Serum Levels Of CCL17 In Patients With Bullous Pemphigoid

Objective: Japanese researchers’ studies have shown that hymus and activation-regulated chemokine(TARC/CCL17)which belongs to Th2 chemokines is significantly elevated in Bullous pemphigoid patients serum,and parallel to the disease activity.The aim of this study is to investigate the concentration of CCL17 in the serum of Chinese BP patients so as to reveal the correlation of CCL17 with the disease severity and the thraepeutic response.Methods: Sixty-five newly diagnosed untreated BP patients hospitalized in the First Hospital of China Medical University between January 1,2015 and May 1,2017 were enrolled in the study.As a healthy control group,34 healthy individuals were recruited.Thirty newly diagnosed untreated autoimmune bullous diseases patients were recruited.In all patients and controls,serum levels of CCL17 and anti-BP180 antibodies,anti-BP230 antibodies were measured using enzyme-linked immunosorbent assays(ELISA).Results: Serum CCL17 levels showed a sensitivity of 87.60% and specificity of 91.20%.Serum anti-BP180 antibody levels showed a sensitivity of 87.70%,Serum anti-BP230 antibody levels showed a sensitivity of 52.31%,both of them showed same specificity of100%.At basaline,serum CCL17 levels were significantly elevated in BP patients[1798.114(3415.087)pg/ml] than those in both healthycontrols [219.367(210.46)pg/ml](p=0.000)and autoimmune bullous diseases controls [132.813(383.675)pg/ml](p=0.000).In patients with elevated serum CCL17 levels(n=53),EO% [15.500%(20.450%)] and the percentage of patients with high EO%(≥8%)were significantly elevated than patients with normal serum CCL17 levels [4.750%(4.425%)](p=0.015 and p=0.02),and in patients with elevated serum CCL17 levels,there was a significant correlation between serum CCL17 levels and EO%(rs=0.661,p=0.000);serum CCL17 levels corelated significantly with serum ALB levelsin patients with elevated serum CCL17 levels(rs=-0.391,p=0.004);anti-BP180 antibody and anti-BP230 antibody levels[100.830U/ml(159.490 U/ml)and 42.120 U/ml(100.490U/ml)] significantly elevated than patients with normal serum CCL17 levels [42.120U/ml(100.490U/ml)and1.881U/ml(6.194U/ml)](p=0.018 and p=0.015),serum CCL17 levels corelated significantly with serum anti-BP180 antibody in patients with elevated serum CCL17levels(p=0.000).In patients with elevated serum CCL17 levels,the percentage of patients with positive anti-BP230 antibody were significantly elevated than patients with normal serum CCL17 levels(p=0.002).serum CCL17 levels,Anti-BP180 antibody levels and CRP levels of 14 BP patients were remarkably related to the BPDAI scores(n=14,r=0.757,p=0.002 and n=14,r=0.665,p=0.009 and r=0.722,p=0.004).Anti-BP180 antibody and anti-BP230 antibody levels [159.200(176.793)U/ml and 86.693(125.093)U/ml] of 18 bedriddden patients were significant elevated than those of 47 ambulatory patients(p=0.002,p=0.008).After effective treatment,serum CCL17 levels[863.120(957.360)pg/ml] were significantly descreased than those at baseline[2059.900(7097.300)pg/ml](n=7,p=0.018).Conclusion: Serum CCL17 level is significantly elevated in BP patients,and parallel to the disease activity.The serum CCL17 level,BPDAI score,anti-BP180 antibody level,anti-BP230 antibody level,EO%,and ALB level can be used as the target of BP patients’ disease activity.