PDF(Pubmed)
Abstract：
Bullous pemphigoid (BP) is an autoimmune inflammatory skin disease, mostly affecting the elderly population. Therefore, patients often have multiple comorbidities, but there is inconsistent data regarding the relationship between HIV-1 infection and BP, which has been rarely reported in combination. Herein, we describe three patients who presented with BP and concomitant HIV-1 infection that was well controlled with modern combined antiretroviral therapy. All patients received topical and oral corticosteroids. Depending on the individual severity, further add-on therapeutics, such as azathioprine, dapsone, doxycycline and the interleukin 4/13 antibody dupilumab, were added to the therapy regimen. All patients recovered from pruritic skin lesions and blistering. The cases are further discussed in the context of the current study landscape. In conclusion, HIV-1 infection shifts the cytokine profile from T-helper type 1 (TH1) towards T-helper type 2 (TH2), resulting in the excessive secretion of distinct cytokines, such as interleukin 4 (IL-4) and interleukin 10 (IL-10). With IL-4 being a main driver in the pathogenesis of BP, HIV-1-positive patients may benefit greatly from targeting IL-4 with monoclonal antibodies.
摘要：
大疱性类天疱疮（BP）是一种自身免疫性炎症性皮肤病，主要影响老年人口。因此,患者通常有多种合并症，但是关于HIV-1感染和BP之间的关系有不一致的数据，很少结合报道。在这里，我们描述了3例出现BP并伴随HIV-1感染的患者,这些患者通过现代联合抗逆转录病毒治疗得到了良好控制.所有患者均接受局部和口服皮质类固醇。根据个人的严重程度，进一步的附加疗法，如硫唑嘌呤，氨苯砜,多西环素和白介素4/13抗体dupilumab，被添加到治疗方案中。所有患者均从瘙痒性皮肤损伤和起泡中恢复。这些案例将在当前研究环境的背景下进一步讨论。总之,HIV-1感染将细胞因子谱从T辅助型1（TH1）转移到T辅助型2（TH2），导致不同细胞因子的过度分泌，如白细胞介素4(IL-4)和白细胞介素10(IL-10)。IL-4是BP发病的主要驱动因素,HIV-1阳性患者可能会从单克隆抗体靶向IL-4中受益匪浅。
