Bullous pemphigoid and pemphigus vulgaris: correlated behaviour of serum VEGF, sE-selectin and TNF-alpha levels.
BACKGROUND
Recently, we reported that soluble E-selectin (sE-selectin), an isoform of the cell membrane E-selectin, an adhesion molecule synthesized only by endothelial cells, is significantly increased in sera of the patients with bullous pemphigoid (PB) or pemphigus vulgaris. A significant correlation was also found between the serum sE-selectin levels and the number of skin lesions, suggesting the possible use of this molecule to gauge disease intensity before therapy. One of the sE-selectin inducers is tumor nerosis factor-alpha (TNF-alpha), that is also able to enhance vascular endothelial growth factor (VEGF), a strong endothelium activator.


OBJECTIVE
On the basis of these observations, the present study was conducted to analyze the serum levels of VEGF, sE-selectin, and TNF-alpha in 8 patients with BP (age: 82, range 54-87, 7 males, 1 female) and in 6 patients affected affected with PV (age: 55, range 44-65; 5 males, 1 female) and to verify possible correlations between these variables and the disease activity, In addition, serum sE-selectin levels were measured over time and compared with the serum anti-epithelium antibodies titers.


METHODS
The sE-selectin, VEGF and TNF-alpha levels were measured in the samples by means of commercially available ELISA kit. The same samples were also employed to measure the anti-epithelium antibody titers.


RESULTS
Serum VEGF, sE-selectin and TNF-alpha levels were significantly correlated each other (p at least < 0.01). All three variables were also significantly correlated with the number of lesions (p at least < 0.01). Serum VEGF levels were found increased (median = 178 pg/ml, range 37-595) as compared to 28 healthy controls (median = 135 pg/ml, range 18/269, p < 0.05). Also serum TNF-alpha levels were found increased (median = 5.5 pg/ml, range < 0.1-41.0) as compared to 28 healthy controls (median < 0.1 pg/ml, range < 0.1-5.3), p < 0.01). When the patients were observed over time, serum sE-selectin levels highly correlated with the disease intensity in both dermatoses, although with different regression curves.


CONCLUSIONS
These data further underline the endothelium involvement in these bullous dermatoses and stress the possibility of employing sE-selectin as a non-specific follow-up marker of both BP and PV.
Ameglio
F
F
Laboratory of Clinical Pathology, San Gallicano Institute, Roma, Italy.
D'Auria
L
L
Cordiali-Fei
P
P
Mussi
A
A
Valenzano
L
L
D'Agosto
G
G
Ferraro
C
C
Bonifati
C
C
Giacalone
B
B
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D019040:E-Selectin / Q000097:blood*; D016228:Endothelial Growth Factors / Q000097:blood*; D004730:Endothelium, Vascular / Q000378:metabolism; D005260:Female; D006801:Humans; D008222:Lymphokines / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010391:Pemphigoid, Bullous / Q000097:blood* / Q000473:pathology; D010392:Pemphigus / Q000097:blood* / Q000473:pathology; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D012867:Skin / Q000473:pathology; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis*; D042461:Vascular Endothelial Growth Factor A; D042442:Vascular Endothelial Growth Factors
D015415:Biomarkers; D019040:E-Selectin; D016228:Endothelial Growth Factors; D008222:Lymphokines; D014409:Tumor Necrosis Factor-alpha; D042461:Vascular Endothelial Growth Factor A; D042442:Vascular Endothelial Growth Factors