Triggering agents and microbiome as environmental factors on Behcet's syndrome


MUMCU G. , DİRESKENELİ R. H.

INTERNAL AND EMERGENCY MEDICINE, vol.14, no.5, pp.653-660, 2019 (Journal Indexed in SCI) identifier identifier identifier

  • Publication Type: Article / Review
  • Volume: 14 Issue: 5
  • Publication Date: 2019
  • Doi Number: 10.1007/s11739-018-2000-1
  • Title of Journal : INTERNAL AND EMERGENCY MEDICINE
  • Page Numbers: pp.653-660
  • Keywords: Triggering agents, Environmental factors, Microbiome, Behcet's syndrome, FAMILIAL MEDITERRANEAN FEVER, ORAL ULCER ACTIVITY, DAGGER-ETS DISEASE, CLINICAL-FEATURES, SALIVARY LEVELS, SKIN-LESIONS, HNP 1-3, NICOTINE, AUTOIMMUNITY, AZITHROMYCIN

Abstract

Environmental and other triggering factors are suggested to cause the onset and the clinical relapses of Behcet's syndrome (BS), a multi-systemic inflammatory disorder. In this review, environmental factors are discussed according to their interactions with etiopathogenesis, immune response and disease activity. Stress is a common self-triggering factor for most BS patients. Stimuli such as some foods can activate oral ulcers, and may be linked to the histamine content of the food. Oral/skin trauma and menstruation associated with hormonal factors aggravate, whereas allergy/atopy seem to alleviate the symptoms of BS. Infections are associated with BS, and microbial stimuli can activate inflammation in mucosal surfaces with increased Th1/Th17 responses. Fecal and oral microbiome patterns change in diversity and composition in BS. Better oral hygiene applications and anti-microbial interventions might be helpful to suppress oral ulcers in BS.