Short CommunicationThe MCP-1 Promoter -2518 Polymorphism in Behcet's Disease: Correlation Between Allele Types, MCP-1 Production and Clinical Symptoms among Korean Patients

Introduction. Behcet's disease is multisystemic vasculitis which affects vein and artery blood vessels. Intestinal perforation rarely occurs as clinic manifestation in as litle as 1% of patients. The transverse colon is the most infrequent site of perforation. We presented a patient diagnosed with Behcet's disease who underwent both surgical and conversative treatment due to perforation of the colon. Case report. A 34-year-old patient was admitted to the hospital with fever, aphthous ulcerations on oral mucosa and genitals and bilateral uveitis. On the basis of clinical symptoms and the International Criteria developed in 1990 Behcet's disease was diagnosed. During the next few days the patient developed erythema nodosum, diarrheic syndrome and acute abdominal symptoms due to perforation of the transverse colon. An emergent laparotomy was undertaken involving resection of a perforated segment of the colon, and bipolar colostomy on the left side of abdomen. Following the surgery the patient was treated except for antibiotics with three successive pulse doses of methylprednisolone (500 mg/daily) and cyclophosphamide (15 mg/kg). The treatment was continued by gradual decrease in the close of the corticosteroid (perorally) and by cyclophosphamide first with monthly doses (5 monthly pulse doses of 15 mg/kg cyclophosphoamide), and then with 3-month doses (totally 6 doses) up to totally 12 g. Conclusion. The therapy with pulse doses of methylprednisolone combined with pulse doses of cyclophosphamide was very effective in the reported case with the complex clinical manifestations leading to resolution of gastrointenstinal, ocular and orogenital lesions.

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Features of systemic cytokine production in Behcet's disease associated with uveitis without ocular lesions

Medical Immunology (Russia) ◽

10.15789/1563-0625-fos-2341 ◽

2021 ◽

Vol 23 (5) ◽

pp. 1079-1088

Author(s):

E. S. Sorozhkina ◽

G. I. Krichevskaya ◽

N. V. Balatskaya ◽

I. G. Kulikova ◽

A. E. Andryushin ◽

...

Keyword(s):

Behçet’S Disease ◽

Detection Rate ◽

Behcet’S Disease ◽

Clinical Symptoms ◽

Behçet's Disease ◽

Systemic Disease ◽

Control Group ◽

People Detection ◽

Detection Rates ◽

Behcet's Disease

Behcet's disease (BD) is a systemic disease underlyed by chronic vasculitis. Hyperactivity of innate and adaptive immunity plays important role in its pathogenesis. Uveitis occurs in 30-70% of the patients, often recurring and reducing visual function. The objective of our work was to study the features of systemic production of immune mediators in BD patients, depending on presence and activity of uveitis. 116 BD patients were divided into 3 groups: (1) 41 patients with active uveitis (UA), (2) 64 subjects with uveitis remission (UR), (3) 11 uveitis-free BD patients (WU). Control group (CG) comprised 34 conditionally healthy people. Detection rate (%) and contents (pg/ml) were measured for IL-1β IL-2, IL-4, IL-5, IL-6, IL-12p70, IL-13, IL-18, IFNγ, CCL2/MCP-1, CCL3/MIP-1α, CCL4/MIP-1β, CCL5/RANTES, CCL11/Eotaxin, СXCL1/GRO-α, CXCL8/IL-8, CXCL10/IP-10, CXCL12/SDF-1α, GM-CSF, TNFα in blood serum by means of multiplex analysis using MAGPIX analyzer (Luminex Corp., USA), Procarta Plex “Human Th1/Th2&Chemokine Panel 20 plex” kits (Bioscience, Austria). TGF-P1, TGF-P2 levels were assayed by ELISA-test (“Vfector-Best”). All the BD patients showed high detection rates of CXCL1/GRO-α (but not its level) in comparison with CG. Detection rate and levels of IL-6, IL-8 were increased in 1st and 2nd BD groups, compared to CG. In UR, unlike UA and WU groups, IL-4 was detected more often than in CG. WU patients showed increased detection rate of only CXCL1/GRO -α. When compared with UA, WU patients had lower serum concentrations of IFNγ, MCP-1, IP-10, MIP-1a, SDF-1α, TGF-β1; UR patients also showed decreased serum levels of IL-18, Eotaxin, GRO-α, RANTES, TGF-β2. Our results indicate the importance of angiogenic and proinflammatory chemokines and cytokines in pathogenesis of BD uveitis, as well as imbalanced production of various immunomediators. Higher detection rates and levels of IL-6 and IL-8 in UA and UR patients may result from weak persistent intraocular inflammation, even upon relief of clinical symptoms, thus, probably, requiring therapeutic correction.

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