Context: Monoclonal antibody therapies have revolutionized the treatment of autoinflammatory-immune/genetic disease including spondylarthritis, asthma and rheumatoid arthritis. Behcet’s disease (BD) is a multi-systemic vasculitis, which is generally recurrent aphthous lesions (RAL) as well as ocular and skin lesions. Today, the immunohistopathogenesis of BD is mostly unknown.

Method: Omalizumab (Anti-IgE humanized monoclonal antibody) therapy is given for severe persistent allergic asthma, and unintentionally it had effect on RAL. Our patient has received omalizumab treatment for 3 years. The steroid treatment was completely discontinued a month later and the systemic-steroid dependent diabetes mellitus was healed. The IL-1 β, IL-6, IL-8, IL-33, IL-25, IL-10, IL-23, and IL-17A levels were measured using an Enzyme-Linked Immunosorbent Assay (ELISA) kit.

Results: After a long-term omalizumab treatment administered, the levels of WBC, d-dimer, IL-33, IL-6, IL-25 and IL-1 β decreased. The patient’s hsCRP decreased from 3 to 0.1 and Eosinophil Cationic Protein (ECP) levels decreased from 78 to 21. A significant improvement was noticed in the RAL, the asthma symptoms (cough, shortness of breath), the number of emergency admissions, and the average length of stay of the patient within the days following the initiation of the omalizumab treatment.

Conclusions: Here, for the first time, we introduce omalizumab treatment of a patient diagnosed with BD and the examination of the treatment for the clinical manifestations and the cytokines/coagulant protein levels. A significant improvement is observed in the patient's RAL following the initiation of omalizumab. There is strong evidence that the serum proinflammatory cytokines/coagulant factors could also play an important role in the relationship between RAL and IgE-dependent vascular autoinflammation.

背景：单克隆抗体疗法彻底改变了自发性免疫/遗传疾病的治疗方法，包括脊椎炎，哮喘和类风湿关节炎。白塞病（BD）是一种多系统性血管炎，通常是复发性口疮性病变（RAL）以及眼部和皮肤病变。如今，BD的免疫组织病理学已基本未知。

方法：奥马珠单抗（抗IgE人源化单克隆抗体）疗法用于严重的持续性过敏性哮喘，无意中对RAL有影响。我们的患者已接受奥马珠单抗治疗3年。一个月后，类固醇的治疗被完全中止，全身类固醇依赖性糖尿病得到治愈。使用酶联免疫吸附测定（ELISA）试剂盒测量IL-1β，IL-6，IL-8，IL-33，IL-25，IL-10，IL-23和IL-17A的水平。

结果：长期给予奥马珠单抗治疗后，WBC，d-二聚体，IL-33，IL-6，IL-25和IL-1β的水平降低。患者的hsCRP从3降低到0.1，而嗜酸性粒细胞阳离子蛋白（ECP）的水平从78降低到21。在RAL，哮喘症状（咳嗽，呼吸急促），急诊入院的次数以及开始奥马珠单抗治疗后几天内患者的平均住院时间。

结论：在这里，我们首次引入奥马珠单抗治疗被诊断为BD的患者，并检查该治疗的临床表现和细胞因子/凝血蛋白水平。在开始使用奥马珠单抗后，患者的RAL明显改善。有强有力的证据表明，血清促炎细胞因子/凝血因子也可能在RAL与依赖IgE的血管自身炎症之间的关系中发挥重要作用。