Mediators of Inflammation in Blister Fluids From Patients With Pemphigus Vulgaris and Bullous Pemphigoid

• Blister fluids from 39 previously untreated patients with pemphigus vulgaris (PV) and 28 patients with bullous pemphigoid (BP) were tested for the presence of inflammatory mediators. Blister fluids from patients with PV and BP showed interleukin 1 (IL-1)- and interleukin 2 (IL-2)-like activity and contained prostaglandin (PG) E₂, F_1α, and F_2α, thromboxane B₂ (TB₂), leukotriene (LT) B₄ and C₄, serine esterases, and proteolysis inhibitors. Pemphigus blister fluid was distinguished by high IL-1-like activity, proteolytic activity, and high concentrations of TB₂ and LTB₄, while pemphigoid blister fluid was characterized by higher IL-2-like activity, antiprotease activity, and high PGE₂ concentration. We also determined that the content of mediators of inflammation varied depending on the duration of blister development. In both PV and BP, the initially high IL-1-like activity, amount of serine proteases, and concentrations of PGF_2α, TB,₂ LTB₄, and LTC₄ decreased by the fifth day of blister existence, whereas antiprotease activity as well as PGE₂ and PGF_1α concentrations gradually increased as blisters developed. These findings suggest certain differences in the character of the bullous inflammatory process in pemphigus and pemphigoid.

(Arch Dermatol 1989;125:925-930)