Journal
INTERNAL AND EMERGENCY MEDICINE
Volume 14, Issue 5, Pages 653-660Publisher
SPRINGER-VERLAG ITALIA SRL
DOI: 10.1007/s11739-018-2000-1
Keywords
Triggering agents; Environmental factors; Microbiome; Behcet's syndrome
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Environmental and other triggering factors are suggested to cause the onset and the clinical relapses of Behcet's syndrome (BS), a multi-systemic inflammatory disorder. In this review, environmental factors are discussed according to their interactions with etiopathogenesis, immune response and disease activity. Stress is a common self-triggering factor for most BS patients. Stimuli such as some foods can activate oral ulcers, and may be linked to the histamine content of the food. Oral/skin trauma and menstruation associated with hormonal factors aggravate, whereas allergy/atopy seem to alleviate the symptoms of BS. Infections are associated with BS, and microbial stimuli can activate inflammation in mucosal surfaces with increased Th1/Th17 responses. Fecal and oral microbiome patterns change in diversity and composition in BS. Better oral hygiene applications and anti-microbial interventions might be helpful to suppress oral ulcers in BS.
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