Serum tumor necrosis factor alpha (TNF-α) level in patients with Behçet’s disease: Relation to clinical manifestations and disease activity

Behçet’s disease (BD) is a chronic multisystem disorder characterized by recurrent uveitis, oral aphthae, genital ulcers, and skin lesions. Evidence suggests an exaggerated response to increased cytokine and chemokine production and function.Aim of the workTo determine serum tumor necrosis factor-alpha (TNF-α) levels in BD and its relation to clinical manifestations, disease activity and acute phase reactants.Patients and methodsThirty Egyptian male patients with BD (active n = 20, inactive n = 10) and 20 age and sex matched healthy control subjects were included in this study. Serum TNF-α level was determined and correlated with high sensitivity C-reactive protein (hs-CRP), erythrocyte sedimentation rate (ESR) and Behçet’s disease current activity form (BDCAF).ResultsThe TNF-α level of BD patients was significantly higher (30.75 ± 16.94 pg/ml) compared with the control group (5.08 ± 3.19 pg/ml; P < 0.0001). Patients with ocular manifestation had a statistically significant higher TNF-α than those without (P = 0.007). The TNF-α level was significantly higher in those with active disease (36.51 ± 16.36 pg/ml) compared to those inactive (19.24 ± 11.78 pg/ml). However there was a statistically significant difference in ESR and Hs-CRP only between the active group and controls (P = 0.0001 and 0.001, respectively) and not between active and inactive groups.ConclusionHigh levels of TNF-α indicate the activation of immune response in BD. Serum TNF-α seems to be related to disease activity. High levels of TNF-α were present in patients with active ocular disease, raising the hope of the efficacy of anti TNF-α agents in the treatment of refractory ocular involvement.