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ORIGINAL PAPER
A proliferation-inducing ligand (APRIL) level among risk factors of ocular involvement in patients with Behçet’s disease
1
Department of Rheumatology and Rehabilitation, Minia University, Egypt
2
Department of Ophthalmology, Minia University, Egypt
3
Department of Clinical Pathology, Minia University, Egypt
Submission date: 2024-07-14
Final revision date: 2024-08-14
Acceptance date: 2024-10-04
Online publication date: 2024-11-06
Corresponding author
Rasha M. Ghaleb
Rheumatology and Rehabilitation Department, Minia University, Egypt Aswan Agricultural Road, 61519 Minia, Egypt
Rheumatology and Rehabilitation Department, Minia University, Egypt Aswan Agricultural Road, 61519 Minia, Egypt
KEYWORDS
TOPICS
Cytokines, Inflammatory mediators and adaptive immunity in rheumatic diseasesVasculitis - aetiology, pathogenesis, clinical features and treatment
ABSTRACT
Introduction:
Ocular involvement is quite common in Behçet’s disease (BD) and may cause crucial functional complications. Even though the mechanisms of BD remain unclear, advances in genetic and immunological fields have improved our understanding of the immunopathogenesis of BD ocular involvement. Little is known about the expression of a proliferation-inducing ligand (APRIL) in terms of ocular involvement in BD. The objective of this study was to determine whether serum APRIL concentrations are associated with ocular involvement in patients with BD.
Material and methods:
The study included 60 patients diagnosed with BD matched by age and sex to 30 healthy individuals. Every patient underwent a clinical evaluation, and the Behçet’s Disease Current Activity Form (BDCAF) was utilized to quantify disease activity. All patients underwent a comprehensive ophthalmological assessment. Serum APRIL was assessed for patients as well as controls.
Results:
One or more ocular manifestations were found in 42 BD patients (70%), while 18 patients (30%) had no ocular involvement. The mean level of serum APRIL levels was markedly elevated in BD patients, particularly those with ocular involvement, compared to both BD patients without ocular involvement and healthy individuals. A statistically significant association was determined between high APRIL concentration and development of uveitis, cataract, and hypopyon. Cutaneous lesions and arthritis were strong independent predictors for ocular involvement in BD patients.
Conclusions:
Overexpression of APRIL in patients with BD, particularly in terms of uveitis, cataract, and hypopyon, lends credence to the idea that B cell activating factors have an important function in BD. These findings may indicate that serum APRIL concentrations can differentiate a clinical subgroup of BD patients with ocular disease. As a result, finding a new therapeutic strategy targeting the APRIL pathway might be beneficial in BD patients suffering from ocular involvement.
Ocular involvement is quite common in Behçet’s disease (BD) and may cause crucial functional complications. Even though the mechanisms of BD remain unclear, advances in genetic and immunological fields have improved our understanding of the immunopathogenesis of BD ocular involvement. Little is known about the expression of a proliferation-inducing ligand (APRIL) in terms of ocular involvement in BD. The objective of this study was to determine whether serum APRIL concentrations are associated with ocular involvement in patients with BD.
Material and methods:
The study included 60 patients diagnosed with BD matched by age and sex to 30 healthy individuals. Every patient underwent a clinical evaluation, and the Behçet’s Disease Current Activity Form (BDCAF) was utilized to quantify disease activity. All patients underwent a comprehensive ophthalmological assessment. Serum APRIL was assessed for patients as well as controls.
Results:
One or more ocular manifestations were found in 42 BD patients (70%), while 18 patients (30%) had no ocular involvement. The mean level of serum APRIL levels was markedly elevated in BD patients, particularly those with ocular involvement, compared to both BD patients without ocular involvement and healthy individuals. A statistically significant association was determined between high APRIL concentration and development of uveitis, cataract, and hypopyon. Cutaneous lesions and arthritis were strong independent predictors for ocular involvement in BD patients.
Conclusions:
Overexpression of APRIL in patients with BD, particularly in terms of uveitis, cataract, and hypopyon, lends credence to the idea that B cell activating factors have an important function in BD. These findings may indicate that serum APRIL concentrations can differentiate a clinical subgroup of BD patients with ocular disease. As a result, finding a new therapeutic strategy targeting the APRIL pathway might be beneficial in BD patients suffering from ocular involvement.
REFERENCES (29)
1.
Tong B, Liu X, Xiao J, Su G. Immunopathogenesis of Behcet’s disease. Front Immunol 2019; 10: 665, DOI: 10.3389/fimmu.2019.00665.
2.
Takeuchi M, Mizuki N, Ohno S. Pathogenesis of non-infectious uveitis elucidated by recent genetic findings. Front Immunol 2021; 12: 640473, DOI: 10.3389/fimmu.2021.640473.
3.
Gheita TA, El-Latif EA, El-Gazzar II, et al. Behçet’s disease in Egypt: a multicenter nationwide study on 1526 adult patients and review of the literature. Clin Rheumatol 2019; 38: 2565–2575, DOI: 10.1007/s10067-019-04570-w.
4.
El-Najjar AR, Abou El-Soud AM, Amar HA, et al. Clinical characteristics and disease activity of Behçet’s disease patients in Zagazig, Egypt. Egypt Rheumatol 2015; 37: 191–196.
5.
Azizlerli G, Köse AA, Sarica R, et al. Prevalence of Behçet’s disease in Istanbul, Turkey. Int J Dermatol 2003; 42: 803–806, DOI: 10.1046/j.1365-4362.2003.01893.x.
6.
Okada AA. Behçet’s disease: general concepts and recent advances. Curr Opin Ophthalmol 2006; 17: 551–556, DOI: 10.1097/01.icu.0000247411.59213.bb.
7.
Çakar Özdal P. Behçet’s uveitis: current diagnostic and therapeutic approach. Turk J Ophthalmol 202; 50: 169–182, DOI: 10.4274/tjo.galenos.2019.60308.
8.
Allam A, Ammar H, Radwan A. Serum homocysteine level and eye involvement in Egyptian patients with Behçet’s disease. Egypt Rheumatol 2014; 36: 29–34.
9.
Gheita TA, Raafat H, Khalil H, et al. Serum level of APRIL/BLyS in Behçet’s disease patients: clinical significance in uveitis and disease activity. Mod Rheumatol 2013; 23: 542–546, DOI: 10.1007/s10165-012-0694-x.
10.
Glenney GW, Wiens GD. Early diversification of the TNF superfamily in teleosts: genomic characterization and expression analysis. J Immunol 2007; 178: 7955–7973, DOI: 10.4049/jimmunol.178.12.7955.
11.
Baert L, Manfroi B, Casez O, et al. The role of APRIL – a proliferation inducing ligand-In autoimmune diseases and expectations from its targeting. J Autoimmun 2018; 95: 179–190, DOI: 10.1016/j.jaut.2018.10.016.
12.
Koyama T, Tsukamoto H, Miyagi Y, et al. Raised serum APRIL levels in patients with systemic lupus erythematosus. Ann Rheum Dis 2005; 64: 1065–1067, DOI: 10.1136/ard.2004.022491.
13.
Kiyama K, Kawabata D, Hosono Y, et al. Serum BAFF and APRIL levels in patients with IgG4-related disease and their clinical significance. Arthritis Res Ther 2012; 14: R86, DOI: 10.1186/ar3810.
14.
Jonsson MV, Szodoray P, Jellestad S, et al. Association between circulating levels of the novel TNF family members APRIL and BAFF and lymphoid organization in primary Sjögren’s syndrome. J Clin Immunol 2005; 25: 189–201, DOI: 10.1007/s10875-005-4091-5.
15.
International Team for the Revision of the International Criteria for Behçet’s Disease (ITR-ICBD). The International Criteria for Behçet’s Disease (ICBD): a collaborative study of 27 countries on the sensitivity and specificity of the new criteria. J Eur Acad Dermatol Venereol 2014; 28: 338–347, DOI: 10.1111/jdv.12107.
16.
Bhakta BB, Brennan P, James TE, et al. Behçet’s disease: evaluation of a new instrument to measure clinical activity. Rheumatology (Oxford) 1999; 38: 728–733, DOI: 10.1093/rheumatology/38.8.728.
17.
Dąbrowska-Zimoń A, Bobrowska-Snarska D, Wódecki M, et al. Behçet’s disease – three successive cases in Poland. Reumatologia 2007; 45: 431–435.
18.
Akdeniz N, Elmas ÖF, Karadağ AS. Behçet syndrome: a great imitator. Clin Dermatol 2019; 37: 227–239. DOI: 10.1016/j.clindermatol.2019.01.001.
19.
Cho SB, Cho S, Bang D. New insights in the clinical understanding of Behçet’s disease. Yonsei Med J 2012; 53: 35–42, DOI: 10.3349/ymj.2012.53.1.35.
20.
Saadoun D, Cassoux N, Wechsler B, et al. Manifestations oculaires de la maladie de Behçet [Ocular manifestations of Behçet’s disease]. Rev Med Interne 2010; 31: 545–550 [Article in French].
21.
Sachetto Z, Mahayri N, Ferraz RH, et al. Behcet’s disease in Brazilian patients: demographic and clinical features. Rheumatol Int 2012; 32: 2063–2067, DOI: 10.1007/s00296-011-1921-z.
22.
Shaker OG, Tawfic SO, El-Tawdy AM, et al. Expression of TNF-, APRIL and BCMA in Behçet’s disease. J Immunol Res 2014; 2014: 380405, DOI: 10.1155/2014/380405.
23.
Ghaleb RM, Said HM. Assessment of neurocognitive function in patients with Behçet’s disease. Reumatologia 2024; 62: 169–175, DOI: 10.5114/reum.2024.141289.
24.
Elzanaty R, Wassef AMA, Seif M, et al. Pattern of uveitis in Behçet’s disease patients from a highly specialized university hospital-based tertiary care eye unit. Egypt Rheumatol 2024; 46: 112–116. DOI: 10.1016/j.ejr.2024.04.001.
25.
Wang H, Marsters SA, Baker T, et al. TACI-ligand interactions are required for T cell activation and collagen-induced arthritis in mice. Nat Immunol 2001; 2: 632–637, DOI: 10.1038/89782.
26.
Seyler TM, Park YW, Takemura S, et al. BLyS and APRIL in rheumatoid arthritis. J Clin Invest 2005; 115: 3083–3092, DOI: 10.1172/JCI25265.
27.
Tan SM, Xu D, Roschke V, et al. Local production of B lymphocyte stimulator protein and APRIL in arthritic joints of patients with inflammatory arthritis. Arthritis Rheum 2003; 48: 982–992, DOI: 10.1002/art.10860.
28.
Ibrahim ZA, Ghaly NR, El-Tatawy RA, et al. A proliferation-inducing ligand in atopic dermatitis and vitiligo. Int J Dermatol 2014; 53: 1073–1079, DOI: 10.1111/ijd.12176.
29.
Vu AT, Baba T, Chen X, et al. Staphylococcus aureus membrane and diacylated lipopeptide induce thymic stromal lymphopoietin in keratinocytes through the Toll-like receptor 2-Toll-like receptor 6 pathway. J Allergy Clin Immunol 2010; 126: 985–993, DOI: 10.1016/j.jaci.2010.09.002.
Copyright: © Narodowy Instytut Geriatrii, Reumatologii i Rehabilitacji w Warszawie. This is an Open Access journal, all articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License (https://creativecommons.org/licenses/by-nc-sa/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
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