Expression Of Programmed Cell Death‐1 (PD-1) On CD4+T Cells In Pemphigus Vulgaris

Abstract

Background: Pemphigus is chronic autoimmune intra-epidermal bullous skin disease. Recent studies have found that programmed cell death‐1 (PD-1) plays a role in autoimmune diseases. In this study PD-1 expression on CD4 cells were assessed by flowcytometry, soluble PD-1 were assessed by ELISA and corelated with activity and severity in pemphigus patients.

Methods: 20 patients with active pemphigus, 20 patients in remission on therapy and 40 age-matched healthy controls presented to the Dermatology department in Mansoura University Hospital. Blood samples from all precipitants were studied by flow cytometry to assess expression of PD‐1 on CD4+ cells and assess the level of serum PD‐1 by ELISA.

Results: A highly significant difference in PD-1 percentage on CD4+ was observed the active old group much higher expression than the remission group (p < 0.001), and in the remission group higher expression than the control group (p < 0.001). PD-1 percentage correlated positively with the PDAI scores (p < 0.001) indicating that higher PDAI scores are associated with higher PD-1% values. Serum levels of sPD-1 were significantly lower in PV patients than in controls (p < 0.001) and significantly lower in patients with active disease than those in remission (p < 0.001). Serum sPD-1 correlated negatively with the PDAI scores (p < 0.001, r = −0.4).

Conclusions: Elevated PD-1 expression on CD4+ cells in the highest PDAI score patients. may show the importance of PD-1 in the pathogenesis of PV. Further studies are required to confirm the role of PD-1 in pemphigus vulgaris.