Assessment of T Regulatory cells in Egyptian patients with Behcet's disease as a prognostic marker of Uveitis

Behcet's disease is an autoimmune type of vasculitis presenting by attacks of oral, skin and genital ulcers, as well as ophthalmic disorders that cause blindness in 25% of affected patients. Circulating T regulatory cells suppress atypical autoimmune responses and help developing immune self-tolerance. An X chromosome encoded forkhead transcription factor (Foxp3) is essential for proper T reg cell development and function. Aim of the work; The aim of the study was to determine the correlation between T reg cell percentage of expression, Behcet's uveitis pathogenesis, and disease manifestations. Materials and Methods; Forty-four subjects were involved in this study: 15 subjects diagnosed with Behcet's uveitis (including a female) in addition to 29 healthy age and sex-matched controls. The percentage of CD25 and Foxp3 expression in peripheral blood CD4(+) T-lymphocytes was determined by flowcytometry. X-rays and magnetic resonance imaging (MRI) were used to assess patients with suspected Behcet's arthritis. Results; Percentages of CD4(+)CD25(-)Foxp3(+)and CD4(+)CD25(+)Foxp3(+) T reg cell expression were higher in Behcet's uveitis patients compared to the controls without a significant difference. Conversely, CD4(+)CD25(+)Foxp3 (-) T reg cell percentage was found to be higher in the controls than in Bechet's uveitis cases without a significant difference. However, the mean fluorescence intensity of Foxp3 factor necessary for Treg cell function was significantly higher in the control group compared to Behcet's uveitis cases (p = 0.02). Conclusions; Results of the current work indicate the protective role played by T reg cells (especially the Foxp3(+) group) against Behcet's uveitis that could be used as a valuable prognostic marker.