Abstract
Background and aims
Behçet’s disease (BD) is an auto-immune vasculitis, characterized by episodic inflammation of multiple organs. The neutrophil to lymphocyte ratio (NLR) is used as a marker of inflammation in several diseases nowadays. While nitric oxide (NO) seem to be involved in BD pathogenicity. Our study aims to investigate the NLR as an inflammatory marker of BD activity as well as to evaluate the relationship between the NO production and NLR in Algerian BD patients with different clinical manifestations before and under colchicine + corticosteroid treatment.
Methods
For this purpose, we evaluated the NLR as the ratio of neutrophil count to lymphocyte count in naïve and treated active BD patients with different clinical manifestations and in inactive ones. Furthermore, we assessed NO production by the Griess’ method in the same patients. Additionally, we evaluated in vivo interferon-γ (IFN-γ) and interleukin-4 (IL-4) levels using ELISA.
Results and discussion
Our results indicate that the NLR and nitrite levels were higher in naïve active BD patients. Interestingly, this high ratio and NO production differed according to the clinical manifestations and was associated with an increased risk of mucocutaneous and vascular involvement. Importantly, in treated BD patients NLR was higher in active patients especially in those with mucocutaneous involvement while increased nitrites levels were regardless of the clinical manifestations studied. Both NLR and NO production decreased in these treated active patients. In addition, IL-4 production differed according to the clinical manifestations studied contrary to the IFN-γ production.
Conclusion
Collectively our results suggest that the NLR is a potential marker of BD activity in Algerian patients, predicting the disease severity. Moreover, the positive relationship between the NLR and NO production is related to an increased risk of mucocutaneous lesions and vascular involvement. Thus, the application of these two accessible tools could be benefit for the clinical prognosis and treatment of BD.
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Acknowledgements
The authors thank the patients and the controls. They also express their gratitude to the Department of Internal Medicine of Mustapha Pacha Hospital and that of Dr Md Seghir NEKKACHE Hospital in Algiers, and to the Hematology Department of Dr Md Seghir NEKKACHE Hospital in Algiers.
Funding
This work was supported by grants from National Agency for Research and Development (ATRSS, ex ANDRS), project code number 58-DFPR-ATRSS-AAP-2014 Algeria.
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This manuscript was approved by the co-author. The local ethics committee “Algerian National Agency for Research in Health Sciences, ATRSS ex-ANDRS” in compliance with Helsinki declaration has approved our study (Code number 58-DFPR-ATRSS-AAP-2014).
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Djaballah-Ider, F., Touil-Boukoffa, C. Effect of combined colchicine-corticosteroid treatment on neutrophil/lymphocyte ratio: a predictive marker in Behçet disease activity. Inflammopharmacol 28, 819–829 (2020). https://doi.org/10.1007/s10787-020-00701-x
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DOI: https://doi.org/10.1007/s10787-020-00701-x