Amal A Senusi1, Jie Liu1, Dorian Bevec2, Lesley A Bergmeier1, Miles Stanford3, Desmond Kidd3, Ali Jawad3, Steve Higgins3, Farida Fortune4. 1. Institute of Dentistry, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, UK. 2. THERAMetrics Discovery AG, Stans, Switzerland. 3. Behçet's Centre of Excellence, Royal London Hospital, London, UK. 4. Centre for Clinical and Diagnostic Oral Sciences, Institute of Dentistry, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, UK. f.fortune@qmul.ac.uk.
Abstract
OBJECTIVES: Patients with Behçet's disease (BD) constantly complain of fatigue and many have problems with poor sleep. This ultimately has a major impact on all aspects of normal living. To attempt to understand this, Artificial Intelligence (AI) was used to identify potential biomarkers. These were alpha-melanocyte stimulating hormone (α-MSH), vasoactive intestinal peptide (VIP) and some inflammatory cytokines. We assessed the association of fatigue, quality of sleep and disease activity with circulating concentration of α-MSH, VIP and inflammatory cytokines. METHODS: There were 127 participants, 97 BD patients, and 30 healthy controls (HC). All completed the Multi-Dimensional Assessment of Fatigue questionnaire (MAF) and the Pittsburgh Sleep Quality Index (PSQI) on the day of their clinical assessment. Enzyme-linked immunosorbent assays (ELISA) were used to evaluate the serum concentrations of α-MSH, VIP and cytokines (IL-1β, IL-6, IL-10, and TNF-α). RESULTS: 64% of BD patients experienced high fatigue scores, and 63% had poor quality of sleep. When BD and HC were compared the MAF and PSQI scores as well as the serum concentrations of α-MSH, VIP, and IL-6 were significantly higher in BD (p values were: 0.001, 0.001, 0.001, 0.004 and 0.036, respectively). Both α-MSH and IL-6 had significant impact on MAF and PSQI. Interestingly, VIP had a significant influence on PSQI and disease activity, but not on MAF. CONCLUSIONS: A better understanding of these complex clinical and biochemical interactions between α-MSH, VIP and IL-6 might lead to the development of novel approaches to manage fatigue and sleep disorders as well as disease activity in BD patients.
OBJECTIVES:Patients with Behçet's disease (BD) constantly complain of fatigue and many have problems with poor sleep. This ultimately has a major impact on all aspects of normal living. To attempt to understand this, Artificial Intelligence (AI) was used to identify potential biomarkers. These were alpha-melanocyte stimulating hormone (α-MSH), vasoactive intestinal peptide (VIP) and some inflammatory cytokines. We assessed the association of fatigue, quality of sleep and disease activity with circulating concentration of α-MSH, VIP and inflammatory cytokines. METHODS: There were 127 participants, 97 BD patients, and 30 healthy controls (HC). All completed the Multi-Dimensional Assessment of Fatigue questionnaire (MAF) and the Pittsburgh Sleep Quality Index (PSQI) on the day of their clinical assessment. Enzyme-linked immunosorbent assays (ELISA) were used to evaluate the serum concentrations of α-MSH, VIP and cytokines (IL-1β, IL-6, IL-10, and TNF-α). RESULTS: 64% of BD patients experienced high fatigue scores, and 63% had poor quality of sleep. When BD and HC were compared the MAF and PSQI scores as well as the serum concentrations of α-MSH, VIP, and IL-6 were significantly higher in BD (p values were: 0.001, 0.001, 0.001, 0.004 and 0.036, respectively). Both α-MSH and IL-6 had significant impact on MAF and PSQI. Interestingly, VIP had a significant influence on PSQI and disease activity, but not on MAF. CONCLUSIONS: A better understanding of these complex clinical and biochemical interactions between α-MSH, VIP and IL-6 might lead to the development of novel approaches to manage fatigue and sleep disorders as well as disease activity in BD patients.