Serum Vitamin B12, Homocysteine and Methylmalonic Acid Levels in Patients With Parenchymal Neuro-Behçet’s Syndrome

Bıtık, Berivan; Tufan, Abdurrahman; Elbeğ, Şehri; Mercan, Rıdvan; Küçük, Hamit; Küçükşahin, Orhan; Öztürk, Mehmet Akif; Haznedaroğlu, Şeminur; Göker, Berna

doi:10.5606/archrheumatol.2017.6070

Cited by 4 publications

(4 citation statements)

References 24 publications

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“…The initial database search yielded 184 entries plus another 2 found on Google; following the screening and exclusion processes indicated in Fig. 1 , we identified 53 studies (52 full papers and one abstract) 6 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 examining the relationship between HC and BD (48 case–control and 5 cohort studies) that were included in our systematic review and meta-analysis ( Table 1 ). Of the 48 case–control studies, one did not report the mean ages of participants 22 and another did not report gender data (both full papers), 31 whereas a third (in abstract form only) did not report the mean ages and the gender data 40 : two missing data each for mean age of participants and for male/female ratio (4.1%) are unlikely to compromise the results of the sensitivity analysis; of the five cohort studies one did not report the mean age of participants.…”

Section: Resultsmentioning

confidence: 99%

“…Twenty articles explored the relationship between HC and any vascular involvement; however, two studies were excluded at this stage: one dealt with venous incompetence only 58 and the other dealt with neuro-BD, with only five VTs in the latter group. 56 Hence, we pooled data from 18 studies comprising 927 BD participants without and 423 with vascular involvement: the effect size favored vascular involvement ( p < 0.0001) with wide heterogeneity ( I 2 = 89.7%, p < 0.0001) ( Fig. 4A ).…”

Section: Resultsmentioning

confidence: 99%

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Plasma Homocysteine in Behcet's Disease: A Systematic Review and Meta-Analysis

et al. 2022

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Aim To evaluate the relevance of plasma homocysteine (HC) in Behcet's disease (BD) and its clinical manifestations. Methods Systematic review of EMBASE and PubMed databases according to PRISMA guidelines from inception to July 2021; random-effects meta-analyses for continuous outcomes. Results The search strategy retrieved 48 case–control (2,669 BD and 2,245 control participants) and 5 cohort studies (708 BD participants). Plasma HC was higher in BD than in controls (p < 0.0001) with wide heterogeneity (I2 = 89.7%) that remained unchanged after sensitivity analysis according to year of article publication, age of BD participants, study size, study quality, method of HC determination, and male/female ratio >1.5; some pooled ethnicities explained a small part of the heterogeneity (I2 = 16.3%). Active BD participants had higher HC than inactive ones (p < 0.0001), with moderate heterogeneity (I2 = 49.2%) that disappeared after removal of an outlier study with very high disease activity. BD participants with any vascular involvement had higher HC than those without (p < 0.0001) with wide heterogeneity (I2 = 89.7%); subgroup analysis on venous thrombosis only changed neither effect size (p < 0.0001) nor heterogeneity (I2 = 72.7%). BD participants with ocular involvement had higher HC than those without (p < 0.0001) with moderate heterogeneity (I2 = 40.3%). Conclusion Although causality cannot be inferred, the consistency of the elevation of plasma HC in BD, particularly in patients with active disease, with vascular and ocular involvement suggests an intrinsic involvement of HC in these clinical manifestations.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Plasma Homocysteine in Behcet's Disease: A Systematic Review and Meta-Analysis

et al. 2022

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“…We can see a clear positive correlation between BU and both arthralgia and parenchymal neurological involvement. On the other hand, there is an opposite association when it comes to genital ulcers, gastrointestinal symptoms, and other systemic symptoms [30][31][32][33]. These complex interactions highlight the need for further investigation to better understand the multifaceted pathogenesis of BD.…”

Section: Epidemiologymentioning

confidence: 99%

Decoding Behcet’s Uveitis: an In-depth review of pathogenesis and therapeutic advances

Guan,

Li,

et al. 2024

J Neuroinflammation

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Behcet’s disease (BD) is a rare but globally distributed vasculitis that primarily affects populations in the Mediterranean and Asian regions. Behcet’s uveitis (BU) is a common manifestation of BD, occurring in over two-thirds of the patients. BU is characterized by bilateral, chronic, recurrent, non-granulomatous uveitis in association with complications such as retinal ischemia and atrophy, optic atrophy, macular ischemia, macular edema, and further neovascular complications (vitreous hemorrhage, neovascular glaucoma). Although the etiology and pathogenesis of BU remain unclear, numerous studies reveal that genetic factors (such as HLA-B51), dysregulated immune responses of both the innate and adaptive immune systems, infections (such as streptococcus), and environmental factors (such as GDP) are all involved in its development. Innate immunity, including hyperactivity of neutrophils and γδT cells and elevated NK1/NK2 ratios, has been shown to play an essential role in this disease. Adaptive immune system disturbance, including homeostatic perturbations, Th1, Th17 overaction, and Treg cell dysfunction, is thought to be involved in BU pathogenesis. Treatment of BU requires a tailored approach based on the location, severity of inflammation, and systemic manifestations. The therapy aims to achieve rapid inflammation suppression, preservation of vision, and prevention of recurrence. Systemic corticosteroids combined with other immunosuppressive agents have been widely used to treat BU, and beneficial effects are observed in most patients. Recently, biologics have been shown to be effective in treating refractory BU cases. Novel therapeutic targets for treating BU include the LCK gene, Th17/Treg balance, JAK pathway inhibition, and cytokines such as IL-17 and RORγt. This article summarizes the recent studies on BU, especially in terms of pathogenesis, diagnostic criteria and classification, auxiliary examination, and treatment options. A better understanding of the significance of microbiome composition, genetic basis, and persistent immune mechanisms, as well as advancements in identifying new biomarkers and implementing objective quantitative detection of BU, may greatly contribute to improving the adequate management of BU patients.

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“…The MTHFR, catalyzing the synthesis of 5-methyltetrahydrofolate, is required for vitamin B12-dependent enzyme methionine synthase and Hcy regulation [ 24 , 25 ]. Vitamin B12 deficiency and Hcy imbalance have been identified to play a role in the pathology of psoriasis [ 26 ], MS [ 27 ], BD [ 28 ], AS [ 29 ], and GD [ 30 ]. Previously, some authors reported that the two genetic variants were risk factors for psoriasis [ 31 ], MS [ 32 ], and GD [ 33 ].…”

Section: Introductionsmentioning

confidence: 99%

Association between Genetic Polymorphisms in Methylenetetrahydrofolate Reductase and Risk of Autoimmune Diseases: A Systematic Review and Meta-Analysis

Peng

et al. 2022

Disease Markers

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Methylenetetrahydrofolate reductase (MTHFR) is a critical rate-limiting enzyme in the homocysteine/methionine metabolism pathway that is implicated in the pathogenesis and progression of autoimmune diseases. Previous association studies have been performed to investigate the effect of polymorphisms in MTHFR on the risk of autoimmune diseases with inconsistent results. Therefore, this meta-analysis was designed to assess the association between the MTHFR 677 C/T and 1298 A/C polymorphisms and the susceptibility to autoimmune diseases. We identified reports by a literature search in the following electronic databases: PubMed, Ovid, Web of science, and China National Knowledge Infrastructure. Statistical analyses of the summary odds ratios (ORs) and 95% confidence intervals (CIs) were done using STATA software. In a recessive genetic model, the MTHFR 677 C/T polymorphism was associated with an increased risk of Behcet’s disease ( OR = 1.97 , 95% CI, 1.31-2.97), multiple sclerosis ( OR = 1.57 , 95% CI, 1.03-2.38), and ankylosing spondylitis ( OR = 2.90 , 95% CI, 1.92-4.38). The MTHFR 1298 A/C polymorphism was associated an increased risk of multiple sclerosis in a heterozygote comparison ( OR = 2.36 , 95% CI, 1.29-4.30) and in a dominant model ( OR = 2.31 , 95% CI, 1.24-4.29). This meta-analysis demonstrated that the MTHFR 677 C/T was a risk factor for Behcet’s disease, multiple sclerosis, and ankylosing spondylitis, and the 1298 A/C was a risk factor for multiple sclerosis.

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Serum Vitamin B12, Homocysteine and Methylmalonic Acid Levels in Patients With Parenchymal Neuro-Behçet’s Syndrome

Cited by 4 publications

References 24 publications

Plasma Homocysteine in Behcet's Disease: A Systematic Review and Meta-Analysis

Plasma Homocysteine in Behcet's Disease: A Systematic Review and Meta-Analysis

Decoding Behcet’s Uveitis: an In-depth review of pathogenesis and therapeutic advances

Association between Genetic Polymorphisms in Methylenetetrahydrofolate Reductase and Risk of Autoimmune Diseases: A Systematic Review and Meta-Analysis

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