Pathophysiologic mechanisms of itch in bullous pemphigoid

Hashimoto, Takashi; Kursewicz, Christina; Fayne, Rachel; Nanda, Sonali; Shah, Serena; Nattkemper, Leigh; Yokozeki, Hiroo; Yosipovitch, Gil

doi:10.1016/j.jaad.2019.07.060

Cited by 84 publications

(102 citation statements)

References 48 publications

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“…TSLP, as a Th2-related cytokine, was found to be involved in BP recently [ 19 – 21 ]. By investigating TSLP in the BP mouse model and patients, Zhang et al found high levels of TSLP in sera, blister fluids, and BP lesions of patients with BP [ 19 ], and severe pruritus of BP was related to TSLP, whereas in another study, TSLP levels did not correlate with the severity of pruritus in BP, although the expression of TSLP was enhanced in BP lesions compared to HCs [ 21 ]. Regardless of whether or not TSLP is associated with itch, it is possible that TSLP is related to BP and could not be ignored in the pathophysiology.…”

Section: Discussionmentioning

confidence: 99%

“…It was previously demonstrated that TSLP is highly produced by skin keratinocytes in dermatitis and psoriasis [ 26 – 28 ]. In the BP lesional skin, TSLP was discovered to be expressed mainly in the epidermis [ 20 , 21 ]. A study by Zhang et al showed that dysfunction of BP180 led to the increased expression of TSLP in skin keratinocytes [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

“…This form of BP180 also induced distinctive pruritus in mice, which is one of the distinguishing symptoms of BP [ 19 ]. Moreover, increased levels of TSLP have been found not only in experimental mice but also in sera and lesions of patients with BP [ 19 – 21 ]. Furthermore, TSLP acts on DCs as an adjuvant to promote germinal center reactions and Th2 immune reactions, which enhance and shift antibody synthesis [ 22 , 23 ].…”

Section: Introductionmentioning

confidence: 99%

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Thymic Stromal Lymphopoietin Is Implicated in the Pathogenesis of Bullous Pemphigoid by Dendritic Cells

Jin

et al. 2020

Journal of Immunology Research

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Objectives. Both thymic stromal lymphopoietin (TSLP) and dendritic cells (DCs) are involved in many autoimmune diseases, but the potential roles of TSLP and DCs in bullous pemphigoid (BP) have not been clarified. We sought to explore the contributions of TSLP and DCs in patients with BP. Methods. TSLP levels in sera and blister fluids were measured by enzyme-linked immunosorbent assay. The TSLP expression in the BP lesional skin was detected by immunohistochemical staining. Infiltration of DCs, marked by DC-specific intercellular adhesion molecule-3-grabbing nonintegrin (DC-SIGN), and its relationship with TSLP and TSLP receptors was evaluated by immunofluorescence staining. Results. We found that TSLP levels in sera and in blister fluids of patients with BP were higher compared to the control groups. In patients with BP, TSLP levels in sera correlated with TSLP levels in blisters. The expression of TSLP in the BP lesional skin was higher compared to the healthy controls’ skin. Greater numbers of TSLP-positive cells were observed in the epidermis of patients with BP compared to the healthy controls. Greater numbers of DC-SIGN-positive cells were present in the BP lesional skin compared to the skin of controls. The expression of TSLP was highly upregulated in DC-SIGN-positive cells, and most DC-SIGN-positive cells expressed TSLP receptors. Conclusions. We conclude that TSLP may activate DC-SIGN-positive DCs directly, which may be involved in the pathogenesis of BP.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Thymic Stromal Lymphopoietin Is Implicated in the Pathogenesis of Bullous Pemphigoid by Dendritic Cells

Jin

et al. 2020

Journal of Immunology Research

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“…105,114,115 In bullous pemphigoid, itch severity was described to correlate with SP expression as assessed by immunofluorescence staining. 116 The clinical data are summarized in Table III. Supplementary to the strongly indicative data in humans, recent murine studies have reinforced the mechanistic role of Mrgprb2 and SP in the development of cutaneous inflammatory conditions.…”

Section: The Role Of Mrgprx2 Ligands In Chronic Pruritic Skin Diseasementioning

confidence: 99%

Mas-related G protein–coupled receptor X2 and its activators in dermatologic allergies

Kühn

Kolkhir

Babina

et al. 2021

Journal of Allergy and Clinical Immunology

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“…BP is also associated with Parkinson disease and dementia [37]. Itch in BP has been recently correlated to several mediators including substance P and IL-31 and activation of eosinophils and basophils [38]. BP may initially present with a prodrome of non-bullous, non-specific eczematous skin changes accompanied by pruritus lasting months to years prior to the presentation of tense bullae [39].…”

Section: Age-related Changes In the Skinmentioning

confidence: 99%

Management of Itch in the Elderly: A Review

Fourzali

Yosipovitch

2019

Dermatol Ther (Heidelb)

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Chronic itch is common in the elderly patient and may be caused by a variety of known dermatologic and non-dermatologic conditions and can have a significant effect on quality of life. Age-related changes in barrier function, immunosenescence, and neuronal changes and neuropathies are common predisposing factors to chronic itch in this age group. Certain primary dermatologic conditions are more common in the elderly and can cause chronic itch. Also, co-morbid diseases particularly of the renal, hepatobiliary, or hematologic systems, psychologic conditions, or medications may contribute to chronic itch in this population. Thus, medical workup for an elderly patient with chronic itch requires special attention to the patient's medical history, current health status, and medications. Topical treatments and emollients may be recommended for elderly patients, with consideration of specific adverse effects and alternatives. Systemic medications pose a higher risk of adverse effects and many are contraindicated in the elderly for this reason. In addition, management in the elderly may be complicated by differential pharmacokinetics of medications, the presence of comorbid health conditions, cognitive disorders, physical limitations, and polypharmacy. New and emerging treatment modalities hold promise for use in the elderly due to these special considerations.

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Pathophysiologic mechanisms of itch in bullous pemphigoid

Cited by 84 publications

References 48 publications

Thymic Stromal Lymphopoietin Is Implicated in the Pathogenesis of Bullous Pemphigoid by Dendritic Cells

Thymic Stromal Lymphopoietin Is Implicated in the Pathogenesis of Bullous Pemphigoid by Dendritic Cells

Mas-related G protein–coupled receptor X2 and its activators in dermatologic allergies

Management of Itch in the Elderly: A Review

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