Evaluation of serum cytokine and chemokine levels in dermatitis herpetiformis: a systematic review and meta-analysis

Excerpt

Characterized as an autoimmune bullous skin disease, dermatitis herpetiformis (DH) is preceded by burning pruritus and subsequent papulovesicular eruptions over the extensor surfaces of the knees, elbows, and buttocks. It is the most common extraintestinal manifestation of celiac disease and exhibits a therapeutic response to a gluten-free diet. While not all patients exhibit gastrointestinal symptom characteristic of celiac, all exhibit a celiac-type enteropathy in the small bowel (SB) mucosa. DH is thought to occur due to an immune response to transglutaminase (TG) 2 in the SB with cross reactivity and deposition of IgA-TG3 complexes in the papillary dermis [1]. How the immune complex deposition induces a cascade of proinflammatory cytokines and granulocytic infiltration resulting in subepidermal blistering remains unclear. To better understand and summarize the immune cascade, we performed a systematic review and meta-analysis of cytokine and chemokine changes involved in DH. …