Jedd D. Wolchok, MD, PhD
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Wolchok JD. Treatment of Behcet Disease with Pentoxifylline. Ann Intern Med. 1997;126:493. doi: 10.7326/0003-4819-126-6-199703150-00020
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Published: Ann Intern Med. 1997;126(6):493.
TO THE EDITOR:
Yasui and colleagues  recently published an interesting report on the efficacy of pentoxifylline in the treatment of three patients with Behcet disease. The precise cause of Behcet disease remains unknown; however, international diagnostic criteria include the classic symptoms of oral and genital ulcerations, uveitis, and skin lesions .
I was intrigued by one possible mechanism of action of pentoxifylline that may help elucidate the cause of Behcet disease. This compound, a methylxanthine derivative, has been shown to inhibit the production of various proinflammatory cytokines, especially tumor necrosis factor-α (TNF-α) . Interestingly, levels of TNF-α induced by lipopolysaccharide have been shown to be increased in peripheral blood mononuclear cells from patients with Behcet disease when compared with levels in age-matched healthy controls . Thus, TNF-α may play a substantial role in the pathogenesis of Behcet disease, either directly or through the induction of other cytokines. This proposed mechanism is supported by the finding that thalidomide, an inhibitor of TNF-α action, also reduces mucosal ulcerations in patients with Behcet disease .
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