The role of infections in Behçet disease and neuro-Behçet syndrome

Abstract

Infections are considered an environmental trigger for exacerbations of immune-mediated diseases. We aimed to establish if common viral infections could be identified as a precipitant of Behçet disease (BD) with or without neurological involvement and to assess the variability of the immune response to common viruses. We also investigated whether cytokines and chemokines could be markers of neurological involvement. Finally, we explored if anti-basal ganglia antibodies (ABGAs) would be associated with neurological involvement in BD. Our study included 14 individuals with BD with neurological involvement (neuroBehçet syndrome - NBS), 16 individuals with BD without neurological involvement and 18 healthy controls (HC). Overall we found a tendency for increased levels of anti-viral IgG antibody levels in BD, more evident in NBS patients versus HC. Epstein-Barr viral-capsid antigen IgG titres were increased in NBS patients versus other BD patients (p=0.032). Anti-measles antibody titres induced by vaccination were similarly elevated. ABGAs were not detected in the serum of our cohort. Raised levels of serum IL-8 in some BD patients did not reflect clinical activity or severity. In conclusion, there was evidence for a polyclonal immune activation rather than a specific virus effect in the sera of individuals with BD or NBS.

Proteomics Landscape Mapping of Organ‐Resolved Behçet's Disease Using In‐Depth Plasma Proteomics for Identifying Hyaluronic Binding Protein 2 Expression Associated With Vascular Involvement

“…Several pathogenic infection pathways were identified using KEGG pathway analysis in the study, including Staphylococcus aureus infection, prion disease, pertussis, human papillomavirus infection, herpes simplex virus 1 infection, and viral protein interactions with cytokine and cytokine receptor, highlighting the role of pathogenic infection in BD (Supplementary Figure 8A, available on the Arthritis & Rheumatology website at https://onlinelibrary.wiley.com/doi/10.1002/art.42348) (12–17). The KEGG pathway of Staphylococcus aureus infection involving 13 differentially expressed proteins ( P < 0.05) was significantly enriched (some of them are marked in Supplementary Figure 8B), implicating the role of Staphylococcus aureus infection in the pathogenesis of BD (18,19).…”

Behçet's Disease with Severe Autonomic Disorders Developing after Herpes Zoster

“…Several reports have mentioned a relationship between BD and the Herpesviridae family. It has been reported that the rate of serological positivity for VZV IgG and IgM antibodies does not differ between patients with BD and those with other skin diseases (7); however, another report showed that the VZV IgG titer in BD patients with neurological involvement was higher than that in those without neurological involvement (8). A nationwide population-based study in Taiwan revealed that the risk of anterior uveitis increased in the year following a diagnosis of herpes zoster (9).…”

Radiological Neuro-BehçEt'S Associated with Bipolar Disorder: First Presentation of a Multisystem Disease

“…6 It is postulated that genetic susceptibility combined with an extrinsic trigger factor, such as viral agents, may be responsible for the pathophysiological changes. 1,2,7 Neurological manifestations of BD include central nervous system (CNS) and peripheral nervous system (PNS) involvement. 1,5,8 CNS involvement is broadly categorised into parenchymal and nonparenchymal lesions.…”