BULLOUS PEMPHIGOID AND PEMPHIGUS-VULGARIS - CORRELATED BEHAVIOR OF SERUM VEGF, SE-SELECTIN AND TNF-ALPHA LEVELS

Background. Recently we reported that soluble E-selectin (sE-selectin) , an isoform of the cell membrane E-selectin, an adhesion molecule syn thesized only by endothelial cells, is significantly increased in sera of the patients with bullous pemphigoid (PB) or pemphigus vulgaris. A significant correlation was also found between the serum sE-selectin levels and the number of skin lesions, suggesting the possible use of this molecule to gauge disease intensity before therapy: One of the sE -selectin inducers is tumor nerosis factor-alpha (TNF-alpha), that is also able to enhance vascular endothelial growth factor (VEGF), a stro ng endothelium activator. Objective. On the basis of these observation s, the presnt study was conducted to analyze the serum levels of VEGF; sE-selectin, and TNF-alpha in 8 patients with BP (age: 82, range 54-8 7, 7 males, 1 female) and in 6 patients affected with PV (age: 55, ran ge 44-65; 5 males, 1 female) and to verify possible correlations betwe en these variables and the disease activity. In addition, serum sE-sel ectin levels were measured over time and compared with the serum anti- epithelium antibodys titers. Methods. The sE-selectin, VEGF and TNF-al pha levels were measured in the samples by means of commercially avail able ELISA kit. The same samples were also employed to measure the ant i-epithelium antibody titers. Results. Serum VEGF sE-selectin and TNF- alpha levels were significantly correlated each other (p at least <0.0 1). All three variables were also significantly correlated with the,lu mber of lesions (p at least<0.01). Serum VEGF levels were found increa sed (median = 178 pg/ml, range 37-595) as compared to 28 healthy contr ols (median = 135 pg/ml, range 18/269, p<0.05). Also serum TNF-alpha l evels were found increased (median = 5.5 pg/ml, range <0.1-41.0) as co mpared to 28 healthy controls (median <0.1 pg/ml, range <0.1-5.3), p<0 .01). When the patients were observed over time, serum sE-selectin lev els highly correlated with the disease intensity in both dermatoses, a lthough with different regression curves. Conclusions. These data furt her underline the endothelium involvement in these bullous dermatoses and sti-ess the possibility, of employing sE-selectin as a non-specifi c follow-up marker of both BP and PV.