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Behçet's uveitis in Turkey, why is it still number one?
Author(s) -
TugalTutkun I.
Publication year - 2015
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2015.0066
Subject(s) - disease , immunology , uveitis , medicine , behcet's disease , immune system , acquired immune system , population , hygiene hypothesis , environmental health , pathology
Summary Pathogenetic mechanisms underlying Behçet's disease include complex interactions between genetic factors, environmental factors, and immunological aberrations. The strong association of Behçet's disease with the HLA ‐B51 antigen has been known for more than 3 decades. Recent genome‐wide association studies have also shown several shared genetic factors throughout the old Silk Route. In contrast to the recent trend for lower disease prevalence and milder disease forms in Japan, Behçet's disease still accounts for around 25% of uveitis cases in Turkey. This suggests the strong role of environmental factors in disease onset and phenotype. Infections are suspected in the initial triggering of the disease as well as in relapses of its manifestations. It is thought that an aberrant immune response may be generated to different microorganisms recognized by pattern receptors in genetically susceptible individuals. An impaired microbial clearance and exuberant innate and adaptive immune responses to microbial products may have a major contribution to the pathogenesis. Better socioeconomic status with improved living conditions and personal hygiene in the Turkish population will hopefully lead to a lower disease prevalence and severity.