Investigation of Methylglioxal, Ischemia-Modified Albumin Levels and Prolidase Activity in Behcet's Patients

Öz

Background: Behçet's disease is an autoimmune, chronic, inflammatory, multisystemic disease. Although oral aphthae, genital ulcers, skin lesions and uveitis are commonly seen in the disease, vasculitis is the main pathological finding. There is no laboratory finding specific to Behçet's disease. The levels of various routine parameters such as erythrocyte sedimentation rate and C-reactive protein have been shown to be high in Behçet's disease, however, the change in these parameters is not always consistent with clinical activity. The aim of this study was to investigate the relationship between Behçet's disease and ischemia-modified albumin, methylglyoxal and serum prolidase activity.
Materials and Methods: 35 Behçet patients and 35 controls were included in to the study. Serum ischemia-modified albumin levels and prolidase activity were measured spectrophotometrically (Perkin Elmer Lambda 25 UV/Vis, US) and serum methylglyoxal levels were measured by Thermo Ultimate 3000 Ultra-High Performance Liquid Chromatography.
Results: In the Behcet group, serum ischemia-modified albumin (p <0.001), prolidase, methylglyoxal (p <0.001), neutrophil lymphocyte ratio (p = 0.011), platelet lymphocyte ratio (0.015), erythrocyte sedimentation rate (p = 0.047), erythrocyte distribution width (p=0.021), neutrophil (p=0.007) levels were found to be significantly higher than the control group, whereas mean corpuscular hemoglobin concentration value was found to be significantly lower than the control group (p = 0010).
Conclusions: Serum ischemia modified albumin, methylglioxal levels and prolidase activity were statistically significantly different in the Behçet group compared to the control group.

Behçet Hastalarında Metilglioksal, İskemi Modifiye Albumin Düzeyleri ve Prolidaz Aktivitesinin Araştırılması

Öz

Amaç: Behçet hastalığı otoimmün, kronik, enflamatuvar, multisistemik bir hastalıktır. Hastalıkta yaygın olarak oral aft, genital ülserler, cilt lezyonları, üveit görülmekle birlikte temel patolojik bulgu vaskülittir. Behçet hastalığının spesifik bir laboratuvar bulgusu yoktur. Behçet hastalığında eritrosit sedimentasyon hızı, C-reaktif protein gibi çeşitli rutin parametrelerin düzeylerinde yükseklikler belirtilmekle birlikte bu parametrelerin düzeylerindeki değişiklikler klinik aktiviteyle her zaman paralellik göstermemektedir. Bizim bu çalışmadaki amacımız Behçet hastalığı ile iskemi modifiye albumin, metilglioksal ve serum prolidaz aktivitesi arasındaki ilişkiyi ortaya koymaktır.
Materyal ve metod: Çalışmaya 35 Behçet hastası, 35 kontrol dahil edilmiştir. Tüm bireylerin metilglioksal düzeyleri kromatografik yöntemle Thermo Ultimate 3000 Ultra-Yüksek Performanslı Likit Kromatografisi cihazında, serum iskemi modifiye albumin düzeyleri ve prolidaz aktivitesi spektrofotometrik (Perkin Elmer Lambda 25 UV/Vis, US ) yöntemle ölçülmüştür.
Bulgular: Behçet grubunda serum iskemi modifiye albumin (p<0.001), prolidaz, metilglioksal (p<0.001), nötrofil lenfosit oranı (p=0.011), platelet lenfosit oranı (0.015), eritrosit sedimentasyon hızı (p=0.047), eritrosit dağılım genişliği (p=0.021), nötrofil(p=0.007) düzeyleri kontrol grubuna göre istatistiksel olarak belirgin düzeyde yüksek bulunurken, ortalama eritrosit hemoglobin konsantrasyonu değeri ise kontrol grubuna göre istatistiksel olarak belirgin düzeyde düşük bulunmuştur (p=0.010).
Sonuç: Serum iskemi modifiye albumin, metilglioksal düzeyleri ve prolidaz aktivitesi Behçet grubunda kontrol grubuna göre istatistiksel olarak belirgin düzeyde farklı bulunmuştur.

Anahtar Kelimeler

• Behçet
• metilglioksal
• prolidaz

Kaynakça

1. 1.Ferizi M, Gerqari A, Ferizi M. Behçet's disease - case presentation and review literature. Open Access Maced J Med Sci. 2018; 6(10):1871-4.
2. 2.Scherrer MAR, Rocha VB, Garcia LC. Behçet's disease: review with emphasis on dermatological aspects. An Bras Dermatol. 2017; 92(4):452-64.
3. 3.Nair JR, Moots RJ. Behcet's disease. Clin Med (Lond). 2017; 17(1):71-7.
4. 4.Melikoğlu MA, Melikoğlu M. The influence of age on Behcet's disease activity. Eurasian J Med. 2008; 40(2):68-71.
5. 5.Kokturk A. Clinical and pathological manifestations with differential diagnosis in Behçet's disease. Patholog Res Int. 2012; 2012:690390.
6. 6. Anjos EB, Freitas EM, Martelli DRB, Dias VO, Machado RA, Anjos JPD, et al. Behçet's disease: a systemic case with recurrent oral ulcers. J Oral Diag. 2016; 1(1).
7. 7.Ceylan N, Bayraktaroglu S, Erturk SM, Savas R, Alper H. Pulmonary and vascular manifestations of Behcet disease: imaging findings. AJR Am J Roentgenol. 2010; 194(2):W158-64.
8. 8.Chen Y, Cai JF, Lin CH, Guan JL. Demography of vascular Behcet's disease with different gender and age: an investigation with 166 Chinese patients. Orphanet J Rare Dis. 2019; 14(1):88. 9.Fouad N, Ahmed T, Shaker O, Abdelaleem O. Relation of ischemia-modified albumin to disease manifestations and activity in Egyptian patients with Behcet’s disease. Egypt Rheumatol. 2019; 46(2):108-12.

9. 10.Majtan J. Methylglyoxal-a potential risk factor of manuka honey in healing of diabetic ulcers. Evid-Based Compl Alt. 2011; 2011:295494.
10. 11.Allaman I, Bélanger M, Magistretti PJ. Methylglyoxal, the dark side of glycolysis. Front in Neurosci. 2015; 9(23).
11. 12. Yadav SK, Singla-Pareek SL, Sopory SK. An overview on the role of methylglyoxal and glyoxalases in plants. Drug Metabol Drug Interact. 2008; 23(1-2):51-68.
12. 13.Wetzels S, Wouters K, Schalkwijk CG, Vanmierlo T, Hendriks JJA. Methylglyoxal-derived advanced glycation endproducts in Multiple Sclerosis. Int J Mol Sci. 2017; 18(2):421.
13. 14.Schalkwijk CG. Vascular AGE-ing by methylglyoxal: the past, the present and the future. Diabetologia. 2015; 58(8):1715-9.
14. 15. Bozkurt M, Yüksel H, Em S, Oktayoglu P, Yildiz M, Akdeniz D, et al. Serum prolidase enzyme activity and oxidative status in patients with Behçet's disease. Redox Report. 2014; 19(2):59-64.
15. 16.Collinson PO, Gaze DC. Ischaemia-modified albumin: clinical utility and pitfalls in measurement. J Clin Pathol. 2008; 61(9):1025-8. 17.Leitemperguer MR, Tatsch E, Kober H, Carvalho JA, Moresco RN, Silva JE. Assessment of ischemia-modified albumin levels in patients with rheumatoid arthritis. Clin Lab. 2014; 60(6):1065-70.
16. 18.Ozdemir M, Kiyici A, Balevi A. Assessment of ischaemia-modified albumin level in patients with psoriasis. Clin Exp Dermatol. 2012; 37:610–4.
17. 19.Guntas G, Sahin A, Duran S, Kahraman R, Duran I, Sonmez C, et al. Evaluation of ischemia-modified albumin in patients with inflammatory bowel disease. Clin Lab. 2017; 63(2):341-7.
18. 20. Bonorino NF, Lunardelli A, Oliveira JR. Use of ischemia modified albumin for the diagnosis of myocardial infarction. J Bras Patol Med Lab. 2015; 51:383-8.
19. 21.Wang X, Desai K, Clausen JT, Wu L. Increased methylglyoxal and advanced glycation end products in kidney from spontaneously hypertensive rats. Kidney Int. 2004; 66(6):2315-21.
20. 22.Myara I, Myara A, Mangeot M, Fabre M, Charpentier C, Lemonnier A. Plasma prolidase activity: a possible index of collagen catabolism in chronic liver disease. Clin Chem. 1984; 30(2):211-5.
21. 23. Bar-Or D, Lau E, Winkler JV. A novel assay for cobalt-albumin binding and its potential as a marker for myocardial ischemia-a preliminary report. J Emerg Med. 2000; 19(4):311-5. 24. Zeidan MJ, Saadoun D, Garrido M, Klatzmann D, Six A, Cacoub P. Behçet's disease physiopathology: a contemporary review. Auto Immun Highlights. 2016; 7(1):4.
22. 25. İnanır I, Onur E, Pırıldar T, Gündüz K, Var A. IL-2R, IL-6 and IL-8 levels in Behçet's disease. Türkdem. 2010; 44: 213-5.
23. 26. Aksoy SN, Savas E, Sucu M, Kisacik B, Kul S, Zengin O. Association between red blood cell distribution width and disease activity in patients with Behcet's disease. J Int Med Res. 2015; 43(6):765-73.
24. 27.Capkin E, Karkucak M, Kola M, Karaca A, Aydin Capkin A, Caner KS. Ischemia-modified albumin (IMA): a novel marker of vascular involvement in Behcet's disease? Joint Bone Spine. 2015; 82(1):68-9.
25. 28. Kılıç S, Işık S, Hiz MM, Çakır DÜ, Türkön H, Cevizci S, et al. The ischemia modified albumin and mean platelet volume levels in patients with Behçet's disease. Postepy Dermatol Alergol. 2016; 33(5):345-8.
26. 29. Keskin S, Arica DA, Orem A, Akçan B, Menteşe A, Bahadır S. Ischemia modified albumin: a useful marker for increased oxidative stress in Behçet’s disease. Mucosa. 2019; 2(1):19.
27. 30. Knani I, Bouzidi H, Zrour S, Bergaoui N, Hammami M, Kerkeni M. Methylglyoxal: A relevant marker of disease activity in patients with rheumatoid arthritis. Disease Markers. 2018; 2018:6.