Interleukin-17 in Behçet’s disease: relation with clinical picture and disease activity

Dina S Al-Zifzaf,Doaa M Abdelaziz,Abir N Mokbel

doi:10.4103/1110-161x.155646

Dina S Al-Zifzaf, Doaa M Abdelaziz + Show 1 more

Open Access

https://doi.org/10.4103/1110-161x.155646

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Abstract

Aim The aim of this study was to assess serum levels of interleukin-17 (IL-17) in patients with Behcet's disease (BD) and to evaluate its relation to the clinical picture and disease activity. Patients and methods This case-control study was carried out on 38 patients with BD. A total of 20 age-matched and sex-matched healthy volunteers serving as the control group were also enrolled in this study. All patients were subjected to full history taking, thorough clinical examination, and clinical activity assessment using Behcet's Disease Current Activity Form. Serum IL-17 levels were measured with enzyme-linked immunosorbent assay. Results Serum IL-17 levels were significantly elevated among BD patients. Patients with ocular involvement had higher IL-17 levels compared with those without; however, the difference did not reach statistical significance. Patients with neurological involvement had significantly higher IL-17 levels in their serum compared with those without neurological involvement and controls. Twenty-seven patients had active disease, whereas 11 patients had inactive disease. Serum IL-17 levels were significantly elevated in active BD patients. Patients with and without activity showed highly significant rise in IL-17 levels compared with healthy controls. There was no significant correlation between the amount of corticosteroids or colchicine being used and serum IL-17 levels. Conclusion IL-17 is elevated among BD patients and further increased with activity, ocular affection, and neuroinvolvement. Our findings suggest that IL-17 exerts an important role in the pathogenesis of BD, thus providing a promising target for novel therapy.

Highlights

Behçet’s disease (BD) is a systemic inflammatory disorder
Previous studies have suggested that BD is predominated by a Th1-type immune response, as increased Th1associated cytokines such as interleukin (IL)-12 and tumor necrosis factor (TNF)-α have been documented in BD patients
Th17 cells were linked to the pathogenesis of various human autoimmune and inflammatory diseases, and IL-17 levels are increased in rheumatoid arthritis, psoriasis, multiple sclerosis, and inflammatory bowel disease [3]

Summary

Introduction

Stay in inflammatory tissues longer compared with Th1 cells; they are suggested to be involved in both early neutrophil chemotaxis to tissues and organ-specific autoimmunity [4]. Studies in mice have reported that strategies aimed at suppressing the Th17 cell response were an effective therapeutic approach in experimental autoimmune uveitis [5]. Previous studies have suggested that BD is predominated by a Th1-type immune response, as increased Th1associated cytokines such as interleukin (IL)-12 and tumor necrosis factor (TNF)-α have been documented in BD patients. Studies in mice have reported that strategies aimed at suppressing the Th17 cells were proposed as a major pathogenic subset in patients with BD, as these cells proliferate later and IL-17 (IL-17A) has been described as Th17 cell-derived cytokine and is highly expressed in autoimmune disorders and inflammatory diseases [6]. IL-17 has been known to play a role in inducing the activation of macrophages, fibroblasts, and endothelial cells, and in stimulating these cells to release various mediators such as IL-1, IL-6, IL-8, TNF-α, and granulocyte colony stimulating factor [8]

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