Possible Role of Regulatory B Cells in Different Behçet’s Disease Phenotypes and Therapies: First Report from Egypt

Abstract

Background and Aim The data about the role of regulatory B cells (Breg) in Behcet Disease (BD) are scarce. We aimed to evaluate the frequency of total B lymphocytes and Breg cells in different BD phenotypes and therapies attempting to unravel their function. Methods This cross-sectional study included 35 BD patients and 39 healthy controls (HCs). The demographic data of the study subjects were collected including age and gender. Current medications including disease-modifying anti-rheumatic drugs (DMARDs) were recorded. All patients underwent testing for baseline laboratory investigations including full blood count, liver and kidney function tests, erythrocyte sedimentation rate (ESR) by Westergren blot and C-reactive protein (CRP). Measurement of the total B lymphocytes and their subtypes B regulatory lymphocytes by flow cytometric assay. Assessment of BD activity was done using the revised Behçet’s Disease Current Activity Form (BDCAF) 2006 and Behçet’s Syndrome Activity Score (BSAS) 1111111111 . All participants were assessed for the presence of erectile dysfunction using the International Index of Erectile Function (IIEF-5 score), and for depression using the Beck Depression Inventory. Results A dramatic drop in the number of B cells, total and regulatory, was observed in the patients compared to the HCs. Regulatory cells (Bregs) tend to be upregulated with genital ulcers or vascular disease. Bregs but not B lymphocytes were associated with BSAS and ESR. Neither the total B lymphocytes nor the Bregs correlated with CRP or the sexual function or depression scores. Of all the used medications, low-dose aspirin was seen with markedly high Bregs proportions. Conclusion This study supports the role of B cells in BD pathogenesis and strongly suggests a possible role for Bregs in the resolution of different BD manifestations.

Decoding Behcet’s Uveitis: an In-depth review of pathogenesis and therapeutic advances

“…Interestingly, there appears to be a positive relationship between the number of Bregs and the dosage of corticosteroids administered to patients. However, recent studies suggest that the overall count of B cells and the number of Bregs remain consistent among BD patients, regardless of whether they exhibit symptoms of BU [ 140 ]. This indicates that further investigation is required to fully understand the precise role and impact of B cells in the pathogenesis of BU.…”

Genetics in Behcet’s Disease: An Update Review

“…Interleukin-10 (IL-10) is a widely expressed cytokine that contributes to preventing inflammatory and autoimmune pathologies. Multiple cells of innate and adaptive immune system exert important functions in BD, including CD4 + T cells ( 76 , 77 ), CD8 + T cells ( 78 ), dendritic cells ( 79 ), macrophages ( 80 ), NK cells ( 81 ), neutrophils ( 82 ) and B cells ( 83 , 84 ), and almost all of them could express IL-10 ( 85 ). IL-10 was identified as risk locus for many inflammatory diseases, including bacterial sepsis ( 86 ), type I diabetes ( 87 ), mixed connective tissue disease (MCTD) ( 88 ), ankylosing spondylitis (AS) ( 89 ) and especially BD ( 9 , 11 , 12 , 90 ).…”