The Expression Of Type 2 Inflammatory Cytokines IL-4 And IL-13 In Bullous Pemphigoid

BACKROUND AND OBJECTIVE:Bullous pemphigoid is one of the common autoimmune blister diseases that more affects the elderly.The typical clinical manifestations of bullous pemphigoid are urticaria-like erythema,tense blisters and itchy feeling with at the same time rising serum total IgE level as well as(or)peripheral blood eosinophils level.It has been reported that the amount of cells that produce IL-4 and IL-13 cytokines increase in the serum and blister fluid of bullous pemphigoid patients.It may suggest that type 2 inflammation occurs in the bullous pemphigoid because those two cytokines above relate directly to type 2 inflammation.The corollary has not been verified,so we set out to do the experiments detecting the expression of IL-4、IL-13 cytokines both in the serum and blister fluid between the patients and healthy people.Then we analyze the relationship among cytokines,total IgE level in serum,level of eosinophils in peripheral blood,erythema score of patients and pruritus NRS of patients so as to further explore the expression of type 2 inflammation in bullous pemphigoid.And considering the different expression of bullous pemphigoid antibodies(BP 180 and BP230),we put forward the inquiry:Whether the level of IL-4 and IL-13 cytokines goes with different collocation of bullous pemphigoid antibodies?The conclusion may indicate efficient classification of treatment in bullous pemphigoid.METHOD:1.We collected the serum and blister fluid of bullous pemphigoid patients and healthy people.Then detected the concentration of IL-4、IL-13 cytokines using ELISA method.2.Analyze whether there is difference of IL-4 and IL-13 cytokines between the serum and blister fluid in patients and healthy people?3.Find out the relationship among cytokines,total IgE level in serum,eosinophils level in peripheral blood,erythema score of patients and pruritus NRS of patients.4.Explore the relationship among BP180 and BP230 IgG antibodies,IL-4 and IL-13 cytokines level,total IgE level in serum and eosinophils level in peripheral blood.RESULT:1.Firstly,we found that the concentration of IL-4、IL-13 cytokines in serum shows no difference between patients and healthy ones.While those in blister fluid of patients rise significantly than the other(p<0.01).2.The level of IL-4、IL-13 cytokines in blister doesn’t go with those in serum.3.There is no obvious relationship among cytokines in serum,total IgE level in serum,eosinophils in peripheral blood,erythema score of patients and pruritus NRS in patients.But when it comes to blister,the concentration of IL-4 shows correlation with total IgE level(r=0.979).4.Erythema score and pruritus NRS in patients show positive correlation(r=0.696).5.The level of IL-13 cytokines in blister has positive correlation with single positive classification of bullous pemphigoid antibodies(r=0.579).CONCLUSION:1.IL-4 and IL-13 cytokines gather around in the local skin of bullous pemphigoid patients which gives a clue that type 2 inflammation exits in the local skin of bullous pemphigoid.2.When it comes to blisters,the concentration of IL-4 shows correlation with total IgE level,which suggests that total IgE level in patients may reflect the severity of local type 2 inflammation.3.The level of IL-13 cytokines in blister has correlation with single positive classification of bullous pemphigoid antibodies which prompts that single positive expression of BP antibodies may affect the development of type 2 inflammation through local collection of IL-13 cytokines.This finding might be helpful in the target therapy in the future.