Examining Sirtuin-1 Levels and Inflammation Markers in Behcet's Disease: A Pilot Study

Background/Aims: Interleukin (IL)-1, IL-6, and tumor necrosis factor (TNF)-α are the principal proinflammatory cytokines that contribute to inflammatory activity in patients with Behcet's disease (BD). The aim was to assess circulatory Sirtuin-1 (SIRT1) levels in BD and evaluate potential relationships with disease activity scores and several inflammatory markers in order to investigate its potential as a disease activity marker. Materials and Methods: Forty patients with BD and 40 healthy volunteers matched for age and sex were enrolled. Demographic and clinical data were recorded, including family history of BD, smoking and alcohol consumption, height, weight, and comorbidities. Patients with BD were classified with respect to disease activity, treatments, and organ involvement. Disease activity was determined and categorized using the Behcet Disease Current Activity Form (BDCAF). Inflammation markers and SIRT1 levels were studied in fasting blood samples. Results: C-reactive protein, IL-6, and TNF-α values were found to be significantly higher in patients with BD compared to controls, largely irrespective of disease activity. SIRT1 results were similar in patients and controls. SIRT1 measurements again showed no differences when compared across disease activity groups and patients with and without TNF-α blockade treatment. However, patients with concurrent vascular and ocular involvement appeared to have significantly lower SIRT1 levels when compared to patients with only ocular involvement. Conclusion: SIRT1 levels in the circulation of patients with BD appear to be similar to controls, regardless of disease activity or anti-TNF-α treatment; however, SIRT1 concentrations may be associated with vascular injury as demonstrated by significantly lower SIRT1 levels in patients with vascular + ocular involvement compared to those with only skin or ocular involvement.