Increased serum IL-6, TNF-alpha and IL-10 levels in patients with bullous pemphigoid: Relationships with disease activity

Aim: The present report analyzes the serum levels of three cytokines, interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha) and interleukin-10 (IL-10) in 15 patients with bullous pemphigoid (BP) (compared with 20 healthy controls) to evaluate a possible involvement of these biological modulators in the clinical expression of this disease. Background: BP is a rare, bullous disease of autoimmune origin with evidence of inflammatory processes that cause skin lesions with local increase of various pro-inflammatory mediators. Methods: Determination of cytokine concentrations were obtained employing commercially available ELISA kits. Results: The sera of BP patients showed increased levels of these three cytokines (P <0.01). When the number of skin lesions (blisters and/or erosion) of each patient, employed as a marker of disease activity, was correlated with the serum levels of IL-6 and TNF-alpha, significant correlations were found (IL-6: P <0.01 and TNF-alpha: P <0.01, respectively), suggesting a possible role of these mediators in the development of BP blisters. The serum levels of IL-6 also correlated (P = 0.01) with those of serum C reactive protein (CRP), an acute-phase protein induced by IL-6 in hepatocytes. In addition, serum TNF- alpha and sE-selectin (an adhesion molecule previously reported to be increased by this cytokine) levels were also correlated (P <0.05). Conclusions: On the basis of these data, it may be indicated that at least IL-6 and TNF-alpha are associated with the clinical expression of BP and that the endothelial activation (possibly induced by the TNF-alpha activity), seems to be an important phase of this dermatosis.