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How certain molecules of the immune system affect bullous pemphigoid
Author(s) -
Kamata A.,
Kurihara Y.,
Funakoshi T.,
Takahashi H.,
Kuroda K.,
Hachiya T.,
Amagai M.,
Yamagami J.
Publication year - 2020
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1111/bjd.18988
Subject(s) - bullous pemphigoid , immunoglobulin e , autoantibody , medicine , pemphigoid , immunology , antibody , autoimmune disease
Summary Bullous pemphigoid (BP) is a rare skin disease that mainly affects people aged over 60. Patients develop red patches and blisters. BP is an autoimmune skin disease, meaning that antibodies – instead of attacking dangerous microorganisms as they are meant to – instead recognize and attach to molecules present in normal skin, causing an inflammatory reaction. The two autoantigens (molecules) targeted by BP autoantibodies are BP180 and BP230, both of which are components of the basement membrane zone (BMZ, the junction between the outer and middle layers of skin). In addition to autoantibodies called IgG, a subset of BP patients show deposition (presence) of a different antibody called IgE in the BMZ, yet the relationship between BMZ IgE and the severity of BP remains unclear. In this study, from Japan, the authors investigated the relationship between IgE deposition in the BMZ, IgE levels in the blood serum, and disease severity in BP patients. First, the authors examined skin samples of 53 bullous pemphigoid (BP) patients. 10 of them had strong, and 13 of them had weak IgE deposition in the BMZ. Next, of those 53 PB patients, the authors focused on 15 patients who had tested before treatment. Those who had strong IgE deposition on BMZ had more widespread BP than those who had no IgE deposition, as measured using a score called the bullous pemphigoid disease area index (PDAI). Patients with strong or weak IgE deposition on BMZ took a longer time to improve after treatment with medicines called systemic corticosteroids started. In contrast, no significant differences were found for their Urticaria/Erythema BPDAI scores, which measure skin redness and hives, among other things. These suggest that IgE deposition on BMZ influences the formation of blisters in BP patients. In line with previous work, the results indicate that anti‐IgE therapy such as omalizmab is effective for curing not only erythema (redness) and urticaria (hives) but also erosions and blisters in BP. This is a summary of the study: Basement membrane zone IgE deposition is associated with bullous pemphigoid disease severity and treatment results.