The Role Of Endothelial Microparticles In Behcet’s Disease

Objective:Behcet’s disease(BD) is a multisystemic disorder of unknown etiology characterized by relapsing oral–genital ulcers, uveitis, and involvement of vascular,gastrointestinal, neurological, and musculoskeletal system. BD often involving 20~40years old young adults, the natural course of it showed the alternation of remission and relapse, which can lead to blindness cardiovascular and central nervous system disease and bring great mental stress and economic burden to the patients. Although the current pathogenesis is not clear, The current consensus suggests that the pathogenesis may be triggered by an environmental agent in a genetically susceptible host. Most of the researchers thought that BD is a kind of multi system involvement of the disease. The histopathological characteristics of peripheral vascular leukocytes aggregation increased,leukocyte extravasation into tissue depends on the degree of vascular endothelial cell integrity and surface expression of adhesion molecules. A lot of research has been shown to be endothelial dysfunction is the initial factor of vascular disease and endothelial function injury is one of the vasculitis pathogenesis. At present, regardless of the BD classification criteria, or the evaluation of its activities are mainly based on clinical assessment, there is a lack of specific objective assessment indicators.Thus, it’s urgent to seek a kind of index which can evaluate the degree of BD disease activity and predict the severity of the disease. Endothelial cell-derived microparticles(EMPs) are directly indicative of endothelial cell activation or apoptosis, and may also reflect endothelial inflammation, increased coagulation, and vascular tone. Plasma EMPs level is a newly developed method to evaluate endothelial function. The aim of this study is to investigate whether EMPs would be able to evaluation system involvement and be a new indicators of disease activity in Behcet’s disease(BD).Methods:Thirty-nine consecutive BD patients( who fulfilled the modified International Study Group on Behcet’s disease in 1990 or International Criteria for Behcet’s Disease in 2006)and 30 age and sex-matched healthy controls were enrolled. The plasma levels of EMPs were measured by flow cytometry utilizing specific labels for endothelial MPs(CD31+and CD42b-).The disease activity of BD was evaluated by Behcet’s disease current activity form and Birmingham Vasculitis Activity Score.Results:The levels of circulating EMPs(CD31+ and CD42b-) were significantly elevated in the case group compared with the healthy control group(p=0.000).Moreover, BD patients plasma EMPs were positively correlated with Behcet’s disease current activity form(r=0.802,p=0.000)and Birmingham Vasculitis Activity Score(r=0.607,p=0.000).Vascular involvement in BD patients than in patients without vascular EMPs were significantly increased(p=0.004). Gastrointestinal involvement in BD patients than in patients without Gastrointestinal EMPs were significantly increased(p=0.011). Plasma level of EMPs of patients in gender, skin rashes, nervous system involvement,inflammation, joint symptoms and puncture test whether there positive is no significant difference between the case group and the healthy control group.Conclusion:Levels of circulating EMPs are elevated in BD patients and correlated with disease activity in BD,the elevated EMPs may be a potential indicator to predict disease activity of Behcet’s disease.The plasma level of EMPs was increased, which indicated the increased risk of vascular and digestive tract involvement in BD.