Behçet’s Syndrome: From Pathophysiology to Personalized Therapeutics

Behçet’s syndrome (BS) is a chronic multisystem disorder characterized by recurrent oral and genital ulcers with frequent ophthalmic, gastrointestinal, neurologic, and vascular involvement. BS shows features of both autoimmunity and autoinflammation, yet its exact pathophysiology remains poorly understood.



Diagnosis is entirely clinical, as no specific laboratory test exists. Several sets of diagnostic/classification criteria are available, with the ISG and ICBD criteria most commonly used. However, these criteria may fail to capture a significant subset of patients, particularly those presenting with severe organ‑ or life‑threatening manifestations or with incomplete phenotypes.



Biologic therapies, especially anti–TNF‑α agents, have significantly improved the management of BS and transformed outcomes for many patients. Nonetheless, a considerable proportion fail to respond adequately or lose response over time, creating a major therapeutic challenge and underscoring the need for additional and more personalized treatment options. Another important unmet need is the reliable monitoring of disease activity. Current indices often fail to reflect the heterogeneity, fluctuating course, and multisystem nature of BS, which limits both optimal clinical care and high‑quality clinical research.



This Research Topic aims to address these gaps by focusing on three main areas:



-Exploring the pathophysiology of BS

We invite studies that clarify the immunologic and genetic background of BS, including the role of innate and adaptive immunity, cytokine networks, environmental triggers, and the microbiome. Recent advances in genomics, transcriptomics, proteomics, and single‑cell technologies may help define disease pathways and distinct clinical or molecular endotypes.



-Facilitating better diagnosis of BS

We welcome work on novel or refined diagnostic/classification criteria, as well as clinical, serologic, imaging, or genetic biomarkers that improve early and accurate diagnosis and help distinguish BS from its mimics. Data‑driven approaches, including machine learning, are of particular interest.



-Exploring new and personalized therapeutic options

We encourage submissions on emerging targeted therapies beyond anti–TNF‑α (such as IL‑1, IL‑6, IL‑17, or JAK/STAT pathway inhibitors), on strategies tailored to specific disease phenotypes, and on validated tools for monitoring disease activity and treatment response, including patient‑reported outcomes.



We call for original research, reviews, and perspectives addressing these aspects of BS, with the ultimate goal of improving diagnosis, treatment, and long‑term outcomes for patients affected by this complex disease.