الفهرس 
AcknowledgementOnly 14 pages are availabe for public view
 |  | from | 141 |  |  |
| | | from | 141 | | |
Abstract
Background: Behcet’s disease and systemic lupus erythromatosus are autoimmune and autoinflammatory disorders. Both disorders presented with psychiatric comorbidities as a part of Neuropsychiatric systemic abnormalities. Cognitive impairment depression and anxiety have been reported for BD and SLE patients even without neurological involvement. however, the prevalence of these disorders show variation between studies. Mental, physical and social well-being are important outcomes in patients with chronic rheumatic diseases, including BD and SLE. Assessment of QOL is remarkable part in the evaluation of those patients. The IL23/Th17 Pathway has been implicated in pathogenesis of chronic inflammatory/autoimmune mediated diseases such as psoriasis.
Aim of the work: to analyze the severity of psychological symptoms, in the form of: anxiety, depression, cognitive functions and quality of life in Behcet’s disease and Systemic lupus erythematosus patients, find out the correlation between psychiatric manifestations and disease activity and Evaluate the serum level of IL-23 and IL-17 and its correlation to the disease activity.
Materials and Methods: 45 BD patients, 35 SLE patients and 30 healthy control group were included in this study. All patients and control were subjected to complete clinical evaluation, diseases activity measurement using Behçet’s Disease Current Activity Form (BDCAF) for BD patients and clinical SLEDAI-2 K (c-SLEDAI-2 K) for SLE patients, measuring serum level of IL-17 and IL-23, neuropsychological assessment include Memory Assessment Scale (MAS), Hamilton depression rating scale (HDRS), Hamilton Anxiety Rating scale (HARS), Short form 36 Quality of life questionnaire (SF-36 QOL), and Global Assessment of Functioning scale (GAF).
Results: BD and SLE subjects have a lower score in all components of MAS, SF-36 QOL and in GAF scores and significant high prevalence of depression and anxiety compared to control group. Serum level of IL-17 and IL-23 levels showed significant increase among BD and SLE patients in compare to control group. Serum level of IL-23 were elevated in active SLE patients compared with inactive SLE patients. There was significant positive correlation between SELDAI and IL 17 and IL-23.
Conclusion: we concluded that patients with BD and SLE have with higher incidence of cognitive impairment, depression, anxiety and decreased quality of life. health related quality of life is more affected in SLE patients than those with BD. The comorbid psychiatric manifestations occur independently on the clinical manifestation and unrelated to the disease activity in both diseases. This study supports the role of IL23/Th17 Pathway in the pathogenesis of those diseases. Serum level of IL17 and IL23 could be used as a reliable biomarker for both BD and SLE and the level of IL23 in the serum could be used as indicator of SLE activity.
Recommendations
We recommended to:
• Larger sample size will be needed to confirm our result
• Further studies to confirm the relation between the serum level of theses interlukines and psychiatric manifestation and the relation of psychiatric manifestation with the disease activity
• Additional studies will be required to show the sensitivity of these cytokines in diagnosis of these diseases.
• It is plausible that therapeutic targeting of The IL23/Th17 Pathway might benefit for those with BD and SLE.
• The limitation in this study was inability to stop patient’s treatment during the research, which may affect our result. In addition, the use of subjective tools only in assessment of the patient’s psychiatric manifestations may affect the results. Additionally, lack of variability due to high prevalence of psychiatric manifestation may affect somehow the correlation results. The data presented here, could be considered a preliminary study and should be reproduced using a larger cohort study using imaging modalities as an objective tool to be validated.