Behcet Disease

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Sait Demirkol - One of the best experts on this subject based on the ideXlab platform.

  • neutrophil lymphocyte ratio and carotid intima media thickness in patients with Behcet Disease without cardiovascular involvement
    Angiology, 2015
    Co-Authors: Cengiz Ozturk, Ilknur Balta, Sevket Balta, Sait Demirkol, Turgay Celik, Turker Turker, Atila Iyisoy, Meral Eksioglu
    Abstract:

    Behcet Disease (BD) is associated with endothelial dysfunction and chronic inflammation. The neutrophil–lymphocyte (N/L) ratio and carotid intima–media thickness (cIMT) are markers of inflammation and vascular risk, respectively. We assessed the relationship between cIMT values and N/L ratio in BD (65 patients and 62 control participants). There were statistically significant differences in N/L ratios and cIMT values between the patients with BD and control group (P < .001). There were moderate positive correlations between cIMT value, C-reactive protein, and N/L ratio in patients with BD. Receiver–operating characteristic curve analysis suggested that the optimum N/L ratio cutoff point for patients with BD was 1.29, with a sensitivity, specificity, negative predictive value, and positive predictive value of 97, 77, 96, and 75%, respectively (area under curve: 0.691, 95% confidence interval = 0.600-0.782, P < .001). The N/L ratio may be a useful index of BD activity.

  • mean platelet volume in recurrent aphthous stomatitis and Behcet Disease
    Angiology, 2014
    Co-Authors: Ozlem Ekiz, Ilknur Balta, Emine Nur Rifaioglu, Can Ergin, Sevket Balta, Sait Demirkol
    Abstract:

    Behcet Disease (BD) and recurrent aphthous stomatitis (RAS) are systemic inflammatory Diseases, but the exact pathogenesis of both the Diseases is unknown. Mean platelet volume (MPV) is an indicator of platelet activation. The aim of this study was to investigate the MPV levels in patients with BD, RAS, and healthy participants. A total of 61 patients with BD, 60 patients with RAS, and 60 healthy controls were included in this study. The MPV levels and erythrocyte sedimentation rate in patients with BD and RAS groups were significantly higher than the control groups (P < .001). In the BD group as well as in the RAS group, the Disease activity does not affect the levels of MPV. The MPV levels may be used as a cheap and feasible diagnostic marker in patients with BD and RAS. Nevertheless, the MPV does not have a predictive value in differentiating the diagnosis of BD and RAS.

  • serum endocan levels as a marker of Disease activity in patients with Behcet Disease
    Journal of The American Academy of Dermatology, 2014
    Co-Authors: Ilknur Balta, Sevket Balta, Sait Demirkol, O M Koryurek, Dimitri P Mikhailidis, Turgay Celik, Mustafa Cakar, Ugur Kucuk, Meral Eksioglu, Yasemin Gulcan Kurt
    Abstract:

    Background Endocan is a novel human endothelial cell–specific molecule. The central role of leukocytes and endothelial dysfunction in the development of Behcet Disease (BD) led us to hypothesize that endocan might be a marker of this Disease. Objective We investigated the relationship between serum levels of endocan and Disease activity in patients with BD. Methods In all, 33 patients (16 active, 17 inactive) with BD and 35 healthy persons were included in the study. Endocan and C-reactive protein were measured in all subjects. Results Patients with BD had significantly higher serum endocan levels. Mean serum levels of endocan were 1.29 ± 0.60 ng/mL (range: 0.58-2.99) in patients with BD and 0.75 ± 0.16 ng/mL (range: 0.48-1.21) in control subjects ( P Limitations The main limitation of our study is the relatively small sample size. Conclusions Circulating endocan may be a marker of BD activity.

Carlo Salvarani - One of the best experts on this subject based on the ideXlab platform.

  • higher frequencies of lymphocytes expressing the natural killer group 2d receptor in patients with Behcet Disease
    Frontiers in Immunology, 2018
    Co-Authors: Martina Bonacini, Alessandra Soriano, Alessandro Zerbini, Eleonora Calo, Luca Cimino, Francesco Muratore, Luigi Fontana, Luca Braglia, Maria Parmeggiani, Carlo Salvarani
    Abstract:

    Behcet Disease (BD) is an inflammatory systemic Disease with a fluctuating course, which can affect the skin, eyes, central nervous system, musculoskeletal, gastrointestinal and vascular systems. No laboratory tests are currently available for the diagnosis of BD and monitoring Disease activity. Moreover there is a lack of knowledge on BD pathogenesis. This study focused on circulating Natural Killer (NK), NKT and T cells evaluated as CD3neg CD56pos, CD3pos CD56pos and CD3pos CD56neg. Peripheral blood mononuclear cells (PBMCs) were collected from 38 BD patients and 20 Healthy controls (HC). The frequencies of NK, NKT and T cells expressing CD16, CD69, NKG2D, Nkp30, Nkp46 and NKG2A were assessed by flow cytometry. Cytotoxic potential of NK cells was evaluated by flow cytometry as the percentage of cells expressing the degranulation marker CD107a after incubation with K562 cells. The levels of 27 cytokines were determined in plasma with a multiplex bead-based assay. Higher percentages of NK, NKT and T cells expressing NKG2D were detected in PBMCs of BD patients than HC. ROC curve analysis showed that the evaluation of NKG2Dpos NK, NKT and T cell percentages discriminated between BD patients and HC. Moreover, there was a positive correlation between the BD Current Activity Form (BDCAF) scores and the frequencies of NKG2Dpos NK and NKT cells. A higher frequency of NK cells expressing CD107a was induced in PBMC from BD patients than HC after incubation with K562 cells. Concentrations of IL-5, IL-6, IL-10, IL-13, IP-10 and MIP-1β were higher in plasma of BD patients than HC. Monitoring the frequencies of NKG2Dpos lymphocytes could help the clinicians in BD patients management. In addition, the increased expression of NKG2D in BD patients is likely involved in Disease pathogenesis.

  • Epidemiology of Behçet Syndrome
    Behçet's Syndrome, 2013
    Co-Authors: Olga Addimanda, Giulia Pazzola, Nicolò Pipitone, Carlo Salvarani
    Abstract:

    Behcet Disease (BD) is a systemic inflammatory Disease typically characterized by oral and genital ulcers and variable manifestations affecting other organs, mainly skin and eye. Published epidemiologic studies on BD are difficult to compare because of different study designs, settings, methods and the lack of universally accepted classification criteria: 16 different sets of classification/diagnosis criteria have been published so far; in the beginning of the chapter we compare different criteria subsets with estimates of sensitivity and specificity. After that, we review epidemiologic clinical studies (registries, hospital records, district databases): consistent data point to higher incidence and prevalence rates of BD along the ancient Silk Road (stretching from the Middle Est to the Far East and Mediterranean Countries) compared to a lower prevalence in Northern European Countries and United States genetic and environmental factors have been evaluated as well as age of onset, male-to-female ratio and systems involvement.

  • management of Behcet Disease a systematic literature review for the european league against rheumatism evidence based recommendations for the management of Behcet Disease
    Annals of the Rheumatic Diseases, 2009
    Co-Authors: Gulen Hatemi, A J Silman, Dongsik Bang, B Bodaghi, A M Chamberlain, M H Houman, I Kotter, I Olivieri, Carlo Salvarani, Petros P Sfikakis
    Abstract:

    Objectives: To present and analyse the literature sources regarding the management of Behcet Disease (BD) identified during the systematic literature research, which formed the basis for the European League Against Rheumatism (EULAR) evidence-based recommendations for the management of BD. Methods: Problem areas and related keywords regarding the management of BD were determined by the multidisciplinary expert committee commissioned by EULAR for developing the recommendations. A systematic literature research was performed using MedLine and Cochrane Library resources through to December 2006. Meta-analyses, systematic reviews, randomised controlled trials (RCTs), open studies, observational studies, case control studies and case series’ involving ⩾5 patients were included. For each intervention the effect size and number needed to treat were calculated for efficacy. Odds ratios and numbers needed to harm were calculated for safety issues of different treatment modalities where possible. Results: The literature research yielded 137 articles that met the inclusion criteria; 20 of these were RCTs. There was good evidence supporting the use of azathioprine and ciclosporin A in eye involvement and interferon (IFN)α in mucocutaneous involvement. There were no RCTs with IFNα or tumour necrosis factor (TNF)α antagonists in eye involvement. Similarly controlled data for the management of vascular, gastrointestinal and neurological involvement is lacking. Conclusion: Properly designed, controlled studies (new and confirmatory) are still needed to guide us in managing BD.

  • eular recommendations for the management of Behcet Disease
    Annals of the Rheumatic Diseases, 2008
    Co-Authors: Gulen Hatemi, A J Silman, Dongsik Bang, B Bodaghi, A M Chamberlain, M H Houman, I Kotter, I Olivieri, Carlo Salvarani, Petros P Sfikakis
    Abstract:

    Objectives: To develop evidence-based European League Against Rheumatism (EULAR) recommendations for the management of Behcet Disease (BD) supplemented where necessary by expert opinion. Methods: The multidisciplinary expert committee, a task force of the EULAR Standing Committee for Clinical Affairs (ESCCA), consisted of nine rheumatologists (one who was also a clinical epidemiologist and one also a Rehabilitation Medicine doctor), three ophthalmologists, one internist, one dermatologist and one neurologist, representing six European countries plus Tunisia and Korea. A patient representative was also present. Problem areas and related keywords for systematic literature research were identified. Systematic literature research was performed using Medline and the Cochrane Library databases from 1966 through to December 2006. A total of 40 initial statements were generated based on the systematic literature research. These yielded the final recommendations devel- oped from two blind Delphi rounds of voting. Results: Nine recommendations were developed for the management of different aspects of BD. The strength of each recommendation was determined by the level of evidence and the experts' opinions. The level of agreement for each recommendation was determined using a visual analogue scale for the whole committee and for each individual aspect by the subgroups, who consider themselves experts in that field of BD. There was excellent concordance between the level of agreement of the whole group and the ''experts in the field''. Conclusion: Recommendations related to the eye, skin- mucosa Disease and arthritis are mainly evidence based, but recommendations on vascular Disease, neurological and gastrointestinal involvement are based largely on expert opinion and uncontrolled evidence from open trials and observational studies. The need for further properly designed controlled clinical trials is apparent.

Petros P Sfikakis - One of the best experts on this subject based on the ideXlab platform.

  • management of Behcet Disease a systematic literature review for the european league against rheumatism evidence based recommendations for the management of Behcet Disease
    Annals of the Rheumatic Diseases, 2009
    Co-Authors: Gulen Hatemi, A J Silman, Dongsik Bang, B Bodaghi, A M Chamberlain, M H Houman, I Kotter, I Olivieri, Carlo Salvarani, Petros P Sfikakis
    Abstract:

    Objectives: To present and analyse the literature sources regarding the management of Behcet Disease (BD) identified during the systematic literature research, which formed the basis for the European League Against Rheumatism (EULAR) evidence-based recommendations for the management of BD. Methods: Problem areas and related keywords regarding the management of BD were determined by the multidisciplinary expert committee commissioned by EULAR for developing the recommendations. A systematic literature research was performed using MedLine and Cochrane Library resources through to December 2006. Meta-analyses, systematic reviews, randomised controlled trials (RCTs), open studies, observational studies, case control studies and case series’ involving ⩾5 patients were included. For each intervention the effect size and number needed to treat were calculated for efficacy. Odds ratios and numbers needed to harm were calculated for safety issues of different treatment modalities where possible. Results: The literature research yielded 137 articles that met the inclusion criteria; 20 of these were RCTs. There was good evidence supporting the use of azathioprine and ciclosporin A in eye involvement and interferon (IFN)α in mucocutaneous involvement. There were no RCTs with IFNα or tumour necrosis factor (TNF)α antagonists in eye involvement. Similarly controlled data for the management of vascular, gastrointestinal and neurological involvement is lacking. Conclusion: Properly designed, controlled studies (new and confirmatory) are still needed to guide us in managing BD.

  • eular recommendations for the management of Behcet Disease
    Annals of the Rheumatic Diseases, 2008
    Co-Authors: Gulen Hatemi, A J Silman, Dongsik Bang, B Bodaghi, A M Chamberlain, M H Houman, I Kotter, I Olivieri, Carlo Salvarani, Petros P Sfikakis
    Abstract:

    Objectives: To develop evidence-based European League Against Rheumatism (EULAR) recommendations for the management of Behcet Disease (BD) supplemented where necessary by expert opinion. Methods: The multidisciplinary expert committee, a task force of the EULAR Standing Committee for Clinical Affairs (ESCCA), consisted of nine rheumatologists (one who was also a clinical epidemiologist and one also a Rehabilitation Medicine doctor), three ophthalmologists, one internist, one dermatologist and one neurologist, representing six European countries plus Tunisia and Korea. A patient representative was also present. Problem areas and related keywords for systematic literature research were identified. Systematic literature research was performed using Medline and the Cochrane Library databases from 1966 through to December 2006. A total of 40 initial statements were generated based on the systematic literature research. These yielded the final recommendations devel- oped from two blind Delphi rounds of voting. Results: Nine recommendations were developed for the management of different aspects of BD. The strength of each recommendation was determined by the level of evidence and the experts' opinions. The level of agreement for each recommendation was determined using a visual analogue scale for the whole committee and for each individual aspect by the subgroups, who consider themselves experts in that field of BD. There was excellent concordance between the level of agreement of the whole group and the ''experts in the field''. Conclusion: Recommendations related to the eye, skin- mucosa Disease and arthritis are mainly evidence based, but recommendations on vascular Disease, neurological and gastrointestinal involvement are based largely on expert opinion and uncontrolled evidence from open trials and observational studies. The need for further properly designed controlled clinical trials is apparent.

Alfredo Adan - One of the best experts on this subject based on the ideXlab platform.

  • Behcet Disease associated uveitis successfully treated with golimumab
    Ocular Immunology and Inflammation, 2013
    Co-Authors: Marina Mesquida, M V Hernandez, Victor Llorenc, Laura Pelegrin, Gerard Espinosa, Andrew D Dick, Alfredo Adan
    Abstract:

    AbstractOver the past decade, the off-label use of biologic agents such as TNF-α antagonists, including infliximab and adalimumab, has improved the treatment armamentarium for refractory immune-mediated uveitis, with particular success in Behcet Disease-associated uveitis. Golimumab is a novel fully human anti-TNF-α monoclonal antibody that has been approved for the treatment of rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis, with very promising results. Herein, the authors present the use of GLM in a case of Behcet uveitis refractory to other TNF-α blockers. There are only two reports in the literature about the use of GLM in uveitis, describing four patients with JIA-associated uveitis and a case of idiopathic retinal vasculitis. To the authors’ knowledge, this is the first report about the use of GLM in Behcet uveitis.

Gulen Hatemi - One of the best experts on this subject based on the ideXlab platform.

  • pulmonary artery involvement and associated lung Disease in Behcet Disease a series of 47 patients
    Medicine, 2012
    Co-Authors: Emire Seyahi, Melike Melikoglu, Canan Akman, Vedat Hamuryudan, Harun Ozer, Gulen Hatemi, Sebahattin Yurdakul, Hasan Tuzun, Buge Oz, Hasan Yazici
    Abstract:

    AbstractPulmonary artery aneurysms (PAAs) are well known causes of mortality and morbidity in Behcet Disease (BD). However, pulmonary artery involvement in BD is not limited to PAA; the other main type of pulmonary artery involvement is pulmonary artery thrombus (PAT), with or without associated PAA

  • management of Behcet Disease a systematic literature review for the european league against rheumatism evidence based recommendations for the management of Behcet Disease
    Annals of the Rheumatic Diseases, 2009
    Co-Authors: Gulen Hatemi, A J Silman, Dongsik Bang, B Bodaghi, A M Chamberlain, M H Houman, I Kotter, I Olivieri, Carlo Salvarani, Petros P Sfikakis
    Abstract:

    Objectives: To present and analyse the literature sources regarding the management of Behcet Disease (BD) identified during the systematic literature research, which formed the basis for the European League Against Rheumatism (EULAR) evidence-based recommendations for the management of BD. Methods: Problem areas and related keywords regarding the management of BD were determined by the multidisciplinary expert committee commissioned by EULAR for developing the recommendations. A systematic literature research was performed using MedLine and Cochrane Library resources through to December 2006. Meta-analyses, systematic reviews, randomised controlled trials (RCTs), open studies, observational studies, case control studies and case series’ involving ⩾5 patients were included. For each intervention the effect size and number needed to treat were calculated for efficacy. Odds ratios and numbers needed to harm were calculated for safety issues of different treatment modalities where possible. Results: The literature research yielded 137 articles that met the inclusion criteria; 20 of these were RCTs. There was good evidence supporting the use of azathioprine and ciclosporin A in eye involvement and interferon (IFN)α in mucocutaneous involvement. There were no RCTs with IFNα or tumour necrosis factor (TNF)α antagonists in eye involvement. Similarly controlled data for the management of vascular, gastrointestinal and neurological involvement is lacking. Conclusion: Properly designed, controlled studies (new and confirmatory) are still needed to guide us in managing BD.

  • eular recommendations for the management of Behcet Disease
    Annals of the Rheumatic Diseases, 2008
    Co-Authors: Gulen Hatemi, A J Silman, Dongsik Bang, B Bodaghi, A M Chamberlain, M H Houman, I Kotter, I Olivieri, Carlo Salvarani, Petros P Sfikakis
    Abstract:

    Objectives: To develop evidence-based European League Against Rheumatism (EULAR) recommendations for the management of Behcet Disease (BD) supplemented where necessary by expert opinion. Methods: The multidisciplinary expert committee, a task force of the EULAR Standing Committee for Clinical Affairs (ESCCA), consisted of nine rheumatologists (one who was also a clinical epidemiologist and one also a Rehabilitation Medicine doctor), three ophthalmologists, one internist, one dermatologist and one neurologist, representing six European countries plus Tunisia and Korea. A patient representative was also present. Problem areas and related keywords for systematic literature research were identified. Systematic literature research was performed using Medline and the Cochrane Library databases from 1966 through to December 2006. A total of 40 initial statements were generated based on the systematic literature research. These yielded the final recommendations devel- oped from two blind Delphi rounds of voting. Results: Nine recommendations were developed for the management of different aspects of BD. The strength of each recommendation was determined by the level of evidence and the experts' opinions. The level of agreement for each recommendation was determined using a visual analogue scale for the whole committee and for each individual aspect by the subgroups, who consider themselves experts in that field of BD. There was excellent concordance between the level of agreement of the whole group and the ''experts in the field''. Conclusion: Recommendations related to the eye, skin- mucosa Disease and arthritis are mainly evidence based, but recommendations on vascular Disease, neurological and gastrointestinal involvement are based largely on expert opinion and uncontrolled evidence from open trials and observational studies. The need for further properly designed controlled clinical trials is apparent.