AB0456 ROLE OF CYTOKINES (INTERLEUKIN 17 AND 23) IN PSYCHIATRIC COMORBIDITIES ASSOCIATED WITH BECHET’S DISEASE
Authors: E. Abdelmoty, M. Gaber, R. Gabra, E. Abda, S. Rashad
Journal: Annals of the Rheumatic Diseases (2020)

Background: Behcet’s disease (BD) is a chronic multi-systemic autoinflammatory disease associated with increase prevalence of psychiatric comorbidity (Ilhan et al. 2016 ). Pro-inflammatory cytokines have been reported to be elevated in patients with depression and anxiety. IL-23/IL-17 axis has been shown to play a remarkable role in pathogenesis of BD, depression and anxiety (Sugita et al. 2012, Gheita et al. 2015 ). However, the relation between the serum level of interleukin (IL)-17 and IL-23 and incidence of cognitive impairment, depression and anxiety in Behcet patients are still unknown. Objectives: To evaluate the serum levels of IL-17 and IL-23 in Egyptian patients with BD and evaluate the correlations between the level of inflammatory cytokines and psychiatric manifestations as cognitive impairment, depression and anxiety. Methods: Study design and recruitment In a case control study, we recruited 45 BD patients, who fulfilled the modified International Criteria for Behçet’s Disease (ITR-ICBD 2014 ) from the Rheumatology and Rehabilitation Department, Assiut University hospital. Thirty apparently healthy sex and age matched subjects were recruited, served as controls. This study was approved by the Ethical Committee of the Assiut University, Egypt. Informed consent was obtained from all participants. Study methodology All patients and controls were assessed for cognitive impairment, depression and anxiety using memory assessment scale, Hamilton depression rating scale and Hamilton anxiety rating scale respectively. Serum level of proinflammatory cytokines such as IL-17 and IL-23 were measured by enzyme-linked immunosorbent assay (ELIZA). Results: Psychiatric manifestations BD has significant lower score in all components of MAS and high prevalence of depression and anxiety in HDRS and HARS respectively compared with control group (p &lt;0.001). Severe depression was found in 82.9% of BD patients. Moreover, our data showed 46.7% of BD patients have moderate anxiety compared to the control group. Serum Levels of IL-17 and IL-23 The serum level of IL-17 and IL-23 levels were significantly higher among BD patients than in healthy control (&lt;0.000). There was no significant correlation between those cytokines and cognitive impairment, depression and anxiety. Conclusion: Elevated level of IL-17 and IL-23 were observed in BD patients. However, our results do not support an association between serum IL-17 and IL-23 levels and cognitive dysfunction, depression and anxiety. References: [1]Gheita, T. A., S. M. Gamal, I. Shaker, H. S. El Fishawy, R. El Sisi, O. G. Shaker and S. A. Kenawy (2015). “Clinical significance of serum interleukin-23 and A/G gene (rs17375018) polymorphism in Behcets disease: Relation to neuro-Behcet, uveitis and disease activity.” Joint Bone Spine 82(3): 213-215. [2]Ilhan, B., M. Can, F. Alibaz-Oner, S. Yilmaz-Oner, O. Polat-Korkmaz, G. Ozen, G. Mumcu, H. Maradit Kremers and H. Direskeneli (2016). “Fatigue in patients with Behcet’s syndrome: relationship with quality of life, depression, anxiety, disability and disease activity.” Int J Rheum Dis. [3]ITR-ICBD (2014). “The International Criteria for Behcet’s Disease (ICBD): a collaborative study of 27 countries on the sensitivity and specificity of the new criteria.” J Eur Acad Dermatol Venereol 28(3): 338-347. [4]Sugita, S., Y. Kawazoe, A. Imai, Y. Yamada, S. Horie and M. Mochizuki (2012). “Inhibition of Th17 differentiation by anti-TNF-alpha therapy in uveitis patients with Behcet’s disease.” Arthritis Res Ther 14(3): R99. Disclosure of Interests: : None declared