Increased IgE‐levels in bullous pemphigoid correlate to soluble low affinity Fc‐II‐receptor for IgE and soluble IL‐2‐receptor

Abstract

Background Increased serum-IgE levels in patients with bullous pemphigoid (BP) are one of the well known immunological deviations in this autoimmune dermatosis.Aim and methods Since the mechanism that leads to an increase of IgE in BP is still unclear, we investigated serum-IgE levels and IgE regulating cytokines (soluble low affinity Fc II receptor for IgE, IL-4, IFN-g and soluble IL-2 receptor) in sera and blister fluids of 15 BP patients before and during treatment with immunosuppressants using an ELISA-technique.Results All 15 patients examined proved to have high IgE levels in blister fluids (> 100 KU/I) and 13 of the 15 patients had elevated serum-IgE levels. Soluble low affinity Fc II receptor for IgE (sCD23R) was also increased in sera (7.9 ± 2.4 pg/ml) and ten fold higher in blister fluids (76.7 ± 15.3 pg/ml). Investigation of cytokines interfering with IgE production showed significantly increased levels of the soluble IL-2 receptor in sera whereas the concentrations of IL-4 and IFN-g revealed no significant differences compared to controls. In blister fluids we detected all the cytokines investigated. During treatment with immunosuppressants the elevated concentrations of sCD23R and soluble IL-2 receptor were reduced to normal values.Conclusions The results show a direct correlation between IgE levels, sCD23R and soluble IL-2receptor concentrations and suggest a connection between increased IgE levels and T-celt activation in BP.Abbreviations: BP, bullous pemphigoid; CD, cluster designation; cDNA, complementary deoxyribonucleic acid; ECF-A, eosinophilic chemotactic factor for anaphylaxis; ELISA, enzyme-linked immunosorbent assay; IFN-g, interferon gamma; IgE/G, immunoglobulin E/G; interleukin 4; NK, natural killer; sCD23R, soluble low affinity Fell receptor for IgE; ' Corresponding author: Department of Dermatology, St. SEM, standard error of mean;siL-2R, soluble IL-2 receptor. Barbara Hospital, Barbarastr. 67, 47141 Duisburg, Germany. 0926-995 9/95/$09.50 © 1995 Elsevier Science B.V. All rights reserved SSDI 0926-9959(95)00083-6