Universite des Sciences et de la Technologie Houari Boumediene, Algiers, Algeria.
Service de Medecine Interne, Hopital Dr Md Seghir NEKKACHE, Algiers, Algeria.
Inflammopharmacology. 2018 Jun;26(3):725-735. doi: 10.1007/s10787-018-0472-2. Epub 2018 Mar 29.
Behçet's disease (BD) is a chronic multisystemic inflammatory disease with complex etiopathogenesis. Th1-proinflammatory cytokines seem to be involved in its pathogenesis. Our current study aims to evaluate interleukin-18 (IL-18) and nitric oxide (NO) involvement in the development of different clinical manifestations of BD as well as to investigate the corticosteroid therapy effect on this production in Algerian patients.
For this purpose, we evaluated in vivo and ex vivo IL-18, interferon-γ (IFN-γ) levels using ELISA and NO production by the Griess' method in naïve-active and corticosteroid-treated BD patients with different clinical manifestations. Additionally, we assessed CD40/CD40L expression by flow cytometrics assay in these groups of patients.
Our results indicate that IL-18 and nitrite levels were higher in naïve-active BD patients. Interestingly, this high production differed according to the clinical manifestations and was associated with an increased risk of mucocutaneous and vascular involvement. Concerning corticosteroid treated-active BD patients, no difference was observed in this production between each clinical subgroup. However, IFN-γ levels increased in all categories of active patients. Interestingly, corticosteroid therapy reduced significantly these inflammatory mediators regardless of the clinical manifestations studied. In addition, the CD40/CD40L expression differed according to the clinical presentations.
Collectively, our results suggest that concomitant high production of IL-18 and NO in naïve-active BD patients is related to an increased risk of mucocutaneous lesions and vascular involvement. Moreover, the relationship between these two inflammatory markers could constitute a predictable tool of BD clinical presentations and an early factor of therapy efficiency.
白塞病（BD）是一种慢性多系统炎症性疾病，具有复杂的发病机制。Th1 促炎细胞因子似乎参与其发病机制。我们目前的研究旨在评估白细胞介素-18（IL-18）和一氧化氮（NO）在 BD 不同临床表现的发展中的作用，并研究皮质类固醇治疗对阿尔及利亚患者这种产生的影响。
为此，我们使用 ELISA 评估了初发活跃和皮质类固醇治疗的 BD 患者体内和体外的 IL-18、干扰素-γ（IFN-γ）水平，以及通过格里斯法评估了 NO 的产生。此外，我们通过流式细胞术评估了这些患者群体中 CD40/CD40L 的表达。
我们的结果表明，初发活跃的 BD 患者的 IL-18 和亚硝酸盐水平较高。有趣的是，这种高产量因临床表现而异，并与黏膜皮肤和血管受累的风险增加有关。关于皮质类固醇治疗活跃的 BD 患者，在每个临床亚组中，这种产生没有差异。然而，IFN-γ水平在所有活跃患者类别中均增加。有趣的是，皮质类固醇治疗显著降低了这些炎症介质，无论研究的临床表现如何。此外，CD40/CD40L 的表达因临床表现而异。
总的来说，我们的结果表明，初发活跃的 BD 患者同时产生大量的 IL-18 和 NO 与黏膜皮肤损伤和血管受累的风险增加有关。此外，这两种炎症标志物之间的关系可能构成 BD 临床表现的可预测工具和治疗效果的早期因素。
