Assessment of the Characteristics and Associated Factors of Infectious Complications in Bullous Pemphigoid

Chen, Jia; Mao, Xuming; Zhao, Wenling; Zhang, Bingjie; Chen, Xinyi; Yu, Chuangqi; Zheng, Zehui; Jin, Hongzhong; Li, Li

doi:10.3389/fimmu.2020.01607

Cited by 12 publications

(25 citation statements)

References 35 publications

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“…Furthermore, it will be interesting to investigate whether there is a significantly elevated expression of the cytokines in the perilesional and lesional skin in future work. Nevertheless, our study presented a series of patients matched with a group of healthy subjects and whose clinical features align with those previously reported series, including characteristics such as age, sex, mucosal involvement, corticosteroid dose, and relapse rate (28,36,51,(59)(60)(61). Remarkably, our studies have identified that BP is associated with IL-13 gene polymorphism and an increased IL-13 in the peripheral blood.…”

Section: Discussionsupporting

confidence: 82%

“…Additionally, several lines of evidence have shown that IL-4 and IL-13 could impair skin barrier function by suppressing the expression of tight junction proteins, filaggrin, loricrin, and involucrin (46)(47)(48). Other groups and we have previously shown a high incidence rate of local skin or systemic infections in BP (49)(50)(51). It will be interesting to investigate in the future whether these cytokines are involved in infections in BP patients.…”

Section: Discussionmentioning

confidence: 83%

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IL-13 Genetic Susceptibility to Bullous Pemphigoid: A Potential Target for Treatment and a Prognostic Marker

et al. 2022

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BackgroundBullous pemphigoid (BP) is a senile chronic autoimmune bullous skin disease with a high relapse rate, which significantly impairs patients’ quality of life and contributes to disease mortality. This observational case-control study explores the gene polymorphisms of cytokines and their clinical significance in Chinese patients with BP.MethodsIL-1α (rs1800587), IL-1β (rs16944, rs1143627, rs1143634), IL-4 (rs2243250), IL-6 (rs1800795), IL-10 (rs1800896, rs1800871, rs1800872), IL-13 (rs1800925, rs20541), TNF-α (rs1799964, rs1800630, rs1799724, rs361525), IFN-γ (rs1799964, rs1800630, rs361525, rs1800629, rs4248160, rs1800750), and TGF-β1 (rs2317130, rs1800469, rs4803457) genes were genotyped in the healthy controls and BP patients, respectively. Expression of these cytokines in serum was measured. Medical profiles of patients, including baseline characteristics and prognosis, were statistically analyzed.ResultsWe found that IL-1 β and IL-13 concentrations were higher in the BP patients’ sera compared to those in the controls. For IL-13, significant differences were found in the nucleotide ratio/genotype/haploid frequency/haplotype, respectively. IL-13 (rs20541, rs1800925) is related to gender, and the IL-13 genotype was significantly associated with recurrence.ConclusionsBP is associated with IL-13 gene polymorphism and IL-13 concentration is elevated in blood circulation in patients with BP. Our results support that IL-13 is relevant in the pathogenesis of BP, suggesting that IL-13 could potentially represent a promising target for BP therapy and a prognostic marker.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 83%

IL-13 Genetic Susceptibility to Bullous Pemphigoid: A Potential Target for Treatment and a Prognostic Marker

et al. 2022

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“…19,20 The most common infections in bullous pemphigoid patients are found in the skin and mucosa. 21 In our cohort, all detected skin infections were staphylococcal and required systemic antibiotics. Of these, three (3.3%) patients died of sepsis with methicillin-resistant Staphylococcus aureus.…”

Section: Discussionmentioning

confidence: 73%

Survival and prognostic factors in bullous pemphigoid: A retrospective cohort study

Papara

Chiorean

Leucuţa

et al. 2022

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Background Bullous pemphigoid is the most common subepidermal autoimmune blistering disease. Till now, the reported prognostic factors in bullous pemphigoid vary considerably. Aims The purpose of this study was to determine the overall survival rate and prognostic factors in bullous pemphigoid. Methods We conducted a retrospective cohort study on newly diagnosed bullous pemphigoid patients between July 2001 and November 2019 in a referral unit for autoimmune blistering skin diseases in Romania. Results One hundred forty-eight patients were included in the study. The Kaplan-Meier overall survival rates at 1, 3, 5 and 10 years were respectively 74.2% (95% confidence interval, 67.5-81.6%), 53.4% (45.7-62.2%), 43.6% (35.9-53%) and 31.3% (23.5-41.7%). The median follow-up among survivors was 48 months (interquartile range: 11-150). Ninety (60.8%) patients died during the follow-up period; of them, 38 (42.2%) had active disease at the time of death. Advanced age, neurological diseases, valvular heart disease, malignancies, use of statins, skin infections and extensive cutaneous involvement were linked to poorer outcomes, while the use of topical corticosteroids was associated with increased overall survival. Limitations This study lacks a control cohort to validate the obtained results. It was conducted in a retrospective manner in a single centre. In addition, indirect immunofluorescence microscopy was not performed in all patients. Conclusion Beyond ageing and neurological comorbidities, the prognosis of bullous pemphigoid patients was significantly influenced by the presence of skin infections, valvular heart disease, use of statins and extensive cutaneous involvement. Topical corticosteroid treatment was associated with increased survival in these patients.

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“…9 Infections like cutaneous and respiratory infections are predominant contributor of BP death. 10,11 Thus, cooperation between dermatologist and primary care physicians and other specialties are essential for BP patients. However, our knowledge about the epidemiology of BP is still limited.…”

Section: Introductionmentioning

confidence: 99%

Global incidence and prevalence of bullous pemphigoid: A systematic review and meta‐analysis

Chen

et al. 2022

J of Cosmetic Dermatology

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Background Integrated information on the global prevalence and incidence of bullous pemphigoid (BP) is lacking. Objective To estimate the incidence and prevalence of BP in a systematic review and meta‐analysis. Methods Observational studies were included by using databases of Medline, EMBASE, and Cochrane Library. Subgroup analysis was by continent, age, sex, and country income level. Random‐effects model was used. Between‐study heterogeneity was assessed using the I2 statistic. Results The global incidence was 0.0419 per 1000 person‐years (95% CI: 0.0414–0.0424). The incidence was 0.047 per 1000 person‐years (95% CI: 0.0462–0.0477), 0.0419 per 1000 person‐years (95% CI: 0.0411–0.0426), 0.0072 per 1000 person‐years (95% CI: 0.0067–0.0078), 0.003 per 1000 person‐years (95% CI: 0.0023–0.0039) in North America, Europe, Asia, and Africa, respectively; 0.0202 per 1000 person‐years (95% CI: 0.0196–0.0208) and 0.0181 per 1000 person‐years (95% CI: 0.0175–0.0188) females and males; 0.001 per 1000 person‐years (95% CI: 0.001–0.001), 0.002 per 1000 person‐years (95% CI: 0.001–0.002), 0.004 per 1000 person‐years (95% CI: 0.004–0.004); 0.007 per 1000 person‐years (95% CI: 0.007–0.008), 0.011 per 1000 person‐years (95% CI: 0.011–0.012), 0.017 per 1000 person‐years (95% CI: 0.015–0.018) for age <50, 50–59, 60–69, 70–79, 80–89, and ≥90 years; 0.0038 per 1000 person‐years (95% CI: 0.0036–0.004112) (I2 = 99%, p < .05) and 0.0456 per 1000 person‐years (95% CI: 0.0450–0.0462) (I2 = 100%, p < .05). The pooled clinic‐based prevalence was 0.79% (95% CI: 0.75%–0.84%), 1.13% (95% CI: 1.06%–1.21%), 0.21% (95% CI: 0.17%–0.26%), and 0.13% (95% CI: 0.1%–0.15%) for Asia, Africa, and Europe. Conclusions This study identified the global incidence and prevalence of BP in terms of spatial and population distributions and among various income level. A relatively higher incidence was in Europe, females, older people, and high‐income level country. The prevalence was higher in Asia. These findings should be interpreted with caution due to high heterogeneity of included studies.

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Assessment of the Characteristics and Associated Factors of Infectious Complications in Bullous Pemphigoid

Cited by 12 publications

References 35 publications

IL-13 Genetic Susceptibility to Bullous Pemphigoid: A Potential Target for Treatment and a Prognostic Marker

IL-13 Genetic Susceptibility to Bullous Pemphigoid: A Potential Target for Treatment and a Prognostic Marker

Survival and prognostic factors in bullous pemphigoid: A retrospective cohort study

Global incidence and prevalence of bullous pemphigoid: A systematic review and meta‐analysis

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