Correlation between elevation of serum antinuclear antibody titer and decreased therapeutic efficacy in the treatment of Behçet’s disease with infliximab

  • Daiju Iwata
  • Kenichi NambaEmail author
  • Kazuomi Mizuuchi
  • Nobuyoshi Kitaichi
  • Satoru Kase
  • Yuko Takemoto
  • Shigeaki Ohno
  • Susumu Ishida
Inflammatory Disorders



Infliximab, an anti-TNF-α monoclonal antibody, administered to Behçet’s disease (BD) patients in Japan with refractory intraocular inflammation, has shown excellent clinical results. However, some patients demonstrate a decreased response to infliximab during the course of the treatment. In the present study, we investigated the correlation between this reduced therapeutic effect and elevation of the serum antinuclear antibody (ANA) titers in patients with BD who were undergoing infliximab therapy.


Seventeen patients (14 males and three females) with uveitis in BD who were undergoing treatment with infliximab for 2 years or longer were enrolled. Their blood test results and clinical histories were obtained from medical records.


One patient (5.9%) was ANA-positive prior to the initiation of infliximab, and 11 patients (64.7%) developed positive ANA during the therapy. The appearance of ANA was observed 6 months after the initiation of the infliximab therapy, and its titers gradually increased. None of the patients showed lupus symptoms. Five patients (29.4%) have suffered from ocular inflammatory attacks since the sixth month from the initiation of infliximab treatment and all of them were ANA-positive. In contrast, four patients (23.5%) who were ANA-negative experienced no ocular attacks during the follow-up period.


Here we report the positive conversion and subsequent elevation of serum ANA titers in some patients with BD after the initiation of infliximab therapy. Since all recurrences of uveitis were shown only in the ANA-positive patients, serum ANA titer may be a helpful biomarker for predicting the recurrence of ocular attacks in BD patients treated with anti-TNF-α antibody therapies.


Behçet’s disease Retinal vasculitis Uveitis Antinuclear antibody Infliximab Biomarker Anti-TNF-α monoclonal antibody 


Competing interests




Ethics approval

This study was approved by the institutional Ethics Committee of Hokkaido University

Patient consent



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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Daiju Iwata
    • 1
  • Kenichi Namba
    • 1
    Email author
  • Kazuomi Mizuuchi
    • 1
  • Nobuyoshi Kitaichi
    • 2
    • 3
  • Satoru Kase
    • 1
  • Yuko Takemoto
    • 1
  • Shigeaki Ohno
    • 3
  • Susumu Ishida
    • 1
  1. 1.Department of OphthalmologyHokkaido University Graduate School of MedicineSapporoJapan
  2. 2.Department of OphthalmologyHealth Sciences University of HokkaidoSapporoJapan
  3. 3.Department of Ocular Inflammation and ImmunologyHokkaido University Graduate School of MedicineSapporoJapan

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