Behcet's disease: immunogenetic studies and therapeutic update

Pathogenesis: The pathogenesis of BehAetis disease is still unknown, althou gh a genetic predisposition appears to play an important role with a strong association with the MICA gene located between the HLA-B and TNF genes rat her than HLA B51.Abnormal immune responses affect especially cellular immun ity and significant T-cell proliferative responses by the gamma o subset of T cells are shown after stimulation with heat shock protein peptides. Syst emic levels of the soluble TNF R-75 and IL 12 could be the best biological markers of disease activity. New therapeutic approaches: Systemic colchicine being implicated in polynuc lear neutrophil over-production of toxic super-oxides, its prescription for controlling eye involvement should be reevaluated. Steroids and immunosupp ressive drugs are still the treatment of choice for severe manifestations o f the disease. Beneficial effects of cyclosporine are established in uveiti s. Tacrolimus (FK 506) and pentoxifylline may be valuable.