Skin autoimmunity and blood coagulation.

Area of Science:

• Immunodermatology
• Hematology
• Autoimmune Disorders

Background:

• The immune and coagulation systems are increasingly recognized to interact in systemic autoimmune disorders.
• Proinflammatory mediators can trigger tissue factor (TF) expression, initiating coagulation, while coagulation proteases can activate protease-activated receptors (PARs), promoting inflammation.
• This bidirectional communication amplifies and sustains the activation of both systems.

Purpose of the Study:

• To review the involvement of the immune and coagulation systems in chronic urticaria (CU) and bullous pemphigoid (BP).
• To explore the potential of anticoagulant therapy in managing these autoimmune skin conditions.

Main Methods:

• Literature review focusing on studies investigating immune-coagulation system crosstalk in CU and BP.
• Analysis of evidence for coagulation activation markers and therapeutic responses to anticoagulants.

Main Results:

• Coagulation activation, involving eosinophils and the TF pathway with thrombin generation, is demonstrated in CU, leading to increased vascular permeability.
• Preliminary data suggest heparin and warfarin may alleviate CU symptoms.
• Coagulation activation in BP contributes to local tissue damage and bulla formation, and systemic activation correlates with increased thrombotic risk.

Conclusions:

• Coagulation system activation plays a significant role in the pathogenesis of both CU and BP.
• Anticoagulant treatment strategies warrant further investigation through clinical trials for CU and BP patients.