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Immunoglobulin E and bullous pemphigoid.

Emanuele Cozzani1, Giulia Gasparini1, Giovanni Di Zenzo2

  • 1Di.S.Sal, Section of Dermatology, University of Genoa, San Martino Policlinic Hospital, Genoa 16132, Italy.

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Summary

Bullous pemphigoid (BP) involves a Th2 immune response and IgE autoantibodies, particularly in early and atypical stages. These factors contribute to blister formation and disease progression.

Keywords:
Th2anti-BP230 and anti-BP180 IgEbullous pemphigoidomalizumab

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Area of Science:

  • Immunology
  • Dermatology

Background:

  • Bullous pemphigoid (BP) clinical and histological features suggest a Th2-oriented inflammatory response.
  • Elevated IgE, eosinophilia, and Th2 mediators are observed in BP patients.

Purpose of the Study:

  • To investigate the role of IgE autoantibodies and Th2 immune responses in bullous pemphigoid pathogenesis.
  • To explore the involvement of IgE in early and atypical BP manifestations.

Main Methods:

  • Analysis of clinical and histological findings in BP.
  • Measurement of total serum IgE, blood eosinophilia, and Th2 mediators.
  • Direct and indirect immunofluorescence studies.
  • ELISA testing for anti-BP230 and anti-BP180 IgE autoantibodies.
  • Review of experimental murine models and clinical treatment data.

Main Results:

  • Consistent detection of self-reactive IgE autoantibodies in BP patients.
  • Evidence suggests IgE autoantibodies and Th2 responses contribute to initial BP phases and blister formation.
  • Murine models and omalizumab treatment support IgE's role in BP pathogenesis.

Conclusions:

  • IgE autoantibodies and Th2 immune responses are implicated in the pathogenesis of bullous pemphigoid.
  • These immune mechanisms are relevant in both classic and atypical forms of BP, including blister development.