There might be a role for CD200 in the pathogenesis of autoimmune and inflammatory skin disorders

Abstract

BackgroundSoluble CD200 (sCD200) is a novel immuno-effective molecule, which acts to regulate inflammatory and acquired immune responses. Recently, our study group showed that sCD200 was present in serum and blister fluid in a patient with bullous pemphigoid and a patient with toxic epidermal necrolysis. We therefore planned this study to evaluate the sCD200 levels of autoimmune and inflammatory skin disorder patients and to compare them with that of healthy controls.Maleral/MethodsOur study included 30 consecutive patients with psoriasis vulgaris, 15 with pemphigus vulgaris, and 15 healthy controls. Clinical examination and laboratory tests were performed on the same day. Psoriasis patients were also assessed with the Psoriasis Area and Severity Index (PASI) and pemphigus patients were assessed using the Pemphigus Disease Area Index (PDAI). Levels of sCD200 in the serum samples were quantified using ELISA kits.ResultsThe serum sCD200 level was observed to be statistically significantly higher in patients with psoriasis vulgaris (96.7±15.8) compared to patients with pemphigus vulgaris (76.2±14.6), (p<0.001) and healthy controls (26.8±7.0) (p<0.001). The serum sCD200 levels were observed to be statistically significantly higher in patients with pemphigus vulgaris compared with that in healthy controls (p<0.001). In addition, there was a statistically significant correlation between serum sCD200 levels and PDAI (r=0.987, p=0.001). Nevertheless, there was no statistically significant correlation between serum sCD200 levels and PASI (r=0.154, p=0.407).ConclusionssCD200 might play a role in immune response in the pathogenesis of autoimmune and inflammatory skin disorders. However, it remains to be fully elucidated how sCD200 can orchestrate inflammatory response in psoriasis and pemphigus.

CD200/CD200 receptor axis in psoriasis vulgaris

“…In the current study, we demonstrated a significantly higher level of sCD200 in the serum of psoriatic patients as compared to healthy controls. A similar observation has been made once by Akman-Karakaş A. et al in a study that included 30 psoriasis vulgaris patients [18]. In the previously mentioned study, the authors did not mention excluding patients having…”

“…[22] In the current study, although sCD200 serum level was significantly lower in patients with mild psoriasis than in those with moderate to severe disease, yet no correlation was detected between the expression of either the ligand (sCD200) or the receptor (CD200R) on either lymphocytes or monocytes and the severity of psoriasis expressed as PASI scoring. Akman-Karakaş et al similarly reported lack of correlation between PASI and sCD200 in their studied psoriatic cases [18], but no available literature was found on the relation between severity and receptor expression. Regarding the status in other inflammatory Th17 mediated diseases, both CD200 and CD200R correlated negatively with rheumatoid arthritis severity (expressed as DAS28) [16] while they did not correlate with SLE severity scores [14].…”

“…Up regulation of CD200 with concomitant down regulation of its receptor (CD200R)in peripheral blood or tissues-has been found in systemic lupus erythematosus (SLE) [14], inflammatory bowel disease [15] and rheumatoid arthritis [16], all of which-similar to psoriasis-are characterized by Th17/Treg cell imbalance [17]. sCD200 has been reported to be up regulated in psoriatic patients [18], but the condition of its receptor is currently unknown.…”

Evaluation of soluble CD200 levels in type 2 diabetic foot and nephropathic patients: Association with disease activity

“…We showed the pro-inflammatory effect of sOX-2 in our previous studies [12,13–17]. A patient of ours with TEN (toxic epidermal necrolysis) also had DM and had higher sOX-2 levels versus a healthy control group, despite TEN treatment [15].…”

Recent advances in Immunobullous diseases

“…9 CD 200, which play an important role in maintenance of pro-inflammatory reaction and immune tolerance in the body, is also implicated in pathogenesis of pemphigus, therefore CD200 may also be a potentially important therapeutic target. 10 Theories on the pathogenesis of pemphigus 1. According to this theory, pemphigus is a complex disease, initiated by at least three classes of auto-antibodies directed against desmosomal, mitochondrial and other keratinocyte autoantigens resulting in acantholysis.…”