Profiling the serum cytokine B cell activating factor (BAFF),proliferation inducing ligand (APRIL), and BP180, BP230 antibodies in bullous pemphigoid patients before and after treatment: a prospective case-control study
Shadab Seraji , Kamran Balighi , Amir Hooshang Ehsani , Ala Ehsani , Hamidreza Mahmoudi , Maryam Daneshpazhooh , Pedram Noormohammadpour , Saman Al Zahawi , Zeinab Aryanian , Parvaneh Hatami
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Abstract
Background
Bullous pemphigoid is a subepidermal autoimmune blistering disease caused by auto-antibodies directed against specific components of the basement membrane molecules. It has been shown that T cell function and B cell survival depend on B-cell activating factor (BAFF), a member of the tumor necrosis factor superfamily. Its contribution to the formation of BP is yet unknown, though.
Aim
To measure the serum level of cytokines B cell activating factor (BAFF) and proliferation inducing ligand (APRIL), as well as BP180 and BP230 antibodies in patients with bullous pemphigoid before and after treatment.
Methods
New patients with a confirmed diagnosis of bullous pemphigoid from a tertiary care hospital were selected. After obtaining written consent, blood samples were taken according to the required standards, and the levels of the above indices were checked before and four months after treatment.
Results
This prospective case-control study recruited 32 patients with newly diagnosed BP and 24 healthy controls. Based on the obtained results, BAFF and APRIL levels were higher in the case group than the control group both before and after the treatment. Specifically, the changes in the BAFF index were statistically significant in both conditions: before treatment compared to controls (P = 0.001) and after treatment compared to controls (P = 0.015). Similarly, significant changes were observed in the APRIL index for the cases when comparing before treatment to controls (P < 0.001). Interestingly, those who have been treated with rituximab experienced a high level of BAFF even after treatment and in comparison with the healthy group but a decline in APRIL, BP180, and BP230.
Conclusions
The results of this study showed a decrease in APRIL, BP180, and BP230 indices in patients with Bullous pemphigoid after treatment in accordance with clinical improvement and remission. This study is one step forward in elaborating the role of BAFF and APRIL in the pathogenesis and monitoring of patients with BP.
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