Alterations in Inflammation Markers Due to Disease Activation in Autoimmune Bullous Diseases

Abstract

Background: In the pathogenesis of autoimmune bullous diseases, there is an underlying autoinflammation against epidermal/subepidermal structures caused by many inflammatory cells. Aim / Objectives: In this study, we aimed to determine the alterations in inflammatory markers regarding disease activity in autoimmune bullous diseases and to discuss their contribution to the pathogenesis. Methods: A total of 191 patients with pemphigus vulgaris (PV) and 46 patients with bullous pemphigoid (BP) who were admitted to the outpatient clinic at the Department of Dermatology were included. The mean platelet volume (MPV) values, thrombocyte, eosinophil, and basophil counts, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) levels prior and following treatment were examined retrospectively from the patients' medical files. A decrease of 75% or more in Autoimmune Bullous Skin Disorder Intensity Score (ABSIS) was considered a remission period. Results: Among patients with PV, 78 (40.8%) were men and 113 (59.2%) were women. In patients with PV, MPV value, eosinophil, basophil count, and ESR and CRP levels showed a statistically significant decrease during the remission period, whereas alteration in platelet count was not statistically significant. Eighteen (39.1%) of patients with BP were men and 28 (60.9%) were women. In patients with BP, MPV value, eosinophil count, and ESR and CRP levels showed a statistically significant decrease during the remission period. However, platelet and basophil counts revealed no statistically significant alterations. Limitations: Evaluation of the ABSIS scores of the followed-up patients by different observers due to the long time interval can be considered among the limitations of the study. Conclusion: Eosinophils, basophils, and thrombocytes to the inflammation in the pathogenesis of PV, whereas eosinophils and thrombocytes may contribute in the pathogenesis of BP. During the activation period of autoimmune bullous diseases, the level of acute-phase reactants is higher than in the remission period.