Elucidating the Role of Neutrophils in the Inflammatory Response to Behcet Syndrome

Yesim Ozguler,1,2 Sinem Nihal Esatoglu,1,2 Gulen Hatemi1,2 1Department of Internal Medicine, Division of Rheumatology, Cerrahpaşa Medical School, Istanbul University-Cerrahpaşa, Istanbul, Türkiye; 2Behçet’s Disease Research Center, Istanbul University-Cerrahpaşa, Istanbul, TürkiyeCorrespondence: Gulen Hatemi, Department of Internal Medicine, Division of Rheumatology Cerrahpaşa Medical School, Istanbul University-Cerrahpaşa and Behçet’s Disease Research Center, Istanbul University-Cerrahpaşa, Istanbul, 34098, Türkiye, Tel +905325229501, Email [email protected]: Behçet syndrome (BS) is a chronic, relapsing, multisystem inflammatory disorder in which both innate and adaptive immune mechanisms contribute to disease pathogenesis. Among innate immune cells, neutrophils have emerged as key effectors driving tissue inflammation, endothelial injury, and immunothrombosis. Early studies demonstrated enhanced chemotaxis, oxidative burst, and a primed activation state of circulating neutrophils, whereas more recent evidence highlights excessive neutrophil extracellular trap (NET) formation as an important contributor to vascular inflammation and thrombosis. In addition, recent omics-based studies have provided novel insights into neutrophil heterogeneity, activation pathways, and disease-specific signatures in BS. This review summarizes current knowledge on the role of neutrophils and NETs in the pathogenesis of BS, summarizes available evidence on mechanisms of neutrophil activation, and highlights potential directions for future research.Keywords: Behçet syndrome, neutrophil, neutrophil extracellular traps, NET, oxidative burst, omics