title: Bullous pemphigoid outcome is associated with CXCL10-induced matrix metalloproteinase 9 secretion from monocytes and neutrophils but not lymphocytes.
abstract: BACKGROUND
  The outcome of bullous pemphigoid (BP), the most frequent autoimmune skin-blistering disease, involves matrix metalloproteinase 9 (MMP-9), IL-17, and IL-23 release from infiltrated inflammatory cells. The chemokine CXCL10 has been associated with several autoimmune diseases, but its participation in BP pathophysiology still needs to be clarified.
  
  
  OBJECTIVE
  We sought to assess whether BP outcome was associated with different CXCL10 levels and to evaluate the contribution of CXCL10 to the described cytokine/protease inflammatory loop associated with disease outcome.
  
  
  METHODS
  Skin biopsy specimens (n = 16), serum (n = 114), blister fluid (n = 23), and primary inflammatory cells from patients with BP were used to investigate CXCL10 expression and function.
  
  
  RESULTS
  At baseline, both resident cells, such as keratinocytes and fibroblasts, and infiltrating immune cells expressed CXCL10 at lesional sites in skin of patients with BP. CXCL10 levels were higher in blister fluid (P < .0001) and serum (P < .005) from patients with BP than in serum from age- and sex-matched control subjects (n = 34). Furthermore, CXCL10 serum levels increased at day 60 only in patients who relapsed within the first year of treatment (n = 33, P < .005). Interestingly, CXCL10 expression could be upregulated by itself and IL-17 in inflammatory cells. Notably, neutrophils and monocytes from patients with BP, but not lymphocytes, responded to CXCL10 by increasing MMP-9 secretion through the activation of extracellular signal-regulated kinase 1/2, p38, phosphoinositide-3 kinase signaling pathways. Finally, CXCL10-increased MMP-9 secretion was inhibited by methylprednisolone and also by compound A, a novel nonsteroidal glucocorticoid receptor ligand.
  
  
  CONCLUSIONS
  We showed that increased levels of inflammatory biomarkers in patients with BP, such as CXCL10, favor neutrophil- and monocyte-associated MMP-9 release and disease relapse and opened new therapeutic horizons in patients with this autoimmune disease.
authors.affiliation: Laboratory of Dermatology, EA7319 Derm-I-C, University of Reims-Champagne-Ardenne, Reims, France.
authors.forename: Meriem
authors.initials: M
authors.lastname: Riani
authors.affiliation: Laboratory of Dermatology, EA7319 Derm-I-C, University of Reims-Champagne-Ardenne, Reims, France.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Le Jan
authors.affiliation: Laboratory of Dermatology, EA7319 Derm-I-C, University of Reims-Champagne-Ardenne, Reims, France; Department of Dermatology, University Hospital, University of Reims-Champagne-Ardenne, Reims, France.
authors.forename: Julie
authors.initials: J
authors.lastname: Plée
authors.affiliation: Laboratory Pol Bouin, Hospital Maison Blanche, University Hospital, Reims, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Durlach
authors.affiliation: Laboratory IMAB, EA4683, University of Reims-Champagne-Ardenne, Reims, France.
authors.forename: Richard
authors.initials: R
authors.lastname: Le Naour
authors.affiliation: LEGEST-University Gent, Ghent, Belgium.
authors.forename: Guy
authors.initials: G
authors.lastname: Haegeman
authors.affiliation: Laboratory of Dermatology, EA7319 Derm-I-C, University of Reims-Champagne-Ardenne, Reims, France; Department of Dermatology, University Hospital, University of Reims-Champagne-Ardenne, Reims, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Bernard
authors.affiliation: Laboratory of Dermatology, EA7319 Derm-I-C, University of Reims-Champagne-Ardenne, Reims, France; Department of Dermatology, University Hospital, University of Reims-Champagne-Ardenne, Reims, France. Electronic address: frank.antonicelli@univ-reims.fr.
authors.forename: Frank
authors.initials: F
authors.lastname: Antonicelli
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001768:Blister / Q000276:immunology; D002460:Cell Line; D002478:Cells, Cultured; D054357:Chemokine CXCL10 / Q000276:immunology*; D005260:Female; D006801:Humans; D008214:Lymphocytes / Q000276:immunology; D008297:Male; D020780:Matrix Metalloproteinase 9 / Q000276:immunology*; D008875:Middle Aged; D009000:Monocytes / Q000276:immunology*; D009504:Neutrophils / Q000276:immunology*; D010391:Pemphigoid, Bullous / Q000276:immunology*; D012867:Skin / Q000276:immunology
chemical_list: C114753:CXCL10 protein, human; D054357:Chemokine CXCL10; C579270:MMP9 protein, human; D020780:Matrix Metalloproteinase 9
keywords: Bullous pemphigoid; CXCL10; autoimmunity; compound A; inflammation; selective glucocorticoid receptor activator