Regarding neutrophil and lymphocyte responses to oralStreptococcusin Adamantiades–Behçet's disease

Abstract

Dear Editor, I read the recent study of Kurauchi et al. entitled ‘Neutrophil and lymphocyte responses to oral Streptococcus in Adamantiades–Behcet's disease’ ( FEMS Immunol Med Microbiol 43: 125–131) with great interest. The authors evaluated neutrophil reactions and cytokine production levels by lymphocytes after stimulation with Streptococcus sanguinis strain BD113-20 using a chemiluminescence assay associated with the measurements of Th1 and Th2 cytokines such as gamma interferon (IFN-γ), interleukin-4 (IL-4), IL-8, IL-10 and IL-12 by ELISA. They showed that neutrophils of Behcet patients activated by this strain increased IFN-γ production by lymphocytes and lymphocytes with a dominant Th1 immune response, indicating both bacterial stimulation and host hypersensitivity in the symptoms and pathogenesis of the disease. However, I have five vital queries to the authors to be answered, four from scientific points of view and another crucial one from a historical perspective. First, the authors stated that they included 19 patients with Behcet disease aged 32–79 years with a mean age of 55.8. The ‘disease burden’ period, however, typically occurs between the second and fourth decade of life with frequent attacks with active disease (Evereklioglu et al. , 2000, 2002a, b 2005, c, 2002) that generally ‘burns out’ during the subsequent years; the frequency of oral attack lengthens and the occurrence of Behcet symptoms stabilizes (Evereklioglu, 2004, 2005). In other words, many Behcet patients are in their latent period during the fifth, sixth or seventh decades of life. Ageing, on the other hand, is characterized by a declining ability of the individual to adapt to environmental stress, with a decreased immune function and decrease in circulating T lymphocytes in the elderly when compared with younger persons (Ptak & Szczepanik, 1998). Furthermore, T lymphocytes respond more weakly to mitogens and produce lower level of cytokines with an increase of …