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Velez G, Mahajan VB. Molecular Surgery: Proteomics of a Rare Genetic Disease Gives Insight into Common Causes of Blindness. iScience 2020; 23:101667. [PMID: 33134897 PMCID: PMC7586135 DOI: 10.1016/j.isci.2020.101667] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Rare diseases are an emerging global health priority. Although individually rare, the prevalence of rare "orphan" diseases is high, affecting approximately 300 million people worldwide. Treatments for these conditions are often inadequate, leaving the disease to progress unabated. Here, we review the clinical features and pathophysiology of neovascular inflammatory vitreoretinopathy (NIV), a rare inflammatory retinal disease caused by mutations in the CAPN5 gene. Although the prevalence of NIV is low (1 in 1,000,000 people), the disease mimics more common causes of blindness (e.g. uveitis, retinitis pigmentosa, proliferative diabetic retinopathy, and proliferative vitreoretinopathy) at distinct clinical stages. There is no cure for NIV to date. We highlight how personalized proteomics helped identify potential stage-specific biomarkers and drug targets in liquid vitreous biopsies. The NIV vitreous proteome revealed enrichment of molecular pathways associated with common retinal pathologies and implicated superior targets for therapeutic drug repositioning. In addition, we review our pipeline for collecting, storing, and analyzing ophthalmic surgical samples. This approach can be adapted to treat a variety of rare genetic diseases.
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Affiliation(s)
- Gabriel Velez
- Omics Laboratory, Stanford University, Palo Alto, CA, USA
- Department of Ophthalmology, Byers Eye Institute, Stanford University, Palo Alto, CA 94304, USA
- Medical Scientist Training Program, University of Iowa, Iowa City, IA, USA
| | - Vinit B. Mahajan
- Omics Laboratory, Stanford University, Palo Alto, CA, USA
- Department of Ophthalmology, Byers Eye Institute, Stanford University, Palo Alto, CA 94304, USA
- Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
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Kramer M, Hasanreisoglu M, Weiss S, Kumova D, Schaap-Fogler M, Guntekin-Ergun S, Ozdek S, Gurelik G, Ergün MA, Goldenberg-Cohen N, Cohen Y. Single-Nucleotide Polymorphisms in IL23R-IL12RB2 (rs1495965) Are Highly Prevalent in Patients with Behcet's Uveitis and Vary Between Populations. Ocul Immunol Inflamm 2018; 27:766-773. [PMID: 29792538 DOI: 10.1080/09273948.2018.1467463] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Purpose: To test the frequency of single-nucleotide polymorphisms in the IL-10, IL23R-IL12RB2 genes in patients with Behcet's uveitis. Methods: Blood samples were collected from 89 Israeli and Turkish patients, and from healthy control subjects of different origins. Genomic DNA was extracted from peripheral blood leukocytes and genotyped. Results: The risk allele, A, in rs1800871, of IL-10 gene was highly prevalent in Behcet's uveitis and healthy control samples alike; highest among the Turkish groups. Prevalence of G allele, in rs1495965, in the IL23R-IL12RB2 gene was high in Behcet's uveitis patients, and among healthy Turkish and Israelis of Middle Eastern origin, while lower among the other Israeli control group (77.9%, 78.9%, 27.8%, respectively, P < 0.001). Conclusion: Our findings highlight the differences between populations and may account for the increased prevalence of the disease among Turkish and Israelis of Middle Eastern origin. Further studies are required to map other healthy and affected populations.
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Affiliation(s)
- Michal Kramer
- a Department of Ophthalmology, Rabin Medical Center , Petach Tikva , Israel.,b Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel
| | - Murat Hasanreisoglu
- c Department of Ophthalmology, Gazi University, School of Medicine , Ankara , Turkey
| | - Shirel Weiss
- b Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel.,d The Krieger Eye Research Laboratory, Felsenstein Medical Research Center, Rabin Medical Center , Petach Tikva , Israel
| | - Deniz Kumova
- c Department of Ophthalmology, Gazi University, School of Medicine , Ankara , Turkey
| | | | - Sezen Guntekin-Ergun
- e Department of Medical Genetics, Gazi University, School of Medicine , Ankara , Turkey
| | - Sengul Ozdek
- c Department of Ophthalmology, Gazi University, School of Medicine , Ankara , Turkey
| | - Gokhan Gurelik
- c Department of Ophthalmology, Gazi University, School of Medicine , Ankara , Turkey
| | - Mehmet Ali Ergün
- e Department of Medical Genetics, Gazi University, School of Medicine , Ankara , Turkey
| | - Nitza Goldenberg-Cohen
- f Department of Ophthalmology, Bnei-Zion Medical Center, Rappaport School of Medicine, Technion , Haifa , Israel
| | - Yoram Cohen
- b Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel.,g Department of Obstetrics and Gynecology, Sheba Medical Center , Tel Hashomer , Israel
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Joob B, Wiwanitkit V. Ocular manifestations of sickle cell disease. Taiwan J Ophthalmol 2018; 8:55. [PMID: 29675352 PMCID: PMC5890587 DOI: 10.4103/tjo.tjo_66_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- Beuy Joob
- Sanitation 1 Medical Academic Center, Bangkok, Thailand
| | - Viroj Wiwanitkit
- Department of Tropical Medicine, Hainan Medical University, Hainan Sheng, China
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Yang MM, Wang J, Dong L, Kong DJ, Teng Y, Liu P, Fan JJ, Yu XH. Lack of association of C3 gene with uveitis: additional insights into the genetic profile of uveitis regarding complement pathway genes. Sci Rep 2017; 7:879. [PMID: 28408754 PMCID: PMC5429838 DOI: 10.1038/s41598-017-00833-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Accepted: 03/14/2017] [Indexed: 12/19/2022] Open
Abstract
Uveitis is a devastating ocular disease that causes blindness. Our previous studies have achieved great advancements in depicting the genetic profiles of uveitis regarding complement pathway genes. This study aimed to provide additional insights into this interest by testing the "central" factor of the complement system, C3 gene variants, in two uveitis entities. Eight haplotype-tagging SNPs of C3 gene were genotyped in 141 anterior uveitis (AU), 158 non-infectious intermediate and posterior uveitis (NIPU) and 293 controls. The results showed that none of the tagging SNPs had a significant association with uveitis (P > 0.05), either in the global uveitis or subtypes. Although rs428453 showed a nominal association with NIPU subtype in the recessive model (P = 0.042), the P value could not withstand the Bonferroni correction (P corr > 0.05). Stratification analyses according to HLA-B27 status and correlation analysis still did not find any significant interactions or genetic markers regarding AU. Logistic regression analysis also revealed no gender-related epistatic effects of C3 on uveitis. Two haplotype blocks were defined across the C3 locus but neither of them was significantly associated with uveitis or subtypes. This study shows no significant association of the C3 gene with uveitis, suggesting C3 confers either no or limited risk for uveitis susceptibility.
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Affiliation(s)
- Ming Ming Yang
- Eye Hospital, the First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Jun Wang
- Department of Endocrinology, the First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Li Dong
- Eye Hospital, the First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - De Ju Kong
- Eye Hospital, the First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Yan Teng
- Eye Hospital, the First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Ping Liu
- Eye Hospital, the First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Jiao Jie Fan
- Eye Hospital, the First Affiliated Hospital of Harbin Medical University, Harbin, China.
| | - Xu Hui Yu
- Eye Hospital, the First Affiliated Hospital of Harbin Medical University, Harbin, China.
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Al-Okaily F, Al-Rashidi S, Al-Balawi M, Mustafa M, Arfin M, Al-Asmari A. Genetic Association of HLA-A*26, -A*31, and -B*51 with Behcet's Disease in Saudi Patients. CLINICAL MEDICINE INSIGHTS-ARTHRITIS AND MUSCULOSKELETAL DISORDERS 2016; 9:167-73. [PMID: 27547040 PMCID: PMC4978194 DOI: 10.4137/cmamd.s39879] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/17/2016] [Revised: 06/15/2016] [Accepted: 06/16/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND HLA-B*51 has been universally associated with Behcet’s disease (BD) susceptibility, while different alleles of HLA-A have also been identified as independent BD susceptibility loci in various ethnic populations. The objective of this study was to investigate associations of HLA-A and -B alleles with BD in Saudi patients. MATERIALS AND METHODS Genotyping for HLA-A and HLA-B was performed using HLA genotyping kit (Lab type(R) SSO) in 120 Saudi subjects, including 60 BD patients and 60 matched healthy controls. RESULTS Our results revealed that frequencies of HLA-A*26, -A*31, and -B*51 were significantly higher in BD patients than in controls, suggesting that HLA-A*26, -A*31, and -B*51 are associated with BD. The frequency of HLA-B*15 was significantly lower in BD patients than in controls. Stratification of genotyping results into active and nonactive forms of BD revealed that the frequency of HLA-A*31 was significantly higher in the nonactive form than in the active form of BD, while there was no significant difference in the distribution of other alleles between the two forms of BD. CONCLUSION This study suggests that HLA-A*26, -A*31, and -B*51 are associated with susceptibility risk to BD, while HLA-B*15 may be protective in Saudi patients. However, larger scale studies are needed to confirm these findings.
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Affiliation(s)
- Fahda Al-Okaily
- Department of Rheumatology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Seham Al-Rashidi
- Department of Rheumatology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Maysoon Al-Balawi
- Department of Rheumatology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Md Mustafa
- Research Centre, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Misbahul Arfin
- Research Centre, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
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Huang XF, Lin D, Lin KH, Lee SH, Xia X, Yang YM, Zhu XF, Wang YL, Dai ML, Wang QF, Jin ZB, Wang Y. Genotype-Phenotype Association Study Reveals CFI-Rs13104777 to be a Protective Genetic Marker Against Acute Anterior Uveitis. Ocul Immunol Inflamm 2016; 26:51-56. [PMID: 27380463 DOI: 10.1080/09273948.2016.1178305] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE To investigate the roles of CFI, genotype-phenotype associations were identified in AAU. METHODS A case-control study was conducted in a total of 575 subjects consisting of 279 AAU patients and 296 healthy controls. Genotypic analyses were performed using Sequenom MassARRAY technology. Analyses were stratified to a series of clinical ophthalmic confounding factors. RESULTS A lower frequency of the CFI-rs13104777 C allele was found in the AAU cohort compared with the controls, and, thus, was significantly associated with AAU pathogenesis (p = 0.041, OR = 0.712, 95% CI: 0.513-0.987). Stratified analysis also demonstrated the associations may differ depending on the HLA-B27 status and laterality status. CONCLUSIONS This study has revealed a significant genetic role for CFI-rs13104777 in AAU. This influence may be dependent on human leukocyte antigen (HLA)-B27 and disease laterality. Overall, the results provide evidence for a pathogenic role for CFI in AAU and expand our knowledge on the genetic basis of AAU.
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Affiliation(s)
- Xiu-Feng Huang
- a The Eye Hospital of Wenzhou Medical University, the State Key Laboratory Cultivation Base and Key Laboratory of Vision Science, Ministry of Health , Wenzhou , China
| | - Dan Lin
- a The Eye Hospital of Wenzhou Medical University, the State Key Laboratory Cultivation Base and Key Laboratory of Vision Science, Ministry of Health , Wenzhou , China
| | - Keng-Hung Lin
- b Department of Ophthalmology , Taichung Veterans General Hospital, National Yang-Ming University , Taichung , Taiwan , China
| | - Shi-Huang Lee
- b Department of Ophthalmology , Taichung Veterans General Hospital, National Yang-Ming University , Taichung , Taiwan , China
| | - Xiaoru Xia
- c Department of Rheumatology , The First Affiliated Hospital of Wenzhou Medical University , Wenzhou , China
| | - Yi-Mai Yang
- d Wenzhou People's Hospital, Wenzhou Physical Examination Center
| | - Xue-Fei Zhu
- e Department of Ophthalmology , The First Affiliated Hospital of Soochow University
| | - Yu-Lin Wang
- f The department of ophthalmology , The First Affiliated Hospital of Nanchang University , Nanchang , China
| | - Ma-Li Dai
- a The Eye Hospital of Wenzhou Medical University, the State Key Laboratory Cultivation Base and Key Laboratory of Vision Science, Ministry of Health , Wenzhou , China
| | - Qing-Feng Wang
- a The Eye Hospital of Wenzhou Medical University, the State Key Laboratory Cultivation Base and Key Laboratory of Vision Science, Ministry of Health , Wenzhou , China
| | - Zi-Bing Jin
- a The Eye Hospital of Wenzhou Medical University, the State Key Laboratory Cultivation Base and Key Laboratory of Vision Science, Ministry of Health , Wenzhou , China
| | - Yuqin Wang
- a The Eye Hospital of Wenzhou Medical University, the State Key Laboratory Cultivation Base and Key Laboratory of Vision Science, Ministry of Health , Wenzhou , China
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Germann D, Catarino R, Saiji E, Daikeler T, Petignat P, Vassilakos P. Vulvar intraepithelial neoplasia grade 3 associated with Behçet's disease. BMC Res Notes 2016; 9:172. [PMID: 26983442 PMCID: PMC4794835 DOI: 10.1186/s13104-016-1985-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Accepted: 03/09/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Little information is available regarding the association between vulvar intraepithelial neoplasia grade 3 (VIN3) and Behçet's disease (BD). We report here concomitant VIN3 and genital ulcers in a patient with BD. CASE A 44-year-old Caucasian woman with a history of BD, which had been evolving for 6 years, presented with ulcerated and papillomatous lesions on the vulva. Biopsies revealed a multifocal VIN3 positive for high-risk human papillomavirus (HPV) 33. Multiple biopsies were performed to exclude invasive cancer and VIN3 was treated with laser vaporization. CONCLUSION We report clinical and anatomopathological features of a rare case of multifocal, high-risk, HPV-related VIN3. We also discuss the possible pathogenesis in the context of BD, featuring chronic ulceration and intrinsic or treatment-induced immunosuppression.
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Affiliation(s)
- Daphné Germann
- Department of Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland.
| | - Rosa Catarino
- Department of Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland
| | - Essia Saiji
- Department of Pathology, Geneva University Hospitals, Geneva, Switzerland
| | - Thomas Daikeler
- Department of Rheumatology, Basel University Hospitals, Basel, Switzerland
| | - Patrick Petignat
- Department of Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland
| | - Pierre Vassilakos
- Geneva Foundation for Medical Education and Research, Geneva, Switzerland
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Hafez MM, Al-Harbi NO, Al-Hoshani AR, Al-Hosaini KA, Al Shrari SD, Al Rejaie SS, Sayed-Ahmed MM, Al-Shabanah OA. Hepato-protective effect of rutin via IL-6/STAT3 pathway in CCl4-induced hepatotoxicity in rats. Biol Res 2015; 48:30. [PMID: 26062544 PMCID: PMC4477598 DOI: 10.1186/s40659-015-0022-y] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2014] [Accepted: 06/03/2015] [Indexed: 01/20/2023] Open
Abstract
Background Carbon tetrachloride (CCl4) induces hepatotoxicity in animal models, including the increased blood flow and cytokine accumulation that are characteristic of tissue inflammation. The present study investigates the hepato-protective effect of rutin on CCl4-induced hepatotoxicity in rats. Results Forty male Wistar rats were divided into four groups. Group I (control group) received 1 mL/kg of dimethyl sulfoxide intragastrically and 3 mL/kg olive oil intraperitoneally twice a week for 4 weeks. Group II received 70 mg/kg rutin intragastrically. Groups III and IV received CCl4 (3 mL/kg, 30 % in olive oil) intraperitoneally twice a week for 4 weeks. Group IV received 70 mg/kg rutin intragastrically after 48 h of CCl4 treatment. Liver enzyme levels were determined in all studied groups. Expression of the following genes were monitored with real-time PCR: interleukin-6 (IL-6), dual-specificity protein kinase 5 (MEK5), Fas-associated death domain protein (FADD), epidermal growth factor (EGF), signal transducer and activator of transcription 3 (STAT3), Janus kinase (JAK), B-cell lymphoma 2 (Bcl2) and B-cell lymphoma-extra-large (Bcl-XL). The CCl4 groups showed significant increases in biochemical markers of hepatotoxicity and up-regulation of expression levels of IL-6, Bcl-XL, MEK5, FADD, EGF, STAT3 and JAK compared with the control group. However, CCl4 administration resulted in significant down-regulation of Bcl2 expression compared with the control group. Interestingly, rutin supplementation completely reversed the biochemical markers of hepatotoxicity and the gene expression alterations induced by CCl4. Conclusion CCl4 administration causes alteration in expression of IL-6/STAT3 pathway genes, resulting in hepatotoxicity. Rutin protects against CCl4-induced hepatotoxicity by reversing these expression changes.
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Affiliation(s)
- Mohamed M Hafez
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, P.O. Box 2457, Riyadh, 11451, Kingdom of Saudi Arabia.
| | - Naif O Al-Harbi
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, P.O. Box 2457, Riyadh, 11451, Kingdom of Saudi Arabia.
| | - Ali Rashed Al-Hoshani
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, P.O. Box 2457, Riyadh, 11451, Kingdom of Saudi Arabia.
| | - Khaled A Al-Hosaini
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, P.O. Box 2457, Riyadh, 11451, Kingdom of Saudi Arabia.
| | - Shakir D Al Shrari
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, P.O. Box 2457, Riyadh, 11451, Kingdom of Saudi Arabia.
| | - Salim S Al Rejaie
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, P.O. Box 2457, Riyadh, 11451, Kingdom of Saudi Arabia.
| | - Mohamed M Sayed-Ahmed
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, P.O. Box 2457, Riyadh, 11451, Kingdom of Saudi Arabia.
| | - Othman A Al-Shabanah
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, P.O. Box 2457, Riyadh, 11451, Kingdom of Saudi Arabia.
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Immunopathogenesis of ocular Behçet's disease. J Immunol Res 2014; 2014:653539. [PMID: 25061613 PMCID: PMC4100451 DOI: 10.1155/2014/653539] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Accepted: 06/10/2014] [Indexed: 12/12/2022] Open
Abstract
Behçet's disease (BD) is a chronic recurrent systemic inflammatory disorder of unknown etiology characterized by oral and genital ulcerations, skin lesions, and uveitis. The ocular involvement of BD, or Behçet's uveitis (BU), is characterized by panuveitis or posterior uveitis with occlusive retinal vasculitis and tends to be more recurrent and sight threatening than other endogenous autoimmune uveitides, despite aggressive immunosuppression. Although pathogenesis of BD is unclear, researches have revealed that immunological aberrations may be the cornerstone of BD development. General hypothesis of BD pathogenesis is that inflammatory response is initiated by infectious agents or autoantigens in patients with predisposing genetic factors and perpetuated by both innate and acquired immunity. In addition, a network of immune mediators plays a substantial role in the inflammatory cascade. Recently, we found that the immunopathogenesis of BU is distinct from other autoimmune uveitides regarding intraocular effector cell profiles, maturation markers of dendritic cells, and the cytokine/chemokine environment. In addition, accumulating evidence indicates the involvement of Th17 cells in BD and BU. Recent studies on genetics and biologics therapies in refractory BU also support the immunological association with the pathogenesis of BU. In this review, we provide an overview of novel findings regarding the immunopathogenesis of BU.
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Chung YR, Lee ES, Kim MH, Lew HM, Song JH. Changes in Ocular Manifestations of Behçet Disease in Korean Patients over Time: A Single-center Experience in the 1990s and 2000s. Ocul Immunol Inflamm 2014; 23:157-61. [PMID: 24867632 DOI: 10.3109/09273948.2014.918154] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To analyze chronological changes in ocular manifestations of Behçet's disease (BD) in Korean patients. METHODS Ocular findings were retrospectively analyzed from medical records of patients diagnosed with BD between 1994 and 2010 and divided into two groups according to the date of their first visit to our ophthalmology department. Group A began care between 1994 and 2000, and Group B between 2004 and 2010. RESULTS Fifty-six patients (83 eyes) were included in analyses. There was a significant decrease in the number of complete BD cases in Group B compared to Group A, and fewer patients had genital lesions in Group B. Mean visual acuity was better, and more patients had good vision in Group B than in Group A at the one and two year follow-up. CONCLUSIONS The severity of BD has decreased over the past two decades, allowing BD patients with ocular involvement to have better visual prognoses.
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Affiliation(s)
- Yoo-Ri Chung
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine , Seoul , Korea
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Lee RW, Nicholson LB, Sen HN, Chan CC, Wei L, Nussenblatt RB, Dick AD. Autoimmune and autoinflammatory mechanisms in uveitis. Semin Immunopathol 2014; 36:581-94. [PMID: 24858699 PMCID: PMC4186974 DOI: 10.1007/s00281-014-0433-9] [Citation(s) in RCA: 98] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Accepted: 04/13/2014] [Indexed: 12/12/2022]
Abstract
The eye, as currently viewed, is neither immunologically ignorant nor sequestered from the systemic environment. The eye utilises distinct immunoregulatory mechanisms to preserve tissue and cellular function in the face of immune-mediated insult; clinically, inflammation following such an insult is termed uveitis. The intra-ocular inflammation in uveitis may be clinically obvious as a result of infection (e.g. toxoplasma, herpes), but in the main infection, if any, remains covert. We now recognise that healthy tissues including the retina have regulatory mechanisms imparted by control of myeloid cells through receptors (e.g. CD200R) and soluble inhibitory factors (e.g. alpha-MSH), regulation of the blood retinal barrier, and active immune surveillance. Once homoeostasis has been disrupted and inflammation ensues, the mechanisms to regulate inflammation, including T cell apoptosis, generation of Treg cells, and myeloid cell suppression in situ, are less successful. Why inflammation becomes persistent remains unknown, but extrapolating from animal models, possibilities include differential trafficking of T cells from the retina, residency of CD8+ T cells, and alterations of myeloid cell phenotype and function. Translating lessons learned from animal models to humans has been helped by system biology approaches and informatics, which suggest that diseased animals and people share similar changes in T cell phenotypes and monocyte function to date. Together the data infer a possible cryptic infectious drive in uveitis that unlocks and drives persistent autoimmune responses, or promotes further innate immune responses. Thus there may be many mechanisms in common with those observed in autoinflammatory disorders.
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Affiliation(s)
- Richard W Lee
- National Institute for Health Research Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, University Hospitals Bristol NHS, Foundation Trust, and University of Bristol, Bristol, UK
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12
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Hamzaoui K, Hamzaoui A. Immunological responses in patients with Behçet’s disease: advances in understanding. EXPERT REVIEW OF OPHTHALMOLOGY 2014. [DOI: 10.1586/eop.12.30] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Kronborg C, Mahar PD, Kelly R. Should we keep changing the diagnostic criteria for Behçet's disease? Dermatology 2013; 228:1-4. [PMID: 24280894 DOI: 10.1159/000355481] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Accepted: 09/02/2013] [Indexed: 11/19/2022] Open
Abstract
In medicine, clinical acumen is used to achieve diagnosis, guide management and prevent disease. While for some diseases, diagnosis is reached with the assistance of objective tests, many conditions rely upon the use of clinical diagnostic criteria; Behçet's disease is one such case. In order to remain clinically relevant, as knowledge of a condition changes over time so too must its diagnostic criteria. Preferably, when new criteria for a disease are conceptualised it is through sound methodology, followed by a confirmation of accuracy by way of systematic validation and response to treatment. The most recently proposed revised International Criteria for Behçet's Disease for the diagnosis of Behçet's disease have been systematically validated and should replace the use of the clinically inferior International Study Group criteria, while not displacing the role of clinical judgement. Effort should now be invested in acquiring better understanding of the pathogenesis of the disease in the hope of developing a more objective test.
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Affiliation(s)
- Caroline Kronborg
- Department of Medicine, The Alfred Hospital, Alfred Health, Melbourne, Vic., Australia
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14
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Kiss E, Dohán J, Németh J, Poór G. Behcet’s disease: a hardly diagnosed orphan disorder. Orv Hetil 2013; 154:93-101. [DOI: 10.1556/oh.2013.29528] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Behcet’s disease is a multisystem autoimmune disease with variable clinial manifestations. The diagnosis may pose a difficult challenge for the clinician, who has to be familiar with the wide spectrum and combination of the symptoms of Behcet’s disease. It is considered a rare disease in Hungary, and there are only few reports on Behcet’s disease in the Hungarian literature. However, the past history of Hungary, the worldwide growing incidence of the disease, and the authors’ experience raise the possibility that the occurrence of the disease is higher than previously thought. In this review the authors present and discuss literature data on the pathogenesis and pathomechanism, as well as their own experience concerning the symptomatology of Behcet’s disease in order to promote diagnosis and offer adequate therapy for the patients. The authors presume that the importance of the disease is underestimated in Hungary due to a considerable number of unrecognized cases and they propose to establish a national registry for Behcets disease. Orv. Hetil., 2013, 154, 93–101.
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Affiliation(s)
- Emese Kiss
- Országos Reumatológiai és Fizioterápiás Intézet Budapest Frankel Leó út 38–40. 1023
- Semmelweis Egyetem, Általános Orvostudományi Kar III. Belklinika, II. Reumatológiai Tanszéki Csoport (ORFI) Budapest
| | - Judit Dohán
- Semmelweis Egyetem, Általános Orvostudományi Kar Szemészeti Klinika Budapest Tömő u. 25–29. 1083
| | - János Németh
- Semmelweis Egyetem, Általános Orvostudományi Kar Szemészeti Klinika Budapest Tömő u. 25–29. 1083
| | - Gyula Poór
- Országos Reumatológiai és Fizioterápiás Intézet Budapest Frankel Leó út 38–40. 1023
- Semmelweis Egyetem, Általános Orvostudományi Kar III. Belklinika, II. Reumatológiai Tanszéki Csoport (ORFI) Budapest
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Hou S, Xiao X, Zhou Y, Zhu X, Li F, Kijlstra A, Yang P. Genetic variant on PDGFRL associated with Behçet disease in Chinese Han populations. Hum Mutat 2012; 34:74-8. [PMID: 22926996 DOI: 10.1002/humu.22208] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2012] [Accepted: 08/14/2012] [Indexed: 11/08/2022]
Abstract
Behçet disease is a complex multisystem disorder. This study aimed to explore the predisposition of PDGFRL at the 8p21.3 locus with Behçet disease and its expression level for different genotypes. A two-stage association study was performed in 719 patients and 1,820 controls for 26 tagSNPs in the PDGFRL gene. Real-time PCR and Bonferroni correction were performed. The first-stage study showed that SNP rs17633132 was associated with Behçet disease (Pc = 5.20 × 10(-3)). Replication and combined studies showed consistent association for rs17633132 T allele and TT genotype (replication: Pc = 3.90 × 10(-4) and 5.70 × 10(-3); combined: Pc = 2.05 × 10(-6) and 3.20 × 10(-4)). No haplotype in PDGFRL was associated with Behçet disease. The expression of PDGFRL in skin from rs17633132 CC genotype individuals was increased compared to that in those with the CT or TT genotype (P = 0.028, P = 0.032, respectively). This study identified a Behçet-disease-associated gene, PDGFRL, and suggests its involvement of Behçet disease by modulating its transcription.
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Affiliation(s)
- Shengping Hou
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Eye Institute, Chongqing and Chongqing Key Laboratory of Ophthalmology, Chongqing, PR China
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16
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Liu B, Sen HN, Nussenblatt R. Susceptibility Genes and Pharmacogenetics in Ocular Inflammatory Disorders. Ocul Immunol Inflamm 2012; 20:315-23. [DOI: 10.3109/09273948.2012.710706] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Willermain F, Rosenbaum JT, Bodaghi B, Rosenzweig HL, Childers S, Behrend T, Wildner G, Dick AD. Interplay between innate and adaptive immunity in the development of non-infectious uveitis. Prog Retin Eye Res 2012; 31:182-94. [PMID: 22120610 PMCID: PMC3288447 DOI: 10.1016/j.preteyeres.2011.11.004] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2011] [Revised: 11/10/2011] [Accepted: 11/11/2011] [Indexed: 12/14/2022]
Abstract
In vertebrates, the innate and adaptive immune systems have evolved seamlessly to protect the host by rapidly responding to danger signals, eliminating pathogens and creating immunological memory as well as immunological tolerance to self. The innate immune system harnesses receptors that recognize conserved pathogen patterns and alongside the more specific recognition systems and memory of adaptive immunity, their interplay is evidenced by respective roles during generation and regulation of immune responses. The hallmark of adaptive immunity which requires engagement of innate immunity is an ability to discriminate between self and non-self (and eventually between pathogen and symbiont) as well as peripheral control mechanisms maintaining immunological health and appropriate responses. Loss of control mechanisms and/or regulation of either the adaptive or the innate immune system lead to autoimmunity and autoinflammation respectively. Although autoimmune pathways have been largely studied to date in the context of development of non-infectious intraocular inflammation, the recruitment and activation of innate immunity is required for full expression of the varied phenotypes of non-infectious uveitis. Since autoimmunity and autoinflammation implicate different molecular pathways, even though some convergence occurs, increasing our understanding of their respective roles in the development of uveitis will highlight treatment targets and influence our understanding of immune mechanisms operative in other retinal diseases. Herein, we extrapolate from the basic mechanisms of activation and control of innate and adaptive immunity to how autoinflammatory and autoimmune pathways contribute to disease development in non-infectious uveitis patients.
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Affiliation(s)
- François Willermain
- Department of Ophthalmology, CHU St-Pierre and Brugmann, Université Libre de Bruxelles, Belgium.
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Abstract
Behçet's disease is a chronic relapsing multisystemic inflammatory disorder characterized by four major symptoms (oral aphthous ulcers, genital ulcers, skin lesions, and ocular lesions) and occasionally by five minor symptoms (arthritis, gastrointestinal ulcers, epididymitis, vascular lesions, and central nervous system symptoms). Although the etiology of Behçet's disease is still unknown, there have been recent advances in immunopathogenic studies, genome-wide association studies, animal models, diagnostic markers, and new biological agents. These advances have improved the clinical understanding of Behçet's disease and have enabled us to develop new treatment strategies for this intractable disease, which remains one of the leading causes of blindness.
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Affiliation(s)
- Sung Bin Cho
- Department of Dermatology and Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Suhyun Cho
- Department of Dermatology and Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Dongsik Bang
- Department of Dermatology and Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea
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