Targeting type 2 inflammation in bullous pemphigoid: current and emerging therapeutic approaches
Bullous pemphigoid (BP) is one of the most common autoimmune bullous diseases and mainly affects an elderly population with multi-morbidity. Due to the frailty of many BP patients, existing treatment options are limited. The blisters associated with BP result from IgG and IgE autoantibodies binding...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-08-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2023.1196946/full |
| _version_ | 1797751763109937152 |
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| author | Wu Han Toh Wu Han Toh Wu Han Toh Wu Han Toh Wu Han Toh Hua-En Lee Hua-En Lee Hua-En Lee Hua-En Lee Chun-Bing Chen Chun-Bing Chen Chun-Bing Chen Chun-Bing Chen Chun-Bing Chen Chun-Bing Chen |
| author_facet | Wu Han Toh Wu Han Toh Wu Han Toh Wu Han Toh Wu Han Toh Hua-En Lee Hua-En Lee Hua-En Lee Hua-En Lee Chun-Bing Chen Chun-Bing Chen Chun-Bing Chen Chun-Bing Chen Chun-Bing Chen Chun-Bing Chen |
| author_sort | Wu Han Toh |
| collection | DOAJ |
| description | Bullous pemphigoid (BP) is one of the most common autoimmune bullous diseases and mainly affects an elderly population with multi-morbidity. Due to the frailty of many BP patients, existing treatment options are limited. The blisters associated with BP result from IgG and IgE autoantibodies binding to the central components of hemidesmosome, BP180, and BP230, stimulating a destructive inflammatory process. The known characteristic features of BP, such as intense pruritus, urticarial prodrome, peripheral eosinophilia, elevated IgE, as well as recent expanding evidence from in vitro and in vivo studies implicate type 2 inflammation as an important driver of BP pathogenesis. Type 2 inflammation is an inflammatory pathway involving a subset of CD4+ T cells that secrete IL-4, IL-5, and IL-13, IgE-secreting B cells, and granulocytes, such as eosinophils, mast cells, and basophils. It is believed that effectors in type 2 inflammation may serve as novel and effective treatment targets for BP. This review focuses on recent understandings of BP pathogenesis with a particular emphasis on the role of type 2 inflammation. We summarize current clinical evidence of using rituximab (B-cell depletion), omalizumab (anti-IgE antibody), and dupilumab (anti-IL-4/13 antibody) in the treatment of BP. The latest advances in emerging targeted therapeutic approaches for BP treatment are also discussed. |
| first_indexed | 2024-03-12T16:53:17Z |
| format | Article |
| id | doaj.art-18ce5c4ecc9e442f935e53302a969121 |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-03-12T16:53:17Z |
| publishDate | 2023-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-18ce5c4ecc9e442f935e53302a9691212023-08-08T11:03:17ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2023-08-011010.3389/fmed.2023.11969461196946Targeting type 2 inflammation in bullous pemphigoid: current and emerging therapeutic approachesWu Han Toh0Wu Han Toh1Wu Han Toh2Wu Han Toh3Wu Han Toh4Hua-En Lee5Hua-En Lee6Hua-En Lee7Hua-En Lee8Chun-Bing Chen9Chun-Bing Chen10Chun-Bing Chen11Chun-Bing Chen12Chun-Bing Chen13Chun-Bing Chen14Institute for NanoBioTechnology, Johns Hopkins University, Baltimore, MD, United StatesTranslational Tissue Engineering Center, Johns Hopkins University School of Medicine, Baltimore, MD, United StatesDepartment of Computer Science, Johns Hopkins University, Baltimore, MD, United StatesDepartment of Biology, Johns Hopkins University, Baltimore, MD, United StatesCancer Vaccine and Immune Cell Therapy Core Laboratory, Chang Gung Memorial Hospital, Chang Gung Immunology Consortium, Taoyuan, TaiwanCancer Vaccine and Immune Cell Therapy Core Laboratory, Chang Gung Memorial Hospital, Chang Gung Immunology Consortium, Taoyuan, TaiwanDepartment of Dermatology and Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Taipei, TaiwanCollege of Medicine, Chang Gung University, Taoyuan, TaiwanChang Gung Immunology Consortium, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, TaiwanCancer Vaccine and Immune Cell Therapy Core Laboratory, Chang Gung Memorial Hospital, Chang Gung Immunology Consortium, Taoyuan, TaiwanDepartment of Dermatology and Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Taipei, TaiwanCollege of Medicine, Chang Gung University, Taoyuan, TaiwanChang Gung Immunology Consortium, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, TaiwanDepartment of Dermatology, Xiamen Chang Gung Hospital, Xiamen, China0Xiamen Chang Gung Allergology Consortium, Xiamen Chang Gung Hospital, Xiamen, ChinaBullous pemphigoid (BP) is one of the most common autoimmune bullous diseases and mainly affects an elderly population with multi-morbidity. Due to the frailty of many BP patients, existing treatment options are limited. The blisters associated with BP result from IgG and IgE autoantibodies binding to the central components of hemidesmosome, BP180, and BP230, stimulating a destructive inflammatory process. The known characteristic features of BP, such as intense pruritus, urticarial prodrome, peripheral eosinophilia, elevated IgE, as well as recent expanding evidence from in vitro and in vivo studies implicate type 2 inflammation as an important driver of BP pathogenesis. Type 2 inflammation is an inflammatory pathway involving a subset of CD4+ T cells that secrete IL-4, IL-5, and IL-13, IgE-secreting B cells, and granulocytes, such as eosinophils, mast cells, and basophils. It is believed that effectors in type 2 inflammation may serve as novel and effective treatment targets for BP. This review focuses on recent understandings of BP pathogenesis with a particular emphasis on the role of type 2 inflammation. We summarize current clinical evidence of using rituximab (B-cell depletion), omalizumab (anti-IgE antibody), and dupilumab (anti-IL-4/13 antibody) in the treatment of BP. The latest advances in emerging targeted therapeutic approaches for BP treatment are also discussed.https://www.frontiersin.org/articles/10.3389/fmed.2023.1196946/fullbullous pemphigoidanti-BP180 IgEeosinophiltype 2 inflammationrituximabomalizumab |
| spellingShingle | Wu Han Toh Wu Han Toh Wu Han Toh Wu Han Toh Wu Han Toh Hua-En Lee Hua-En Lee Hua-En Lee Hua-En Lee Chun-Bing Chen Chun-Bing Chen Chun-Bing Chen Chun-Bing Chen Chun-Bing Chen Chun-Bing Chen Targeting type 2 inflammation in bullous pemphigoid: current and emerging therapeutic approaches Frontiers in Medicine bullous pemphigoid anti-BP180 IgE eosinophil type 2 inflammation rituximab omalizumab |
| title | Targeting type 2 inflammation in bullous pemphigoid: current and emerging therapeutic approaches |
| title_full | Targeting type 2 inflammation in bullous pemphigoid: current and emerging therapeutic approaches |
| title_fullStr | Targeting type 2 inflammation in bullous pemphigoid: current and emerging therapeutic approaches |
| title_full_unstemmed | Targeting type 2 inflammation in bullous pemphigoid: current and emerging therapeutic approaches |
| title_short | Targeting type 2 inflammation in bullous pemphigoid: current and emerging therapeutic approaches |
| title_sort | targeting type 2 inflammation in bullous pemphigoid current and emerging therapeutic approaches |
| topic | bullous pemphigoid anti-BP180 IgE eosinophil type 2 inflammation rituximab omalizumab |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2023.1196946/full |
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