Growth factor levels in saliva of Behcet's patients

Healing is diminished in systemic immune disorders, such as Behcet's disease, where oral ulcers take an excessive time to heal and may be associated with atrophic scarring of the mucosal tissues. Since growth factor activities are crucial to the wound healing process we hypothesized that growth factor levels would be diminished in Behcet's patients. Objectives: The aim of this study was to compare levels of vascular endothelial growth factor (VEGF), epidermal growth factor (EGF) and platelet derived growth factor (PDGF-BB) in saliva from Behcet's patients (BD) and healthy control volunteers (HC). Methods: Whole unstimulated saliva was obtained with informed consent from Behcet's patients (BD, n=18) and age-matched normal healthy controls (HC, n=14). Behcet's patients were diagnosed according to ISBD Study Group criteria. Healthy donors had no history of recurrent aphthous ulceration or other oral pathological conditions. Saliva samples were placed on ice and then centrifuged to remove bacterial and cellular debris. Samples were stored at -70°C until assayed for EGF, VEGF and PDGF-BB using ELISA. Results: Significantly higher levels of EGF (1765 ± 59.1pg/ml) and PDGF (68.4 ± 10.6 pg/ml) were measured in Behcet's patients' saliva as compared to control saliva respectively (1441.7 ± 68.8 pg/ml, 35.2 ± 8.9 pg/ml; p< 0.0005 and p<0.05). However, VEGF was lower in Behcets' patients' saliva (199 ±31.8 pg/ml) than in the healthy control saliva (305.8 ± 32.3 pg/ml; p< 0.05). Conclusions: These results demonstrate that salivary growth factor expression is modulated in Behcet's disease. Low levels of VEGF were in agreement with our hypothesis and suggest that VEGF is likely to be a contributing factor to delayed oral ulcer repair in Behcet's patients. High EGF levels in Behcet's patients' saliva were unexpected and we speculate that a defect may be present in the processing of EGF at the target cell level.