doi: 10.1111/j.1346-8138.2007.00278.x Journal of Dermatology 2007; 34: 308–314 308 © 2007 Japanese Dermatological Association Blackwell Publishing Asia ORIGINAL ARTICLE Oxidative stress in patients with Behcet’s disease: I correlation with severity and clinical parameters Rafid A. NAJIM, 1 Khalifa E. SHARQUIE, 2 Ahmed R. ABU-RAGHIF 1 1 Department of Pharmacology and 2 Dermatology, College of Medicine, University of Baghdad, Baghdad, Iraq ABSTRACT The study was designed to investigate the possible correlation between some oxidative stress parameters in Behcet’s disease and the clinical manifestations of the disease as well as the possible correlation with the disease severity. Seventy-six patients diagnosed according to the International Study Group criteria for Behcet’s disease were included in the study. Sixty patients had mild-to-moderate disease and 16 patients had severe disease. Sixty matched control subjects were also included. After a full history and examination from each subject, 10 mL blood was drawn from each for analysis. Serum malondialdehyde, glutathione, ceruloplasmin, copper and zinc levels were determined. Patients with Behcet’s disease showed increased levels of serum malondialdehyde and copper while glutathione and zinc levels were decreased. Comparison between these parameters in patients with mild- to-moderate disease with those with severe disease showed only that serum zinc levels were lower in severe Behcet’s disease. Serum malondialdehyde levels were found to be significantly positively correlated with oral ulcer size, duration and frequency. Glutathione levels were found to be inversely correlated with the clinical manifestation index and all oral ulcer parameters. Zinc levels were found to be inversely correlated with the clinical manifestation index and pathergy test positivity grades. Copper levels were found to be positively correlated with oral ulcer number. Although the parameters of oxidative stress did not show correlation with disease severity, they were correlated with the disease manifestations. This points out the importance of oxidative stress in Behcet’s disease. Key words: Behcet’s disease, ceruloplasmin, glutathione, malondialdehyde, serum copper, serum zinc. INTRODUCTION Behcet’s disease is a chronic relapsing disease characterized by multiple signs and symptoms such as recurrent orogenital ulceration, eye involvement, skin manifestations and other system affections. 1 It was first described by the Turkish dermatologist Hulusi Behcet in 1937 as “recurrent oral aphthous ulcers, genital ulcers and hypopyon-uveitis”. 2 The initial pathological process is a systemic neutrophilic reaction of the small vessels. 3 Behcet’s disease is considered to be an autoimmune disorder with unknown etiology. 4 However, during the course of Behcet’s disease, a cascade of immunological events occur in the skin. 5 Increasing attention has been focused on the role of reactive oxygen species produced by activated neutrophils during the inflammatory response. 6 These reactive oxygen molecules are highly reactive and can attack almost every cell component, causing further damage to surrounding tissue. 6 There are several reports about oxidative stress in Behcet’s disease, 7,8 but there are few reports deal- ing with the possible correlation of severity with the oxidative stress parameters and these parameters with the clinical manifestations of Behcet’s disease. The aim of the present work is to investigate some oxidative stress parameters in patients with Behcet’s This paper is based on a Ph.D. thesis by A.R.A. Correspondence: Prof. Rafid A. Najim, Department of Pharmacology, College of Medicine, University of Baghdad, P.O. Box 61208, Baghdad 12114, Iraq. Email: rafidnajim@yahoo.com Received 24 February 2006; accepted 9 November 2006.