Exploring Pruritus in Bullous Pemphigoid: Analysis of QOL Metrics and Potential Biological Mechanisms
Bullous pemphigoid is a devastating autoimmune blistering disease with need for improved therapeutics. Limited data are available on the overall burden of pruritus and alterations over time; however, treatment of itch-specific pathways may provide novel therapeutics. In this paper, we analyzed the Q...
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Elsevier
2025-03-01
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| Series: | JID Innovations |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2667026724000778 |
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| author | Olive C. Osuoji Taryn DeGrazia Robin Rolader Emily F. Cole Katy Lawson Henry Hilley Yanyan Xing Liang Han Sarah Chisolm Henry Claussen Xiaobo Yan Yuxian Sun Yuan Liu Suephy C. Chen Ron J. Feldman |
| author_facet | Olive C. Osuoji Taryn DeGrazia Robin Rolader Emily F. Cole Katy Lawson Henry Hilley Yanyan Xing Liang Han Sarah Chisolm Henry Claussen Xiaobo Yan Yuxian Sun Yuan Liu Suephy C. Chen Ron J. Feldman |
| author_sort | Olive C. Osuoji |
| collection | DOAJ |
| description | Bullous pemphigoid is a devastating autoimmune blistering disease with need for improved therapeutics. Limited data are available on the overall burden of pruritus and alterations over time; however, treatment of itch-specific pathways may provide novel therapeutics. In this paper, we analyzed the QOL impact particularly related to itch and determined corresponding changes in intraepidermal nerve fiber density and gene expression. A total of 43 patients with bullous pemphigoid were followed prospectively on standard-of-care treatment and showed average Bullous Pemphigoid Disease Area Index total activity score decrease from 19.1 ± 19.2 to 8.2 ± 11.3 and improvement in QOL measures Autoimmune Bullous Disease Quality of Life, Treatment of Autoimmune Bullous Disease Quality of Life, and ItchyQoL. At baseline, intraepidermal nerve fiber density in patients with bullous pemphigoid and atopic dermatitis were significantly lower than in healthy controls (7.3 ± 1.5 and 3.2 ± 2.0 vs 9.7 ± 5.4 fibers/mm, P = .031) and increased from baseline to follow-up visit (11.7 ± 0.4 and 5.8 ± 2.7), although only atopic dermatitis reached statistical significance (P = .018). S100A8, S100A9, CCL17, and CCL18 genes were highly upregulated in the skin of patients with bullous pemphigoid compared with those in healthy controls. Our data provide evidence for improvements in itch-related QOL over time on standard-of-care therapies with unique alterations in inflammatory mediators related to early immune cell activation and recruitment. |
| format | Article |
| id | doaj-art-bf45849648b44c80bb46a5d1d7ed3401 |
| institution | DOAJ |
| issn | 2667-0267 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JID Innovations |
| spelling | doaj-art-bf45849648b44c80bb46a5d1d7ed34012025-08-20T02:57:33ZengElsevierJID Innovations2667-02672025-03-015210032910.1016/j.xjidi.2024.100329Exploring Pruritus in Bullous Pemphigoid: Analysis of QOL Metrics and Potential Biological MechanismsOlive C. Osuoji0Taryn DeGrazia1Robin Rolader2Emily F. Cole3Katy Lawson4Henry Hilley5Yanyan Xing6Liang Han7Sarah Chisolm8Henry Claussen9Xiaobo Yan10Yuxian Sun11Yuan Liu12Suephy C. Chen13Ron J. Feldman14Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia, USADepartment of Dermatology, Emory University School of Medicine, Atlanta, Georgia, USADepartment of Dermatology, Emory University School of Medicine, Atlanta, Georgia, USADepartment of Biostatistics and Bioinformatics, Emory University Rollins School of Public Health, Atlanta, Georgia, USADepartment of Dermatology, Duke University School of Medicine, Durham, North Carolina, USADepartment of Dermatology, Duke University School of Medicine, Durham, North Carolina, USADepartment of Dermatology, Duke University School of Medicine, Durham, North Carolina, USADepartment of Dermatology, Duke University School of Medicine, Durham, North Carolina, USADepartment of Dermatology, Emory University School of Medicine, Atlanta, Georgia, USAEmory Integrated Computational Core, Emory University School of Medicine, Atlanta, GADepartment of Biological Sciences, Georgia Institute of Technology, Atlanta, Georgia, USADepartment of Biological Sciences, Georgia Institute of Technology, Atlanta, Georgia, USADepartment of Biological Sciences, Georgia Institute of Technology, Atlanta, Georgia, USADepartment of Biostatistics and Bioinformatics, Emory University Rollins School of Public Health, Atlanta, Georgia, USADepartment of Dermatology, Emory University School of Medicine, Atlanta, Georgia, USA; Correspondence: Ron J. Feldman, Department of Dermatology, Emory University School of Medicine, 1525 Clifton Road Northeast, Suite 100, Atlanta, Georgia 30322, USA.Bullous pemphigoid is a devastating autoimmune blistering disease with need for improved therapeutics. Limited data are available on the overall burden of pruritus and alterations over time; however, treatment of itch-specific pathways may provide novel therapeutics. In this paper, we analyzed the QOL impact particularly related to itch and determined corresponding changes in intraepidermal nerve fiber density and gene expression. A total of 43 patients with bullous pemphigoid were followed prospectively on standard-of-care treatment and showed average Bullous Pemphigoid Disease Area Index total activity score decrease from 19.1 ± 19.2 to 8.2 ± 11.3 and improvement in QOL measures Autoimmune Bullous Disease Quality of Life, Treatment of Autoimmune Bullous Disease Quality of Life, and ItchyQoL. At baseline, intraepidermal nerve fiber density in patients with bullous pemphigoid and atopic dermatitis were significantly lower than in healthy controls (7.3 ± 1.5 and 3.2 ± 2.0 vs 9.7 ± 5.4 fibers/mm, P = .031) and increased from baseline to follow-up visit (11.7 ± 0.4 and 5.8 ± 2.7), although only atopic dermatitis reached statistical significance (P = .018). S100A8, S100A9, CCL17, and CCL18 genes were highly upregulated in the skin of patients with bullous pemphigoid compared with those in healthy controls. Our data provide evidence for improvements in itch-related QOL over time on standard-of-care therapies with unique alterations in inflammatory mediators related to early immune cell activation and recruitment.http://www.sciencedirect.com/science/article/pii/S2667026724000778Bullous pemphigoidIntraepidermal nerve fiber densityQOLPruritus |
| spellingShingle | Olive C. Osuoji Taryn DeGrazia Robin Rolader Emily F. Cole Katy Lawson Henry Hilley Yanyan Xing Liang Han Sarah Chisolm Henry Claussen Xiaobo Yan Yuxian Sun Yuan Liu Suephy C. Chen Ron J. Feldman Exploring Pruritus in Bullous Pemphigoid: Analysis of QOL Metrics and Potential Biological Mechanisms JID Innovations Bullous pemphigoid Intraepidermal nerve fiber density QOL Pruritus |
| title | Exploring Pruritus in Bullous Pemphigoid: Analysis of QOL Metrics and Potential Biological Mechanisms |
| title_full | Exploring Pruritus in Bullous Pemphigoid: Analysis of QOL Metrics and Potential Biological Mechanisms |
| title_fullStr | Exploring Pruritus in Bullous Pemphigoid: Analysis of QOL Metrics and Potential Biological Mechanisms |
| title_full_unstemmed | Exploring Pruritus in Bullous Pemphigoid: Analysis of QOL Metrics and Potential Biological Mechanisms |
| title_short | Exploring Pruritus in Bullous Pemphigoid: Analysis of QOL Metrics and Potential Biological Mechanisms |
| title_sort | exploring pruritus in bullous pemphigoid analysis of qol metrics and potential biological mechanisms |
| topic | Bullous pemphigoid Intraepidermal nerve fiber density QOL Pruritus |
| url | http://www.sciencedirect.com/science/article/pii/S2667026724000778 |
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