hcy levels were found significantly elevated in active BD when compared to inactive BD and healthy controls. Hcy levels were found to have high correlation with the number of active clinical manifestations increased. A significant positive correlation was found between serum Hcy and TNF-alpha levels, CRP, and ESR. Hcy was found to be the best predictor of TNF-alpha among other parameters. CONCLUSION Hcy may involve in the pathogenesis of BD by inducing inflammation.
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Kamoun M, Houman MH, Hamzaoui A, Hamzaoui K. Vascular endothelial growth factor gene polymorphisms and serum levels in Behçet’s disease. ACTA ACUST UNITED AC 2008; 72:581-7. [DOI: 10.1111/j.1399-0039.2008.01145.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Ben Dhifallah I, Houman H, Khanfir M, Hamzaoui K. Endothelial nitric oxide synthase gene polymorphism is associated with Behçet's disease in Tunisian population. Hum Immunol 2008; 69:661-5. [PMID: 18718857 DOI: 10.1016/j.humimm.2008.07.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2008] [Revised: 07/15/2008] [Accepted: 07/18/2008] [Indexed: 01/08/2023]
Affiliation(s)
- Imene Ben Dhifallah
- Homeostasis and Cell Dysfunction Unit Research 99/UR/08-40, Medicine University Tunis, Tunisia.
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40
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Ultrasonographic Evaluation of Hand and Foot Tendons in Behçet's Disease. Arch Med Res 2008; 39:709-13. [DOI: 10.1016/j.arcmed.2008.06.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2008] [Accepted: 06/16/2008] [Indexed: 11/22/2022]
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Tousoulis D, Antoniades C, Marinou K, Vasiliadou C, Bouras G, Stefanadi E, Latsios G, Siasos G, Toutouzas K, Stefanadis C. Methionine-Loading Rapidly Impairs Endothelial Function, by Mechanisms Independent of Endothelin-1: Evidence for an Association of Fasting Total Homocysteine with Plasma Endothelin-1 Levels. J Am Coll Nutr 2008; 27:379-86. [DOI: 10.1080/07315724.2008.10719714] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Serum levels of natriuretic peptides in patients with Behcet’s disease. Clin Rheumatol 2008; 27:1153-8. [DOI: 10.1007/s10067-008-0886-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2007] [Revised: 02/20/2008] [Accepted: 03/18/2008] [Indexed: 01/22/2023]
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43
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Evereklioglu C, Ozbek E, Cekmen M, Mehmet N, Duygulu F, Ozkiris A, Calip M, Er H, Turkoz Y. Urinary nitric oxide levels are increased and correlated with plasma concentrations in patients with Behçet's disease: is it a new urinary activity marker? Nephrology (Carlton) 2008; 8:231-8. [PMID: 15012709 DOI: 10.1046/j.1440-1797.2003.00180.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Nitric oxide (NO) is a free radical and serves many functions within the kidney. Excess NO causes glomerular injury. Behçet's disease (BD) is a systemic immunoinflammatory vasculitis, affecting every organ in the body including the kidneys (subclinic glomerulonephritis). We investigated the role of urinary total nitrite levels (end product of NO) in BD and evaluated whether urinary concentrations were correlated with its plasma levels or disease activity. Thirty-six consecutive Behçet's patients (19 men, 17 women; 35.9 years), and 20 age- and sex-matched healthy control volunteers (12 men, eight women; 33.2 years) were divided into an active (n = 16) and inactive (n = 20) period. Urinary and serum NO levels ( micromol/mg urinary creatinine) were higher in BD patients (4.1 +/- 0.3) than control subjects (1.7 +/- 0.2; P < 0.001). Serum NO levels in Behçet's patients and control subjects were 51.3 +/- 9.8 and 21.7 +/- 7.3 micromol/L, respectively (P < 0.001). Active patients had higher urinary NO excretion (4.9 +/- 0.3) than inactive patients (3.3 +/- 0.3; P < 0.01). Urinary NO levels were correlated with its serum levels (r2 = 0.69, P < 0.001). Higher urinary NO levels found in BD may be produced by the kidney as a result of an inflammatory stimulation. As excess NO is toxic to the tissues, increased NO levels may play a role in mediating subclinic glomerular injury of such patients. However, we could not determine the exact site(s) of NO synthesis by the kidney, such as the glomeruli, blood vessels and/or the tubular cells. Whatever the source, urinary NO levels may be used as a new activity marker in the diagnosis and follow up of BD by serial measurements.
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Affiliation(s)
- Cem Evereklioglu
- Department of Ophthalmology, Erciyes University Medical Faculty, Kayseri, Turkey.
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Sarican T, Ayabakan H, Turkmen S, Kalaslioglu V, Baran F, Yenice N. Homocysteine: An activity marker in Behçet's disease? J Dermatol Sci 2007; 45:121-6. [PMID: 17182219 DOI: 10.1016/j.jdermsci.2006.11.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2006] [Revised: 11/06/2006] [Accepted: 11/08/2006] [Indexed: 01/31/2023]
Abstract
BACKGROUND Behçet's disease (BD) is a chronic multisystem inflammatory disorder commonly complicated by vascular thrombosis. OBJECTIVE In this study, we investigated whether hyperhomocysteinaemia, being a well known risk factor for atherothrombogenesis, is also a contributive risk factor for the pathogenesis and the activation of Behçet's disease. METHODS Sixty-four patients fulfilling the criteria of the International Study Group for Behçet's disease (48 males, 16 females, 33+/-8 years) were enrolled. They were separated into two groups with respect to activation features of Behçet's disease. Additionally, we collected the blood samples from 13 patients with BD in both active stage and in inactive stage. Twenty-six healthy individuals were included as a negative control group. Serum total homocysteine (Hcy) levels were determined by chemiluminescence immunoassay. RESULTS Mean serum homocysteine concentrations in total BD patients were significantly higher than in the healthy controls (11.7+/-4.6 versus 8.7+/-2.8micromol/L, p<0.01). Mean serum homocysteine concentrations in the active patients were significantly higher than in the inactive patients and the healthy controls (13.3+/-3.6; 10.8+/-5.0; 8.7+/-2.8micromol/L, respectively) (p<0.05 and p<0.001, respectively). There was no significant difference between the patients with inactive disease and the healthy controls. When the active and the inactive stage of 13 patients with BD were compared, we found that mean serum total homocysteine levels were higher in the active stage than in the inactive stage (p<0.05). CONCLUSION Hyperhomocysteinaemia may be responsible for the endothelial damage in BD and assumed to be a risk factor and a marker for activation of BD.
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Affiliation(s)
- Tuncay Sarican
- Ministry of Health, Okmeydani Educational and Research Hospital, Department of Biochemistry, Okmeydani-Istanbul, Turkey
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Amoura Z, Guillaume M, Caillat-Zucman S, Wechsler B, Piette JC. Physiopathologie de la maladie de Behçet. Rev Med Interne 2006; 27:843-53. [PMID: 16828934 DOI: 10.1016/j.revmed.2006.02.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2006] [Accepted: 02/22/2006] [Indexed: 12/27/2022]
Abstract
SUBJECT Pathophysiology of Behçet's disease (BD) is complex. Recent experimental data shed new light on the mechanisms leading to organ lesions. MAIN ISSUES Neutrophils and cytotoxic lymphocytes are now recognized as key effector cells in BD. Genetic susceptibility, environmental factors (virus and/or bacterial infections), inflammatory response abnormalities (heat shock proteins, dysregulated NO production) and abnormal immune response play also a major role in BD pathogeny. PERSPECTIVES Better understanding of the BD pathophysiology will allow the development of new therapies more specific of BD.
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Affiliation(s)
- Z Amoura
- Centre national de référence maladies rares, service de médecine interne, hôpital Pitié-Salpêtrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France.
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Caramaschi P, Volpe A, Canestrini S, Bambara LM, Faccini G, Carletto A, Biasi D. Correlation between homocysteine plasma levels and nailfold videocapillaroscopic patterns in systemic sclerosis. Clin Rheumatol 2006; 26:902-7. [PMID: 17047894 DOI: 10.1007/s10067-006-0425-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2006] [Revised: 07/26/2006] [Accepted: 08/14/2006] [Indexed: 10/24/2022]
Abstract
The aim of the study is to investigate the relationship between microangiopathy as assessed by nailfold videocapillaroscopy (NVC) and plasma level of homocysteine (Hcy) in systemic sclerosis (SSc). As known, Hcy is a nonessential amino acid that interferes with normal properties of a vascular tree. Sixty patients affected by SSc (4 men and 56 women, mean age 54.6) underwent the determination of plasma Hcy level; at the same time, NVC was performed. Hcy level was also determined in 30 sex- and age-matched controls. In patients affected by SSc the plasma Hcy level was significantly higher than in healthy controls (11.8 and 6.5 micromol/l, respectively; p < 0.001). A significant correlation was found between plasma Hcy concentration and the pattern of NVC with a progressive increase from early to active and above all to late pattern (10.7, 11.8, and 17.4 micromol/l, respectively; p < 0.001). Subjects with high Hcy level (i.e., >75th percentile of Hcy level in controls and in patients considered altogether) were mostly represented in the scleroderma patients with late nailfold videocapillaroscopic pattern; the crude odds ratio was 9.0 (significant; 95% CI from 2.1 to 38.8). In conclusion, Hcy plasma level is related to microvascular involvement in patients affected by SSc; the concentration increases with the progression of the nailfold videocapillaroscopic pattern. Hyperhomocysteinemia may represent an aggravating factor among the complex mechanisms involved in scleroderma damage contributing to the injury of endothelium.
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Affiliation(s)
- Paola Caramaschi
- Dipartimento di Medicina Clinica e Sperimentale, Università di Verona, Policlinico GB Rossi, P.le Scuro, Verona, 37134, Italy.
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Aliyazicioglu Y, Ozkaya O, Yakut H, Islek I, Alvur M. Leptin levels in Henoch–Schönlein purpura. Clin Rheumatol 2006; 26:371-5. [PMID: 16816886 DOI: 10.1007/s10067-006-0363-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2005] [Revised: 09/05/2005] [Accepted: 09/09/2005] [Indexed: 10/24/2022]
Abstract
The objective of this paper is to assess the possible role of nitric oxide (NO) and leptin in Henoch-Schönlein purpura (HSP). We investigated the serum leptin and total nitrite levels in 22 children with HSP in the acute phase and after remission and in 20 age- and sex-matched healthy control. Serum leptin levels (nanograms per milliliter; median, min-max) were statistically higher in the acute phase (12.9, 9.1-19.5) than those in the remission phase (6.1, 3.7-10.5, p<0.001) and in the control group (4.9, 3.8-7.5, p<0.001). Also, serum nitrite levels (micromole per liter; median, min-max) were higher in children in the acute phase (45.0, 32.0-60.0) compared to those in remission phase (30.5, 23.0-48.0) and in the control group (29.5, 18.0-38.0) (p<0.001, p<0.001, respectively). There was a positive correlation between serum leptin and total nitrite levels (r=0.65, p<0.001). We have demonstrated that serum leptin and NO levels were increased during the acute phase in children with HSP, and returned to normal levels in remission. We suggest that leptin and NO may have a role in the immunoinflammatory process of HSP, especially in the acute phase. Further studies are needed to clearly establish the roles of leptin and NO in the pathogenesis of HSP.
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Affiliation(s)
- Yuksel Aliyazicioglu
- Department of Biochemistry, Faculty of Medicine, Ondokuz Mayis University, 55139, Samsun, Turkey.
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Yapişlar H, Aydogan S, Borlu M, Ascioglu O. Decreased nitric oxide and increased platelet aggregation levels in patients with Behçet's disease. Thromb Res 2006; 119:461-5. [PMID: 16806408 DOI: 10.1016/j.thromres.2006.02.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2005] [Revised: 02/20/2006] [Accepted: 02/20/2006] [Indexed: 11/19/2022]
Affiliation(s)
- Hande Yapişlar
- Erciyes University, Medical Faculty, Department of Physiology, 38039-Kayseri, Turkey.
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Mungan AG, Can M, Açikgöz S, Eştürk E, Altinyazar C. Lipid peroxidation and homocysteine levels in Behçet's disease. Clin Chem Lab Med 2006; 44:1115-8. [PMID: 16958606 DOI: 10.1515/cclm.2006.191] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
AbstractClin Chem Lab Med 2006;44:1115–8.
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Affiliation(s)
- A Görkem Mungan
- Department of Biochemistry, Karaelmas University, Faculty of Medicine, Zonguldak, Turkey
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Ozkul Y, Evereklioglu C, Borlu M, Taheri S, Calis M, Dündar M, Ilhan O. 5,10-Methylenetetrahydrofolate reductase C677T gene polymorphism in Behcet's patients with or without ocular involvement. Br J Ophthalmol 2005; 89:1634-7. [PMID: 16299146 PMCID: PMC1772966 DOI: 10.1136/bjo.2005.076836] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2005] [Indexed: 12/14/2022]
Abstract
BACKGROUND Increased serum levels of homocysteine (Hcy) have been reported in patients with Behçet's disease (BD) with an established risk factor for vascular involvement. Recently, the authors demonstrated that elevated Hcy levels are associated with ocular involvement in such patients. On the other hand, elevated levels of Hcy can result from genetic errors. Indeed, a mutation in the 5,10-methylenetetrahydrofolate reductase (MTHFR C677T) gene influences Hcy metabolism and, therefore, MTHFR C677T polymorphism provokes hyperhomocysteinaemia. AIM To investigate the possible genetic factor for the elevation of plasma Hcy level in patients with BD by examining gene interaction with the MTHFR C677T polymorphism, a crucial factor of the Hcy metabolism. In addition, the authors aimed to evaluate if there is an association between the C677T polymorphism and the presence of ocular involvement in such patients. METHOD A total of 59 patients with BD (25 men, 34 women) with a mean age of 34.9 years and 42 age and sex matched healthy control subjects (19 men, 23 women; mean age 32.2) were included in this investigation. MTHFR gene polymorphism was investigated by the polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) of a genomic DNA fragment at nucleotide 677 in all subjects in both groups. The genetic equilibrium is assumed for the gene frequencies of the MTHFR polymorphism in both samples. RESULTS The genotype of the MTHFR gene differed between the Behçet's patients and control subjects (TT: 11.9 v 2.4%; CT: 55.9 v 61.9%; CC: 32.2 v 35.7 %). TT homozygous genotype was more frequently in BD patients than the controls, though the difference was not significant (p = 0.063). In BD patients with ocular involvement, however, the frequencies of MTHFR TT homogenetic type (27.8%) were significantly and statistically higher than those in BD patients without ocular involvement (4.9%, p = 0.022, odds ratio = 7.5), or the controls (2.4%, p = 0.003, odds ratio = 20.0). TT homozygous genotype was associated with an increased risk for ocular involvement. CONCLUSION Elevated serum levels of Hcy seem to be a result of C677T polymorphism of the MTHFR gene, with increased TT individuals over CC and CT genotype BD patients. Although no association was shown between the MTHFR reductase C677T polymorphism and the increased risk of oral aphtahe or genital ulcers, a mutation in this gene was associated with an increased risk of ocular involvement, suggesting genetic instability with a potential initiation of Hcy lowering therapy in this patient group.
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Affiliation(s)
- Y Ozkul
- Sivas Cad Cebeci Apt A-Blok, 175/15, TR-38020, Kayseri, Turkey
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