Assessment of Thiol/Disulfide Homeostasis and Its Association With Clinical Manifestations in Behcet’s Disease

Behcet's disease (BD) is a multisystemic inflammatory vasculitis characterized by recurrent episodes of exacerbation and remission, with unpredictable duration and system involvement in each episode. Although previous studies have shown the role of oxidative stress in the pathogenesis of BD, the relationship between the clinical features of Behcet's disease and oxidative stress has not been fully studied to date. This study aims to assess the parameters of dynamic thiol disulfide homeostasis (DTDH) and their relationship with different clinical characteristics of disease in BD patients. Fifty patients with BD and 54 age and gender-matched healthy controls were included in the study. Disease activity was measured by the BD Current Activity Form. The mean total thiol (TT) levels were higher in BD patients compared to controls (p=0.04). The native thiol (NT) levels were lower in patients with BD compared to healthy individuals (p=0.014). Disulfide levels, disulfide/NT, and disulfide/TT levels were similar in both groups (all, p>0.05). No significant differences in DTDH parameters were observed based on the presence or absence of erythema nodosum, papulopustular lesions, venous thrombosis, arthritis/arthralgia, neurological involvement, pathergy test positivity, or HLA-B51 status (all, p>0.05). We found lower NT levels in patients with genital ulcers or eye involvement compared to those without these manifestations (p=0.036 and p=0.003, respectively). We observed similar DTDH parameters in patients with and without active disease, and in patients with and without current medical therapy (all, p>0.05). In addition, we found a negative relationship between disease duration and TT and NT levels (all, p<0.05). In conclusion, we demonstrated an imbalance of DTDH in the patients with BD, supporting the hypothesis that oxidative stress may contribute to the etiopathogenesis and progression of the disease.