Homocysteine May Involve in the Pathogenesis of Behcet′s Disease by Inducing Inflammation

Abstract

Objective. Our aim was to evaluate the significance of homocysteine (Hcy) in Behcet's disease (BD) and the association of elevated Hcy levels associated with the indices of inflammation in BD. Methods. Untreated 70 patients with BD and 33 healthy individuals were included into the study. Hcy, tumor necrosis alpha (TNF-α), C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) were evaluated with respect to activity and specific individual clinical manifestations of the disease. Results. Hcy levels were found significantly elevated in active BD when compared to inactive BD and healthy controls. Hcy levels were found to have high correlation with the number of active clinical manifestations increased. A significant positive correlation was found between serum Hcy and TNF-α levels, CRP, and ESR. Hcy was found to be the best predictor of TNF-α among other parameters. Conclusion. Hcy may involve in the pathogenesis of BD by inducing inflammation.

Varicose Vein Surgery in Behçet's Disease

“…6 Finally, from clinical observation in 28 patients as well as our experience in Behçet's disease and venous surgery, it is predictable that superficial vein surgery in patients with superficial venous insufficiency without venous thrombosis might decrease expected venous LEVT as well as leg ulcers in Behçet disease. 1,2,[9][10][11][12][13][14][15][16] Ahmet AKGÜL World Clin J Med Sci 2017;1(2):57-9…”

Venous Thrombosis in Behcet’s Disease

“…Venous involvement, including superficial thromboflebitis and deep venous thrombosis, is a characteristic manifestation. Thrombosis of superficial and deep vein is more frequent than arterial aneurism and thrombotic occlusions (Kartal Durmazlar et al, 2008aHouman et al, 2001;Aksoy et al, 2010). Venous thrombosis appeared to be the major vascular involvement reported in 7 to 33% of cases with BD with a male predominance, and representing 85 to 93% of VBD (Houman et al, 2001).…”

“…Homocysteine (Hcy) is an intermediary sulphydryl-containing aminoacid formed during the conversion of methionine to cysteine. Its sulphydryl group can cause direct endothelial cytotoxicity, inhibition of glutathione peroxidase and nitric oxide, interference with clotting factor, and LDL oxidation (Kartal Durmazlar et al, 2008a. The association between Hcy levels and endothelial dysfunction and its correlation to the degree of endothelial damage have been shown in patients with BD.…”

“…Hcy is thought to induce proinflammatory cytokines. Suggested mechanisms of Hcy in promoting such a clotting cascade are the inactivation of protein C, activation of coagulation factor V, and inhibition of thrombomodulin (Kartal Durmazlar et al, 2008a). The increase in Hcy concentration in patients at risk for vascular disease is expressed as odds ratio and for venous thrombosis, this odds ratio is approximately 1.6.…”

“…Hcy was shown to promote TNF-α mediated induction of vascular cell adhesion molecule-1 (VCAM-1) in endothelial cells (Silverman et al, 2002). Some studies have shown hyperhomocysteinemia as a correctable risk factor for thrombosis in BD (Kartal Durmazlar et al, 2008aOmar et al, 2007;Ozdemir et al, 2004;Er et al, 2002;Sarican et al, 2007). In a recent work, thrombogenesis in BD is discussed through the concept of Virchow's triad of venous thrombosis (La Regina et al, 2010).…”