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Environmental Rheumatology

 

The impact of environmental factors on aetiopathogenesis and clinical manifestations of Behçet’s syndrome

1, 2, 3, 4, 5, 6, 7, 8, 9, 10

 

  1. Rheumatology Unit, Azienda Ospedaliero-Universitaria Pisana, Pisa, and Department of Medical Biotechnologies, University of Siena, Italy.
  2. Rheumatology Unit, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
  3. Rheumatology Unit, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
  4. Rheumatology Unit, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
  5. Department of Experimental and Clinical Medicine, University of Florence, Italy.
  6. Rheumatology Unit, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
  7. Department of Medical, Surgery and Health Sciences, University of Trieste, and Clinical Medicine and Rheumatology Unit, Cattinara University Hospital, Trieste, Italy, and Centre for Inflammatory Diseases, Monash University Department of Medicine, Monash Medical Centre, Melbourne, Australia.
  8. Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, IRCSS Polyclinic Hospital San Martino, University of Genoa, Italy.
  9. Rheumatology Unit, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
  10. Rheumatology Unit, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy. sara.talarico76@gmail.com

CER17806
2024 Vol.42, N°10
PI 2008, PF 2013
Environmental Rheumatology

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PMID: 38855958 [PubMed]

Received: 25/04/2024
Accepted : 21/05/2024
In Press: 04/06/2024
Published: 15/10/2024

Abstract

Behçet’s syndrome (BS) is a rare multisystem vasculitis involving blood vessels of any size. BS aetiology is still unclear to date, and the heterogeneity of clinical expression among ethnics and genders make early diagnosis challenging. However, so far, considerable efforts have been made toward the understanding of BS, leading researchers to agree that the coexistence of some environmental triggers and a genetical susceptibility both underlie BS aetiopathogenesis. In particular, viral agents, oral microbial flora, and mucosal microbiota have been widely explored in this regard, but still no specific microorganism has been definitely linked to the disease aetiology. Likewise, the concept that some environmental factors may play a role in BS clinical presentation has emerged based on the growing evidence that disease severity is usually higher in male patients, and that diet and fatigue may be involved in disease recurrence, especially in mucocutaneous manifestations. Moreover, smoke cessation is acknowledged as a risk factor for oral ulcerations, although the underlying mechanism is still not clear. All those environmental factors play their effects through epigenetic mechanisms. The aim of this review is to discuss the evidence on the role of environmental factors in BS aetiopathogenesis and clinical course.

DOI: https://doi.org/10.55563/clinexprheumatol/bk6lc0

Rheumatology Article