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Plasma Homocysteine in Behcet's Disease: A Systematic Review and Meta-Analysis

Mira Merashli1, Tommaso Bucci2, Daniele Pastori3

  • 1Department of Rheumatology, American University of Beirut, Bliss, Beirut, Lebanon.

Thrombosis and Haemostasis
|January 7, 2022
PubMed

Insights

Plasma homocysteine (HC) is elevated in Behcet's disease (BD) patients, especially those with active disease or vascular and ocular involvement. This suggests HC plays a role in BD

Area of Science:

  • Rheumatology
  • Biochemistry
  • Clinical Medicine

Background:

  • Behcet's disease (BD) is a multisystem inflammatory disorder of unknown etiology.
  • Elevated plasma homocysteine (HC) has been implicated in various vascular and inflammatory conditions.
  • The specific role of HC in BD pathogenesis and clinical manifestations requires further elucidation.

Purpose of the Study:

  • To systematically evaluate the association between plasma homocysteine levels and Behcet's disease.
  • To investigate the correlation of plasma HC with clinical manifestations of BD, including disease activity, vascular, and ocular involvement.

Main Methods:

  • A comprehensive systematic review and meta-analysis of studies published up to July 2021.
  • Inclusion of data from EMBASE and PubMed databases adhering to PRISMA guidelines.
  • Random-effects meta-analyses were performed for continuous outcomes.

Main Results:

  • Plasma HC levels were significantly higher in BD patients compared to controls (p < 0.0001).
  • Elevated HC was observed in active BD and in patients with vascular or ocular involvement (p < 0.0001).
  • Heterogeneity was noted, but subgroup analyses and sensitivity analyses provided consistent findings.

Conclusions:

  • Consistent elevation of plasma HC in BD patients, particularly with active disease and specific clinical features, is demonstrated.
  • While causality cannot be definitively established, these findings suggest an intrinsic role of HC in the manifestations of Behcet's disease.
  • Further research into the mechanisms linking HC to BD pathogenesis is warranted.
Abstract

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