The relationship between NETosis findings and disease activity in Behçet's disease: an exploratory study

Area of Science:

• Immunology
• Rheumatology
• Pathophysiology

Background:

• Behçet disease (BD) is a multisystemic inflammatory disorder of unknown etiology.
• Neutrophil extracellular traps (NETs) are involved in innate immunity and implicated in various autoimmune diseases.
• NETosis, the process of NET formation, is a potential contributor to BD pathogenesis.

Purpose of the Study:

• To investigate the association between NETosis findings and disease activity in Behçet disease.
• To evaluate serum and salivary markers of NETosis in active and inactive BD patients compared to healthy controls.

Main Methods:

• Cross-sectional and longitudinal study of 30 active BD patients and 10 healthy controls.
• Measurement of serum and saliva cell-free DNA (cf-DNA), neutrophil elastase (NE), myeloperoxidase (MPO), and citrullinated histone H3 (cit-H3) as NETosis markers.
• Adjustment of NETosis markers for peripheral blood neutrophil counts.

Main Results:

• Unadjusted serum cf-DNA and NE were elevated in active BD patients versus controls.
• Adjusted serum MPO and cit-H3 levels were lower in active BD.
• Salivary NETosis markers did not differ significantly between BD patients and controls.
• Longitudinal analysis showed decreased cf-DNA levels with reduced disease activity.
• cf-DNA correlated positively with inflammatory markers, while adjusted MPO and cit-H3 correlated negatively.

Conclusions:

• Indirect NETosis findings are variable and linked to the systemic and local activity in BD.
• Adjusted marker levels indicate that increased neutrophil turnover in active BD influences serum NETosis markers.
• NETosis markers may serve as indicators of disease activity and neutrophil dynamics in Behçet disease.