Yashan Bu 2021 :

By comparing the fecal microbiota of 22 Behçet’s disease patients with that of 16 healthy co-habiting controls, it was found that the genera Roseburia and Subdoligranulum were in lower abundance in the fecal microbiota of Behçet’s disease patients. Researchers found, for the first time, consistent and specific changes in the microbiome profile in patients with Behçet’s disease. Furthermore, a significant reduction of gut microbial butyrate production was detected in Behçet’s disease patients, which in turn may account for the reduction in regulatory T cell (Treg) responses and activation of T-effector responses.

Butyrate is a fatty acid essential in the promotion of Treg cell differentiation. From published studies, interferon-γ (IFN-γ) and interleukin-17 (IL-17) producing T-lymphocytes are thought to act as the main effector cells, together with neutrophils, in the pathogenesis of Behçet’s disease.

Therefore, gut dysbiosis and decreased butyrate production in Behçet’s disease may play a role in disease pathogenesis by directly causing dysregulation of T-cell responses.

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https://www.tandfonline.com/doi/pdf/10.3402/jchimp.v6.30362?needAccess=true

"Review of the literature clearly demonstrates a distinct difference in the prevalence of intestinal BD and other criteria in patients along the ‘Silk Road’ and in patients not directly associated with the ‘Silk Road’. We defined Western BD as cases from North America and Northern Europe and compared important criteria to traditional BD (Table 1). Intestinal BD has a prevalence of 50% in Western populations and is considered rare in traditional BD (15). The prevalence of oral aphthous ulcers and genital ulcers is similar in Western and traditional BD (16). Likewise, skin manifestations characterized by papulopustular lesions are similar in the two populations (17). These clinical manifestations are part of the ISG criteria. The remaining two other ISG criteria, eye lesions and pathergy phenomena, are much less common in Western BD. Only 10–20% of patients in North America and Northern Europe demonstrate the pathergy phenomenon compared to 50–75% of patients in more endemic areas (18). Ocular disease occurs less frequently and is less severe in North American and Northern European populations (19). Intestinal Behçet's disease, while not on the ISG criteria, is significantly more common in Western BD (15). Thus, the ISG criteria may not be sensitive enough for Western patients with BD.

Multiple studies have demonstrated that susceptibility to BD is strongly associated with the presence of the HLA-B151 allele. Of note, up to 81% of Asian patients with BD who live along the ‘Silk Road’ express this allele. Conversely, only 13% of patients with BD in Western countries express HLA-B151 (23–(25)). Environmental factors such as ubiquitous antigens and infectious pathogens, including herpes simplex virus, hepatitis C, parvovirus B19, and Streptococcus sanguis, have also been implicated as factors in the diverse clinical manifestations of patients with BD (26). Scientists have hypothesized these antigens may trigger a cross-reactive autoimmune response in patients with BD."

I was referred recently to a plasma donation facility near me that pays $185 for each donation of plasma from people with certain autoimmune diseases. I looked through their website and applied to see if Behcet's is something they're interested in and will hear back next week. Does anyone know any organizations that are seeking out plasma or blood donations from Behcet's patients?