Heat shock protein family A member 6 combined with clinical characteristics for the differential diagnosis of intestinal Behçet’s disease

Feng, Rui; Chao, Kang; Chen, Shu Ling; Sun, Can Hui; Qiu, Yun; Chen, Bai Li; Mao, Ren; He, Yao; Cao, Qin; Xue, Ling; Zeng, Zhi; Zhang, Sheng Hong; Chen, Min Hu

doi:10.1111/1751-2980.12613

Cited by 9 publications

(8 citation statements)

References 23 publications

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“…Studies found that over half of intestinal BD patients were misdiagnosed as having CD at their first visit. Significant clinical similarities may contribute to the high rate of misdiagnosis (10). Consistent with past experience, there are factors leading to misdiagnosis between intestinal BD and CD.…”

Section: Discussionsupporting

confidence: 62%

“…It is easily misdiagnosed because there are no specific pathological or laboratory markers for the diagnosis of the entity. Several case reports and clinical studies highlighted the difficulties in making this distinction (5,(10)(11)(12)(13). To date, several discriminating endoscopic findings have been reported, including round shape, five or fewer lesions, focal distribution, and absence of aphthous and cobblestone lesions as features supporting the diagnosis of intestinal BD (12).…”

Section: Discussionmentioning

confidence: 99%

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Differentiation between intestinal Behçet’s disease and Crohn’sdisease based on endoscopy

Ye¹

2019

Turk J Med Sci

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Background/aim: Differentiating intestinal Behçet's disease (BD) from Crohn's disease (CD) is highly challenging, as they often mimic each other in terms of clinical manifestations. Endoscopy is an important modality for distinguishing bowel lesions. The study was designed to identify clinical manifestations that are easily confused and to evaluate the efficacy of endoscopy for distinguishing intestinal BD from CD by several overlapping signs. Materials and methods: The data from 111 patients with intestinal BD and 81 patients with CD were retrospectively analyzed. Logistic regression was applied to establish a prediction model based on endoscopic findings for the differential diagnosis. The diagnostic efficacy of endoscopy was verified using the area under the receiver operating characteristic (ROC) curve. Results: Among intestinal BD patients mucocutaneous lesions were the leading clinical manifestations. Gastrointestinal symptoms were common in CD but were rare in intestinal BD (P < 0.001). CD patients with moderate-to-severe activity were more common than intestinal BD patients presenting with equivalent activity (P < 0.05). Independent factors that distinguished intestinal BD from CD were solitary ulcer in the ileocecal area (P < 0.001), perianal abscess (P = 0.049), single segment (P < 0.001), round intestinal ulcer (P = 0.013), intestinal obstruction (P = 0.035), and fistula (P < 0.001). The scores ranged from-2 to 3. The area under the ROC curve was 0.874 (95% CI: 0.823-0.926) (P < 0.001). With a score of 1.5 as the diagnostic cutoff value, the sensitivity and specificity were 76.3% and 80.6%, respectively. Conclusion: Mucosal injuries were rarer in patients with intestinal BD than in those with CD. The differentiation model combining several endoscopy features appeared to be reliable for distinguishing between intestinal BD and CD.

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Section: Discussionsupporting

confidence: 62%

Section: Discussionmentioning

confidence: 99%

Differentiation between intestinal Behçet’s disease and Crohn’sdisease based on endoscopy

Ye¹

2019

Turk J Med Sci

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“…HSPs and lipopolysaccharides (LPS) of microbial agents were frequently noted in the involved organs of BD patients. [27][28][29][30] It is suggested that microorganisms' HSPs and the LPS cross-reaction with human antigens leads to the innate immune activation and inflammatory response. 31,32 TLR4 can be involved in the pathology of BD by recognizing HSPs and LPS.…”

Section: Discussionmentioning

confidence: 99%

“…Microbial agents have a crucial function in the pathology of BD. HSPs and lipopolysaccharides (LPS) of microbial agents were frequently noted in the involved organs of BD patients 27–30 . It is suggested that microorganisms' HSPs and the LPS cross‐reaction with human antigens leads to the innate immune activation and inflammatory response 31,32 .…”

Section: Discussionmentioning

confidence: 99%

Evaluation of DNA methylation status of toll‐like receptors 2 and 4 promoters in Behcet's disease

Kolahi

Rashtchizadeh

Mahdavi

et al. 2020

The Journal of Gene Medicine

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Background: Altered innate immune function plays an important role in the initiation of inflammatory response in Behcet's disease (BD). Toll-like receptors (TLRs) are the master regulators of the innate immune system. Because the role of TLRs remains unknown in the pathogenesis of BD, the present study aimed to evaluate the expression levels and methylation status of the TLR2 and TLR4 promoters in patients with BD. Methods: In the present study, Iranian Azeri BD patients (n = 47) with an active (n = 22) and inactive (n = 25) period, and healthy controls (n = 61), were matched according to age, sex and ethnicity. TLR2 and TLR4 genes promoter CpG islands were predicted with the Eukaryotic Promoter Database (https://epd.vital-it.ch). Methylated DNA immunoprecipitation (MeDIP) was conducted. Results: The results showed that mRNA of TLR4 was significantly increased in the peripheral blood mononuclear cells (PBMCs) of BD patients with an active phase compared to the control group. Differences in mRNA of TLR4 between the inactive BD and control groups were not significant. Differences in TLR2 mRNA levels in the PBMCs of the active and inactive phase BD and control groups were not significant. The methylation rate of TLR4 gene promoter was significantly lower in the active and inactive BD groups compared to the control group. The difference between the active and inactive BD groups was not significant. There was no significant difference in the methylation rates of the TLR2 gene between studied groups. Conclusions: Our preliminary findings suggest that the hypomethylation of TLR4 gene may be involved in the pathogenesis of BD via increasing TLR4 expression.

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“…There was no correlation between HSPA6 expression levels and oral ulcers, genital ulcers, or disease activity among Crohn’s disease patients. 65 Additionally, Lee et al 66 found increased HSP27 and decreased HSP60 protein expression levels in 17 BS patients compared to 17 healthy controls, using two-dimensional (2D) electrophoresis and MALDI-TOF/TOF MS methods.…”

Section: Heat Shock Proteins In Behçet Syndromementioning

confidence: 99%

Heat Shock Proteins in Behçet Syndrome

Aydın¹,

Hatemi²

2023

Balkan Med J

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Behçet syndrome (BS) is a systemic vasculitis of unknown etiology that affects the skin, mucosa, joints, eyes, central nervous system, gastrointestinal system, arteries, and veins. It is generally believed to have a complex genetic background where both innate and adaptive immune systems are activated through environmental factors, such as infections, and auto-antigens. Heat shock proteins (HSPs) are highly conserved and immunogenic endogenous proteins that are thought to play both an enhancing and regulating role in several autoimmune and inflammatory diseases, such as rheumatoid arthritis, juvenile idiopathic arthritis, and Type I diabetes. There is evidence supporting the role of various microorganisms in BS, which may be using a common pathway to trigger or activate BS through molecular mimicry. The significant homology between microbial and human HSPs suggests that HSPs could serve as a common trigger. This review summarizes the work on the role of HSPs in the pathogenesis of BS. However, it remains unknown whether the HSPs detected in BS lesions play a causative role, their presence is a result of the ongoing inflammation, or they have a protective role against inflammation, as suggested in some other diseases.

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Heat shock protein family A member 6 combined with clinical characteristics for the differential diagnosis of intestinal Behçet’s disease

Abstract: HSPA6 in combination with clinical, radiological and pathological characteristics is useful in distinguishing intestinal BD from CD with ileocolonic involvement.

Cited by 9 publications

References 23 publications

Differentiation between intestinal Behçet’s disease and Crohn’sdisease based on endoscopy

Differentiation between intestinal Behçet’s disease and Crohn’sdisease based on endoscopy

Evaluation of DNA methylation status of toll‐like receptors 2 and 4 promoters in Behcet's disease

Heat Shock Proteins in Behçet Syndrome

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