Analysis of serum cytokine profile in pemphigus

Abstract

Background: Pemphigus is a group of autoimmune blistering diseases affecting skin and mucous membranes. While pemphigus is an autoantibody mediated disease, the role of T cells and cytokines in the pathogenesis of pemphigus is being increasingly recognized. However, contrasting data are available regarding the serum cytokine levels, and its comprehensive role in pemphigus is not fully understood yet. Objective: The purpose of this study was to observe alterations in the serum cytokine levels of patients with pemphigus vularis (PV), pemphigus foliaceous (PF), paraneoplastic pemphigus (PNP) and compare with bullous pemphigoid (BP) and healthy subjects.Methods: A total of 75 subjects (28 PV, 13 PF, 7 PNP, 7 BP and 20 healthy controls) who visited the Dermatology Clinic of Gangnam Severance Hospital between 2006 and 2013 were included in this study. Serum levels of IFN-γ, IL-4, IL-6, IL-17A, IL-10, TNF-α, and IL-8 were measured in the five groups by ELISA.Results: The median concentration of IFN-γ was lower in PV and BP patients compared to the control group (0.765, 0.34 and 1.63 pg/ml, respectively). IL-6 and IL-10 was significantly higher in PNP patients compared to the control group (4.92 and 0.24 pg/ml for IL-6, 0.86 and <0.12 pg/ml for IL-10, respectively). IL-8 was increased significantly in PV and PNP patients compared with the control group (11.85, 31.5 and 8.31 pg/ml, respectively). For IL-4, IL-17A and TNF-α, no significant difference was observed between the five groups.Conclusions: The decreased level of IFN-γ in PV may imply a suppressed Th1 response in the active disease stage. A Th2 predominant response is suggested in the active stage of PNP, with elevated serum level of IL-6 and IL-10. Increased level of IL-8 is observed in the sera of PV and PNP patients.