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Elevated Initial Levels of Diacron-Reactive Oxygen Metabolites in Patients with Bullous Pemphigoid

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The following is a summary of “Diacron-Reactive Oxygen Metabolites Levels Are Initially Elevated in Patients with Bullous Pemphigoid,” published in the July 2024 issue of Dermatology by Tozaki, et al.


Reactive oxygen species (ROS) are implicated in the pathogenesis of bullous pemphigoid (BP), though their role is not fully understood. For a study, researchers sought to further elucidate the pathogenic role of ROS in BP by examining the results of the diacron-reactive oxygen metabolite test and the biological antioxidant potential test in patients with BP before systemic corticosteroid treatment.

About 16 patients with BP were evaluated using the diacron-reactive oxygen metabolite test and the biological antioxidant potential test before systemic corticosteroid treatment. The average diacron-reactive oxygen metabolite levels, expressed in Carratelli units, were measured at baseline and after one month of treatment. Additionally, the Bullous Pemphigoid Disease Area Index (erosions/blisters) scores were correlated with diacron-reactive oxygen metabolite levels. Skin tissues were stained for 3,5-dibromotyrosine, a marker of tissue damage related to inflammation and allergies.

In patients with BP, the average diacron-reactive oxygen metabolite levels significantly decreased after one month of treatment (from 335.6 ± 40.3 Carratelli units to 224.7 ± 61.6 Carratelli units, P < .001). The diacron-reactive oxygen metabolite levels correlated with the Bullous Pemphigoid Disease Area Index scores (r = 0.51), indicating that these levels reflect disease severity. Staining for 3,5-dibromotyrosine revealed its presence in infiltrated cells around the dermis, throughout the blister fluid, and at the basement membrane within the blister. It suggested that tissue destruction from myeloperoxidase released by neutrophils and eosinophil peroxidase released by eosinophils contributes to blister formation.

The findings suggested that ROS plays a significant role in the pathogenesis of BP, as indicated by the correlation between ROS levels and disease severity, as well as the presence of 3,5-dibromotyrosine in damaged tissues.

Reference: sciencedirect.com/science/article/pii/S2667026724000298

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