Upregulation of serum circular RNA FUNDC1 and TNF-α in Behçet's disease: potential diagnostic biomarkers

Behçet's disease (BD) is an inflammatory autoimmune disease characterized by relapsing genital ulcers, ocular involvement, and intestinal disorders. Evaluate serum levels of circular RNA (circRNA) FUNDC1 and tumor necrosis factor-alpha (TNF-α) in BD patients and compare them accordingly to healthy individuals. One hundred participants were enrolled in this study and subdivided equally into BD patients and healthy matched individuals. A five mL sample of blood was drawn from each subject and analyzed to measure circRNA-FUNDC1 and TNF-α. Full clinical investigations have been performed, and the Behcet Disease Current-Activity Form score (BDCAF) has been calculated. circRNA-FUNDC1 and TNF-α were measured by quantitative real time PCR and enzyme-linked immunosorbent assay (ELISA) respectively. An up-regulation of circRNA-FUNDC1 as well as TNF-α (p < 0.0001) in BD group were reported compared to controls. Both biomarkers tended to elevate with the activity of the disease as levels were higher in active BD patients than inactive patients. The level of circRNA-FUNDC1 (FC) tended to be higher in patients with negative musculoskeletal and central nervous system (CNS) manifestations than those with positive manifestations (p-values = 0.007, 0.037, respectively). The level of TNF-α was reported higher in those with oral ulcer with (p = 0.041), also in patients with positive skin manifestations than in negative patients (p = 0.025). The level of circRNA-FUNDC1 (FC) was higher in patients who took Azathioprine and steroids (p = 0.019, 0.035) and lower in patients who took cyclosporin (p = 0.049). TNF-α tended to elevate in patients who took Hydroxychloroquine than those who did not (p = 0.040). The upregulated levels of circRNA-FUNDC1 and TNF-α may have a potential role in improving our understanding of the molecular mechanisms underlying BD.