Influence of corticosteroid therapy on IL-18 and nitric oxide production during Behçet’s disease
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Background and aims
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.
Results and discussion
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.
KeywordsBehçet Interleukin-18 Interferon-γ NO Corticosteroid therapy
The authors thank the patients and the controls. They also express their gratitude to the Department of Immunology and to the staff of the Department of Internal Medicine of Dr Md Seghir NEKKACHE Hospital in Algiers.
This work was supported by grants from National Agency for Research and Development (ATRSS, ex ANDRS), project code number 43-ANDRS-2011 Algeria.
Compliance with ethical standards
Conflict of interest
The author(s) declare that they have no conflicts of interest with regard to the research, authorship, and/or publication of this article.
This manuscript was approved by all co-authors. The local ethics committee “Algerian National Agency for Research in Health Sciences, ATRSS ex-ANDRS” in compliance with Helsinki declaration has approved our study (Code number 43-ANDRS-2011).
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