Changes of neutrophil migration without modification of in vitro metabolism and adhesion in Behcet's disease

Objective. Increase of neutrophil chemotaxis in Behcet's disease (BD) has been described, but it is not clear whether there is a correlation with other variables of neutrophil function and whether these modifications correlate with disease activity. Methods. We studied neutrophil functions in patients with BD in the acute phase in comparison with healthy control subjects and with the same patients during disease remission, with or without therapy. We investigated in vivo neutrophil migration by Senn's skin window technique and measured adhesion assay and superoxide production in circulating and migrating neutrophils after different stimuli. Results. Neutrophil migration in vivo was 101.3 +- 17.9 times 10-6 polymorphonuclear lymphocytes (PMN)/cm-2/24 h in patients with BD in the acute phase and 66.1 +- 7.8 times 10-6 PMN/cm-2/24 h in controls (p lt 0.001). No correlation was found between leukocyte counts and neutrophil migration. Neutrophil migration evaluated in the same patients in a phase of disease remission was 58.3 +- 10.3 times 10-6 PMN/cm-2/24 h (p lt 0.001 vs acute phase, not significant vs controls). The neutrophils of the exudate were normally primed to response to the chemotactic peptide fMLP. No differences between the 2 groups were found in superoxide production, adhesion under basal conditions, or in response to different stimuli by circulating and migrating neutrophils. Conclusion. Abnormally high migration of neutrophils in the active phase of BD is the only consistent neutrophil dysfunction. Since this modification is reversed by therapy, the evaluation of in vivo neutrophil migration may be useful in diagnosing and monitoring disease activity. Blood neutrophils have normal responses to different stimuli, indicating they are not primed by the disease state.