Пациенты и методы

mrj

Современная ревматология

Modern Rheumatology Journal

1996-70122310-158X

IMA-PRESS, LLC

10.14412/1996-7012-2019-2-84-89

mrj-915

Research Article

ОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯ

ORIGINAL INVESTIGATIONS

Болезнь Бехчета: клинико-гендерные ассоциации

Behсet's disease: clinical and gender associations

Алекберова

З. С.

Alekberova

Z. S.

Москва

Moscow

Лисицына

Т. А.

Lisitsyna

T. A.

Москва

Moscow

talisitsyna@rambler.ru

Голоева

Р. Г.

Goloeva

R. G.

Москва

Moscow

Давыдова

Г. А.

Davydova

G. A.

Москва

Moscow

ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»РоссияV.A. Nasonova Research Institute of RheumatologyRussian Federation

ФГБУ «Московский научно-исследовательский институт глазных болезней им. Гельмгольца» Минздрава РоссииРоссияHelmholtz Moscow Research Institute of Eye Diseases, Ministry of Health of RussiaRussian Federation

2019

20052019

1328489

2019

Алекберова З.С., Лисицына Т.А., Голоева Р.Г., Давыдова Г.А.

Alekberova Z.S., Lisitsyna T.A., Goloeva R.G., Davydova G.A.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://mrj.ima-press.net/mrj/article/view/915

Цель исследования – сравнение частоты клинических проявлений болезни Бехчета (ББ) у больных разного пола в российской когорте.

Пациенты и методы

Пациенты и методы. Обследовано 425 пациентов с достоверным диагнозом ББ: 285 мужчин и 140 женщин, средний возраст – 33,2±10,2 года, медиана длительности ББ – 134,3 [60,0; 192,0] мес (около 11 лет). 208 (48,9%) пациентов являлись этническими жителями Северного Кавказа. Активность ББ оценивали по индексу BDCAF (Behсet Disease Current Activity Form), тяжесть ББ – по Сh. Zouboulis.

Результаты и обсуждение

Результаты и обсуждение. У мужчин с ББ в российской когорте достоверно выше были активность, степень тяжести заболевания и чаще выявлялся HLA-B5(51)-антиген. Прослежена ассоциация мужского пола с тромбозами глубоких вен и синусов головного мозга, поражением глаз, кожи (псевдопустулез и псевдофолликулит), язвами гениталий, положительным тестом патергии. Полученные данные согласуются с результатами исследований других когорт пациентов – иранской, немецкой, турецкой, в которых у мужчин чаще выявлялись поражение сосудов, кожи и глаз.

Выводы

Выводы. В российской когорте пациентов мужской пол ассоциируется с высокой активностью ББ, тяжелыми органными поражениями и позитивностью по HLA-B5(51)-антигену, что является основанием для назначения иммуносупрессивной терапии мужчинам с ББ на ранних стадиях болезни.

Objective

Objective: to compare the frequency of clinical manifestations of Behcet's disease (BD) in patients of both sexes in a Russian cohort.

Patients and methods

Patients and methods. Examinations were made in 425 patients (285 men and 140 women; mean age, 33.2±10.2 years; median duration of BD, 134.3 [60.0; 192.0] months (about 11 years) with a reliable diagnosis of the disease. 208 (48.9%) patients were ethnic residents of the North Caucasus. The activity of BD was assessed using the BD Current Activity Form; the disease severity was evaluated according to the classification proposed by Ch. Zouboulis.

Results and discussion

Results and discussion. In men with BD in the Russian cohort, the activity and severity of the disease were significantly higher and the HLA-B5(51)- antigen was more common. There was an association of male sex with thromboses in the deep cerebral veins and cerebral sinuses, damage to the eyes and skin (pseudopustulosis and pseudofolliculitis), genital ulcers, and a positive pathergy test. The findings are consistent with the results of studies of other patient cohorts: Iranian, German, Turkish ones, in which the men were more frequently detected to have damage to the vessels, skin and eyes.

Conclusion

Conclusion. In the Russian patient cohort, the male sex is associated with high BD activity, severe organ damages, and HLA-B5(51)-antigen positivity, which is the basis for prescribing immunosuppressive therapy in men with early-stage BD.

болезнь Бехчетаклинические проявленияактивностьтяжестьгендерные особенностисравнительный анализ

Behcet's diseaseclinical manifestationsactivityseveritygender featurescomparative analysis

References1

Алекберова ЗС. Болезнь Бехчета. Москва: ГУ РАМН; 2007. 90 с.

Alekberova ZS. Bolezn' Bekhcheta [Behcet’s disease]. Moscow: GU RAMN; 2007. 90 p..

Jennette J, Falk R, Bacon P, et al. 2012 revised international Chapell Hill Consensus conference nomenclature of vasculitides. Arthritis Rheum. 2013 Jan;65(1):1-11. doi: 10.1002/art.37715.

Zouboulis Ch. Epidemiology of Adamantiades – Behcet's disease. In: Zierhut M, Ohno S, editors. Immunology of Behcet's disease. Lisse; 2003. P. 1-16.

Tursen U, Gü rler A, Boyvat A. Evaluation of clinical findings according to sex in 2313 Turkish patients with Behcet's disease. Int J Dermatol. 2003 May;42(5):346-51. 5. Davatchi F, Chams-Davatchi C, Shams H, et al. Behcet's disease: epidemiology, clinical manifestations, and diagnosis. Expert Rev Clin Immunol. 2017 Jan;13(1):57-65. Epub 2016 Jul 11.

Takeno M, Ishido T, Horita N, et al. Influence of sex and age on clinical manifestations of Behcet's disease: data of 6627 patients from Japanese nationwide survey database (P44). Clin Exp Rheumatol. 2018; 36(Suppl. 115):S172.

Bang D, Oh S, Lee KH, et al. Influence of sex on patients with Behcet's disease in Korea. Adv Exp Med Biol. 2003;528:59-63.

Davatchi F, Shahram F, Chams-Davatchi C, et al. Behcet's disease: is there a gender influence on clinical manifestations? Int J Rheum Dis. 2012 Jun;15(3):306-14. doi: 10.1111/j.1756-185X.2011.01696.x.

Hamuryudan V, Hatemi G, Sut N, et al. Frequent oral ulceration during early disease may predict a severe disease course in males with Behcet's syndrome. Clin Exp Rheumatol. 2012 May-Jun;30(3 Suppl 72):S32-4.

Tugal-Tutkun I, Önal S, Altan Yayciolglu R, et al. Uveitis in Behcet's disease: an analysis of 880 patients. Am J Ophthalmol. 2004 Sep; 138(3):373-80.

Jacyk WK. Behcet's disease in South African blacks: report of five cases. J Am Acad Dermatol. 1994 May;30(5 Pt 2):869-73.

Poon W, Verity DH, Larkin GL, et al. Behcet's disease in patients of west African and Afro-Caribbean origin. Br J Ophthalmol. 2003 Jul;87(7):876-8.

Yurdakul S, Hammuryudan V, Yazici H. Behcet's syndrome. Curr Opin Rheumatol. 2004 Jan;16(1):38-42.

Kechida M, Ksiaa I, Hammami S, et al. Gender influence in Behcet disease: a bicentric Tunisian stud. 18th International Conference on Behcet's syndrome. Rotterdam, Netherlands, 13-15 September 2018.

Ishido T. Clinical manifestations of Behcet's disease depending on sex and age: results from Japanese nationwide registration. Rheumatology (Oxford). 2017 Nov 1;56(11): 1918-1927. doi: 10.1093/rheumatology/kex285.

Criteria for diagnosis of Behcet's disease. International Study Group for Behcet's Disease. Lancet. 1990 May 5;335(8697): 1078-80.

International Team for the Revision of the International Criteria for Behcet's Disease (ITR-ICBD). 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. 2014 Mar;28(3):338-47. doi: 10.1111/jdv.12107. Epub 2013 Feb 26.

Насонов ЕЛ, редактор. Ревматология. Российские клинические рекомендации. Москва: ГЭОТАР-Медиа; 2017. 464 c.

Nasonov EL, editor. Revmatologiya. Rossiiskie klinicheskie rekomendatsii [Rheumatology. Russian clinical guidelines]. Moscow: GEOTAR-Media; 2017. 464 p. (In Russ.).

Yavuz S, Akdeniz T, Hancer V, et al. Dual effects of testosterone in Behcet's disease: implications for a role in disease pathogenesis. Genes Immun. 2016 Sep;17(6):335-41. doi: 10.1038/gene.2016.28.

Ryu HJ, Seo MR, Choi HJ, et al. Clinical phenotypes of Korean patients with Behcet disease according to gender, age at onset, and HLA-B51. Korean J Intern Med. 2018 Sep; 33(5):1025-1031. doi: 10.3904/kjim.2016.202. Epub 2017 Jan 12.

Голоева РГ, Алекберова ЗС, Гусева ИА и др. Болезнь Бехчета и ассоциации с антигеном HLA-В5 (обзор литературы и собственные данные). Терапевтический архив. 2010;(5):45-50.

Goloeva RG, Alekberova ZS, Guseva IA, et al. Behcet disease and association with antigen HLA-B5 (review of literature and own data). Terapevticheskii arkhiv. 2010;(5):45-50 (In Russ.).

Demirseren D, Ceylan G, Akoglu G, et al. HLA-B51 subtypes in Turkish patients with Behcet's disease and their correlation with clinical manifestations. Genet Mol Res. 2014 Jul 2;13(3):4788-96. doi: 10.4238/2014.July.2.8.

Maldini C, Lavalley M, Cheminant M, et al. Relationships of HLA-B51 or B5 genotype with Behcet's disease clinical characteristics: systematic review and meta-analyses of observational studies. Rheumatology (Oxford). 2012 May;51(5):887-900. doi: 10.1093/rheumatology/ker428. Epub 2012 Jan 11.

Bonitsis NG, Luong Nguyen LB, et al. Gender-specific differences in AdamantiadesBehcet's disease manifestations: an analysis of the German registry and meta-analysis of data from the literature. Rheumatology (Oxford). 2015 Jan;54(1):121-33. doi: 10.1093/rheumatology/keu247. Epub 2014 Aug 12.

Davatchi F, Chams-Davatchi C, Shams H, et al. Adult Behcet's disease in Iran: analysis of 6075 patients. Int J Rheum Dis. 2016 Jan; 19(1):95-103. doi: 10.1111/1756-185X.12691. Epub 2015 Aug 10.

Balta I, Akbay G, Kalkan G, Eksioglu M. Demographic and clinical features of 521 Turkish patients with Behcet's disease. Int J Dermatol. 2014 May;53(5):564-9. doi: 10.1111/j.1365-4632.2012.05756.x. Epub 2013 Aug 22.

The authors declare that there are no conflicts of interest present.