Increased Salivary Cytokines and Nitric Oxide Levels in Behçet’s Disease: Interleukin-32, a Novel Player in Disease Prognosis

Oral aphthosis is one of the major manifestations of Behçet's disease (BD), a chronic, multisystemic vasculitis. BD etio-pathogenicity related to oral health lack.This study investigated the possible relationships between poor oral hygiene, oral activity, disease severity and saliva's Interleukin (IL)-32, IL-6, IL-10 and nitric oxide (NO) levels in Behçet's patients to determine their role in disease prognosis and their potential therapeutic interest.Fifty-six patients with BD (22 orally active; 34 orally inactive) and 31 healthy subjects have been included in our study. Salivary levels of IL-32, IL-6, and IL-10 were measured using ELISA, while NO levels were assessed by modified Griess's method. Oral health status and disease severity scores were recorded for each participant. Kruskal-Wallis test and Spearman's test were performed for statistical analyses.We observed that the tested molecules were increased in BD patients compared to healthy controls (p˂0.05). Moreover, only IL-32 levels were associated with oral activity in patients (p˂0.05). Interestingly, the disease severity score was noted to be correlated positively and significantly with both IL-32 saliva levels (p˂0.01) and plaque index (p˂0.05) in BD patients. Furthermore, IL-32 levels were correlated with plaque index (p˂0.0001).Our results suggest that IL-32, IL- 6, IL-10 and NO were increased in saliva during BD. Our study indicated that IL-32 was associated with the genesis of oral ulcers in response to dental plaque. Ultimately, salivary IL-32 may serve as a prognostic biomarker and a possible therapeutic target for managing Behçet's disease severity.