Serum DNASE1L3 level as a potential exploratory biomarker for Behçet's disease: a preliminary study

Behçet's disease is a chronic, inflammatory vasculitis affecting multiple systems. In addition to existing laboratory parameters used for the diagnosis and monitoring of Behçet's disease, new biomarkers are needed to improve diagnostic accuracy. The levels and activity of DNASE1L3, an enzyme that degrades chromatin released into circulation during apoptotic processes and can initiate autoimmune mechanisms, have been associated with autoimmune diseases. This study was designed to determine the levels of DNASE1L3 in patients with Behçet's disease, assess its relationship with clinical and inflammatory parameters, and evaluate its potential as a diagnostic biomarker.

This study included 45 patients diagnosed with Behçet's disease and 45 age and sex-matched healthy controls. Serum DNASE1L3 levels were measured in both groups using the enzyme-linked immunosorbent assay (ELISA).

Serum DNASE1L3 levels were significantly lower in patients with Behçet's disease (7.14 ± 1.81 ng/mL) compared to the healthy control group (15.79 ± 3.14 ng/mL) (p < 0.001). A statistically significant negative correlation was observed between serum DNASE1L3 levels and both CRP (r =  - 0.684, p < 0.001) and ESR (r =  - 0.524, p < 0.001). According to ROC curve analysis, a serum DNASE1L3 cutoff value of 9.53 ng/mL distinguished patients with Behçet's disease from healthy individuals with 96% sensitivity and 93% specificity. For this threshold, the positive predictive value was 95% and the negative predictive value was 93% (AUC = 0.983; p < 0.001; positive likelihood ratio, 21.13; negative likelihood ratio, 0.07).

The findings of this preliminary study suggest that serum DNASE1L3 may represent a promising candidate biomarker for Behçet's disease. However, further validation in larger, independent cohorts is required before its potential clinical utility can be established. Key Points • Serum DNASE1L3 levels are significantly lower in patients with Behçet's disease compared to healthy individuals. • DNASE1L3 levels show a strong negative correlation with acute phase reactants, including CRP and ESR. • Low DNASE1L3 levels may reflect impaired extracellular DNA clearance and contribute to the inflammatory process in Behçet's disease. • Serum DNASE1L3 levels show potential as an exploratory biomarker for the clinical evaluation of Behçet's disease, providing a basis for further validation in larger clinical cohorts.