Gene expression profiling and multiplex immunofluorescence analysis of bullous pemphigoid immune‐related adverse event reveal upregulation of toll‐like receptor 4/complement‐induced innate immune response and increased density of T_H1 T‐cells

Abstract

Background: Immune checkpoint inhibitor (ICI)-based cancer therapies cause a variety of cutaneous immune-related adverse events (irAEs) including immunobullous skin eruptions like bullous pemphigoid (BP). However, little is known about the underlying immunopathogenic drivers of these reactions, and understanding the unique gene expression profile and immune composition of BP-irAE remains a critical knowledge gap in the field of oncodermatology/oncodermatopathology. Methods: BP-irAE (n = 8) and de novo BP control (n = 8) biopsy samples were subjected to gene expression profiling using the NanoString ® Technologies nCounter