Hodeib Abeer A, Elsharawy Tarek A, Fawzi Hisham A
Assistant Professor of Dermatology and Venereology, Tanta University, Egypt.
Indian J Dermatol. 2010 Jul-Sep;55(3):215-20. doi: 10.4103/0019-5154.70667.
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.
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.
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.
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.
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.
白塞病（BD）的一些显著特征是由于内皮功能障碍导致的动静脉血栓形成。高同型半胱氨酸血症因血栓形成频率增加而导致血管内皮损伤。内皮素-1（ET-1）是一种血管收缩剂，而一氧化氮（NO）是一种负责抑制血小板黏附的内皮血管舒张肽。
评估血清同型半胱氨酸（Hcy）水平，确定高同型半胱氨酸血症是否被视为BD患者静脉和动脉血栓形成的一个促成危险因素，并将血清ET-1和NO水平与疾病活动度相关联。
我们测量了25例符合BD国际研究组标准的患者的血清Hcy、ET-1和亚硝酸盐（NO₂⁻）水平，并将其与15名健康对照者的水平进行比较。Hcy和ET-1水平采用酶联免疫吸附测定（ELISA）法测量，而血清亚硝酸盐（NO₂⁻）水平采用格里斯反应作为NO生成指标进行测量。所有患者均筛查静脉血栓形成病史，并根据其血栓形成病史分为血栓形成组和非血栓形成组。BD患者根据其临床和实验室检查结果分为活动期和非活动期两个亚组。
与对照组相比，BD患者血清Hcy、ET-1和亚硝酸盐水平显著升高。与非血栓形成亚组相比，血栓形成亚组的血清Hcy水平显著升高。在BD患者中，血清ET-1和亚硝酸盐水平与疾病活动度之间存在正相关。
高同型半胱氨酸血症可能在BD患者静脉和动脉血栓形成的发展中起一定作用。NO生成增加可能具有与疾病活动期病理事件相关的关键生物学活性。
