Bacterial Diversity in Patients with Oral Ulceration in Behcet's Disease
Bacterial Diversity
Keywords:
Behcet's , oral, ulcer, StreptococciAbstract
Background: Behcet's disease is a chronic, relapsing, multi-system inflammatory disorder, clinically characterized by recurrent oral and genital ulcers, skin lesions, and uveitis. Environmental factors such as infectious agents have also been implicated in its pathogenesis. Aims and Objectives: to isolate different types of bacteria from patients with oral ulceration of Behcet's disease that may contribute in pathogenesis of these oral ulcers and tissue typing was done for those patients. Design: Cross-sectional study. Setting: Al-Karamma Teaching Hospital from January 2000 – Septomber 2000 at Baghdad city. Patients and methods: Study included 40 patients with Behcet's disease (BD). The other set was control group, consisted of 30 healthy volunteer's age- and sex-matched with first group from staff employees. Two swabs were taken from basal area of oral ulcer for direct exam and culture. Human Leukocytes Antigens typing was done for them by serological method.Results : Direct examination of their oral ulcer swabs showed significant difference regarding pus cells 87.5% (p= 0.0001) and red blood cells 75% (p= 0.0001). Gram stain showed significant increased in G+ cocci 95% (p= 0.0001). Other swab was cultured on Blood, Chocolate and MacConkey agar. The isolated bacteria were Streptococcus Pyogenes group A 75% (p= 0.0001)and Staphylococcus aureus 47% (p= 0.0001). HLA typing were done for them and 95% of them were HLA-B5 positive Conclusions: Microbial infection by Streptococci has been implicated in the development of Behçet's disease by trigger cross-reactive autoimmune responses in those patients. The frequency of the HLA-B51 allele is high among patients with Behçet's disease
References
2. Thomas HC, Ferguson A, McLennan JG and Mason DK. Food antibodies in oral disease: A study of serum antibodies to food proteins in aphthous ulceration and other oral diseases. J clin Path. 1973;26:371-374.
3. Sallay K, Kulcsar G, Dan P, Nasz I and Geck P. Atiology and prophylaxe der rezidivierenden aphthen. Deutsche Zahnarztliche Zeitschrift. 1975;30:570-575.
4. Barile MF, Graykowski EA, Driscoll EJ and Riggs DB. L form of bacteria isolated from recurrent aphthous stomatitis lesions. Oral Surg Oral Med and Oral Patho.1963;16:1395-1402.
5. Graykowski EA, Barile MF, Lee WB and Stanley HR. Recurrent aphthous stomatitis . Clinical therapeutic histopathologic and hypersensitivity aspects. J Am Med Ass.1966;196:637-644.
6. Strom J. Ectodermosis erosive pluriorificialis Stevens- Johnson's syndrome and other febrile mucocutaneous reaction and Behcet's syndrome in cold agglutination positive infections. Lancet.1965;1:457-458.
7. Lehner T.Progress report oral ulceration and Behcet's syndrome.Gut.1977;18:491-511.
8. Adinolfi M and Lehner T. Acute phase proteins and C9 in patients with Behcet's syndrome and aphthus ulcers. Clin Exp Immunol. 1976;25:36-39.
9. Lehner T. Immunoglobulin estimation of blood and saliva in human recurrent oral ulceration. Archives of Oral Biology.1969;14:351-364.
10. Direskeneli H, Hasan A, Shinnick T, Mizushima Y, Vanderzee R, Fortune F, Stanford MR and Lehner T. Recognition of B-Cell Epitopes of the 65 kDa HSP in Behçet's Disease. Scandinavian Journal of Immunology.1996; 43: 464–471.
11. Saito T, Honma T, Sato T and Fujioka Y. autoimmune mechanisms as a probable aetiology of Behcet's syndrome , an electrone microscopic study of the oral mucosa. Virchows Archiv A Pathologische Anatomie.1971;353:261-272.12. Williams BD and Lehner T. Immune complex in recurrent oral ulceration and Behcet's syndrome.Br Med J.1977; 28 : 1387- 1389.
13. Ohno S, Nakayama E, Sugiura S, Itakura K, Aoki K and Aizawa M. Specific histocompatibility antigens associated with Behcet's disease. Am J Ophth.1975;80:636-641.
14. Grumet FC, Coukell A, Bodmer JG, Bodmer WF and McDevitt HO.HLA antigens associated with systemic lupus erythematosus.New Eng J Med.1971;285:193-196.
15. Forbes BA, Sahm DF, Weissfeld AS. Diagnostic Microbiology. 11th ed. 2002. Mosby.
16. Yesudian PD, Edirisinghe DN, O'Mahony C. Behçet's disease. Int J STD AIDS. 2007;18:221-227.
17. Abdelfattah MH, El-Gengehy MT, Bahgat A and El-Toomy A. Behcet's syndrome-clinico-pathological and bacteriological study. J Egypt Med Assoc. 1972; 55: 634-643.
18. Kaneko F, Takahashi Y, Muramatsu Y and Miura Y. Immunological studies on aphthous ulcer and erythema nodosum-like eruptions in Behcet's disease. British Journal of Dermatology.1985; 113: 303–312.
19. Yoshikawa K, Kotake S and Matsuda H. Behcet's disease and streptococcal antigens. Nippon Ganka Gakkai Zasshi. 1996. 100: 173-180.
20. Apan TZ, Gursel R and Dolgum A. Increased seropositivity of Helicobacter pylori cytotoxin-associated gene-A in Behçet's disease. Clin Rheumatol .2007; 26:885-889.
21. Monselise A, Weinberger A, Monselise Y, Fraser A, Sulkes J and Krause I. Anti-Saccharomyces cerevisiae antibodies in Behçet's disease--a familial study. Clin Exp Rheumatol.2007;25:507-508.
22. Mumcu G, Inanc N, Yavuz S and Direskeneli H. The role of infectious agents in the pathogenesis , clinical manifestations and treatment strategies in Behcet's disease.Clin Exp Rheumatol.2007;25:S27-33.
23. Kaeko F, Oyama N, Yanagihori H, Isogai E, Yokota and Oguma K. The role of streptococcal hypersensitivity in the pathogenesis of behcet's disease. Eur J Dermatol .2008;18:489-498.
24. Bank I, Duvdevani M and Livneh A. Expansion of gammadelta T cells in Behcet's disease: role
of diseae activity and microbial flora in oral ulcers. J Lab Clin Med .2003; 141:33-40.
