BP230 IgE autoantibodies in topical‐steroid‐resistant bullous pemphigoid

Shih, Yen-Chi; Yuan, Hsiao-Kuan; Shen, Jia; Zheng, Jie; Pan, Meng

doi:10.1111/1346-8138.15952

Cited by 5 publications

(4 citation statements)

References 29 publications

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“…It has also been reported that the level of anti-BP230 IgE is associated with disease activity or local eosinophil infiltration ( 125 , 126 ). Moreover, anti-BP230 IgE is more common in patients resistant to topical corticosteroids, suggesting that it can be used as a marker for systemic corticosteroid therapy ( 127 ). In addition, in vitro experiments have shown that anti-BP180 IgE can cause a decline in keratinocyte adhesion and hemidesmosomal density ( 128 ), suggesting its function in blister formation.…”

Section: Type 2 Inflammation In Bp and Potential Therapeutic Targetsmentioning

confidence: 99%

Bullous pemphigoid: The role of type 2 inflammation in its pathogenesis and the prospect of targeted therapy

Zhang

Chen²,

Wang³

et al. 2023

Front. Immunol.

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Bullous pemphigoid (BP) is an autoimmune disease that mainly occurs in the elderly, severely affecting their health and life quality. Traditional therapy for BP is mainly based on the systemic use of corticosteroids, but long-term use of corticosteroids results in a series of side effects. Type 2 inflammation is an immune response largely mediated by group 2 innate lymphoid cells, type 2 T helper cells, eosinophils, and inflammatory cytokines, such as interleukin (IL)-4, IL-5 and IL-13. Among patients with BP, the levels of immunoglobulin E and eosinophils are significantly increased in the peripheral blood and skin lesions, suggesting that the pathogenesis is tightly related to type 2 inflammation. To date, various targeted drugs have been developed to treat type 2 inflammatory diseases. In this review, we summarize the general process of type 2 inflammation, its role in the pathogenesis of BP and potential therapeutic targets and medications related to type 2 inflammation. The content of this review may contribute to the development of more effective drugs with fewer side effects for the treatment of BP.

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Section: Type 2 Inflammation In Bp and Potential Therapeutic Targetsmentioning

confidence: 99%

Bullous pemphigoid: The role of type 2 inflammation in its pathogenesis and the prospect of targeted therapy

Zhang

Chen²,

Wang³

et al. 2023

Front. Immunol.

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“…BP180 IgE was detected in 22%–100% of BP patients ( 34 , 35 ). BP230-specific IgE is prevalent in BP ( 35 , 36 ). The high IgE autoantibody level in BP patients may necessitate aggressive treatment ( 37 ).…”

Section: Immune Cellsmentioning

confidence: 99%

Adaptive and innate immune pathogenesis of bullous pemphigoid: A review

Yan

Zhang

2023

Front. Immunol.

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Bullous pemphigoid (BP) is an autoimmune blistering disease that primarily affects elderly individuals. The presentation of BP is heterogeneous, typically manifesting as microscopic subepidermal separation with a mixed inflammatory infiltrate. The mechanism of pemphigoid development is unclear. B cells play a major role in pathogenic autoantibody production, and T cells, type II inflammatory cytokines, eosinophils, mast cells, neutrophils, and keratinocytes are also implicated in the pathogenesis of BP. Here, we review the roles of and crosstalk between innate and adaptive immune cells in BP.

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“…Other studies have detected anti-BP230 IgE in patients with BP [ 111 , 112 ] and their levels have been associated with disease activity and local eosinophil infiltration [ 113 , 114 ]. Additionally, anti-BP230 IgE is more common among patients who are resistant to topical corticosteroids, being a potential marker for systemic corticosteroid therapy [ 115 ].…”

Section: Therapymentioning

confidence: 99%

Advancements in Bullous Pemphigoid Treatment: A Comprehensive Pipeline Update

Karakioulaki,

Eyerich,

Patsatsi

2023

Am J Clin Dermatol

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Abastract Bullous pemphigoid (BP) is a common autoimmune bullous disease affecting mainly the elderly, with rising incidence due to increased life expectancy. This disease is characterized by tense bullous lesions on normal or erythematous skin, accompanied by pruritus. BP pathogenesis involves autoantibodies against hemidesmosomal proteins BP180 and BP230, leading to detachment at the dermo-epidermal junction as well as blister formation. BP is associated with coexisting comorbidities and drug exposure, and its management often requires high doses or chronic use of systemic glucocorticoids, posing risks of adverse effects. This review focuses on novel treatment options for BP, exploring therapies targeting different immune pathways. Rituximab, a CD20 monoclonal antibody, depletes B-lymphocytes and has shown efficacy in severe cases. Dupilumab, targeting interleukin (IL)-4 receptor α and thus blocking IL-4 and IL-13, downregulates type 2 helper (Th2) responses and has demonstrated promising results. Targeting eosinophil-related molecules using bertilimumab and AKST4290 has yielded positive results in clinical trials. Omalizumab, an immunoglobulin (Ig) E antibody, can reduce disease severity and allows corticosteroid tapering in a number of cases. Complement inhibitors such as nomacopan and avdoralimab are being investigated. IL-17 and IL-23 inhibitors such as secukinumab and tildrakizumab have shown potential in a limited number of case reports. Neonatal Fc receptor antagonists such as efgartigimod are under investigation. Additionally, topical therapies and Janus kinase inhibitors are being explored as potential treatments for BP. These novel therapies offer promising alternatives for managing BP, with potential to improve outcomes and reduce high cumulative doses of systemic corticosteroids and related toxicities. Further research, including controlled clinical trials, is needed to establish their efficacy, safety, and optimal dosing regimens for BP management.

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BP230 IgE autoantibodies in topical‐steroid‐resistant bullous pemphigoid

Cited by 5 publications

References 29 publications

Bullous pemphigoid: The role of type 2 inflammation in its pathogenesis and the prospect of targeted therapy

Bullous pemphigoid: The role of type 2 inflammation in its pathogenesis and the prospect of targeted therapy

Adaptive and innate immune pathogenesis of bullous pemphigoid: A review

Advancements in Bullous Pemphigoid Treatment: A Comprehensive Pipeline Update

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