title: Integrating longitudinal serum IL-17 and IL-23 follow-up, along with autoantibodies variation, contributes to predict bullous pemphigoid outcome.
abstract: Bullous pemphigoid (BP) is an inflammatory autoimmune bullous disease involving cytokines and proteases in the process of blister formation. Recently, IL-17 and IL-23 were evidenced in lesional skin and serum of BP patients at time of diagnosis, but their involvement in disease outcome has still not been investigated yet. We then analysed IL-17 and IL-23 serum levels during the first months of follow-up upon treatment. Compared with age- and sex- matched controls, high levels of IL-23 were observed at baseline in BP patients serum (P < 0.01), while IL-17 levels was not. However, some BP patients expressed high IL-17 serum level, independently of disease severity. In these patients, those with ongoing remission reduced IL-17 concentration upon treatment (P < 0.001), whereas IL-17 level remained elevated in patients who relapsed. Meanwhile, IL-23 serum levels increased during the first month of treatment in BP patients who later relapsed (P < 0.01) and MMP-9 serum level was not controlled. Accordingly, we found that both IL-17 and IL-23 increased MMP-9 secretion from leukocytes in-vitro. Then, we showed that elevated IL-17/IL-23 serum concentrations helped to discriminate BP patients who later relapsed. Such uncontrolled inflammatory response raises the question whether these molecules could become biological target for BP patients resistant to steroid treatment.
authors.affiliation: Department of Dermatology, Reims University Hospital, University of Champagne-Ardenne, Reims, France.
authors.forename: Julie
authors.initials: J
authors.lastname: Plée
authors.affiliation: Laboratory of Dermatology, Faculty of Medicine of Reims, EA 7319, IFR 53, University of Champagne-Ardenne, Reims, France.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Le Jan
authors.affiliation: Laboratory of Dermatology, Faculty of Medicine of Reims, EA 7319, IFR 53, University of Champagne-Ardenne, Reims, France.
authors.forename: Jérôme
authors.initials: J
authors.lastname: Giustiniani
authors.affiliation: Clinical Research Unit, Reims University Hospital, Reims, France.
authors.forename: Coralie
authors.initials: C
authors.lastname: Barbe
authors.affiliation: Department of Dermatology, Inserm U905, Institute for Research and Innovation in Biomedicine, Rouen University Hospital, University of Normandy, Rouen, France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Joly
authors.affiliation: Department of Dermatology, Limoges University Hospital, Limoges, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Bedane
authors.affiliation: Department of Dermatology, Dijon University Hospital, Dijon, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Vabres
authors.affiliation: Department of Dermatology, Beauregard Hospital, Thionville, France.
authors.forename: François
authors.initials: F
authors.lastname: Truchetet
authors.affiliation: Department of Dermatology, Besançon University Hospital, Besançon, France.
authors.forename: François
authors.initials: F
authors.lastname: Aubin
authors.affiliation: Laboratory of Dermatology, Faculty of Medicine of Reims, EA 7319, IFR 53, University of Champagne-Ardenne, Reims, France.
authors.forename: Frank
authors.initials: F
authors.lastname: Antonicelli
authors.affiliation: Department of Dermatology, Reims University Hospital, University of Champagne-Ardenne, Reims, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Bernard
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001323:Autoantibodies / Q000097:blood* / Q000276:immunology; D015415:Biomarkers; D016207:Cytokines / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020381:Interleukin-17 / Q000097:blood*; D053759:Interleukin-23 / Q000097:blood*; D008297:Male; D020780:Matrix Metalloproteinase 9 / Q000378:metabolism; D063868:Patient Outcome Assessment; D010391:Pemphigoid, Bullous / Q000097:blood* / Q000175:diagnosis* / Q000276:immunology / Q000401:mortality; D011379:Prognosis; D012008:Recurrence
chemical_list: D001323:Autoantibodies; D015415:Biomarkers; D016207:Cytokines; D020381:Interleukin-17; D053759:Interleukin-23; D020780:Matrix Metalloproteinase 9