Pemphigus vulgaris (PV) is classical example of
antigen-driven severe autoimmune bullous skin disorder. Auto reactive T cells are critical for the induction and regulation of antibody production. With regard to
cytokine production profiles, it has been reported that qualitative as well as quantitative alterations in
cytokine production can result in activation of inefficacious effector mechanisms and therefore, complex and severe impairment in immune functions. The purpose of this study was to observe the alterations in the levels of T(H)1 [
Interleukin-2 (IL-2),
Interferon-gamma (IFN-gamma)] and T(H)2 (IL-4 and IL-10)
cytokines in the sera from patients affected with PV and compared with
Pemphigus foliaceus and healthy subjects. This work is aimed to comprehend the involvement of T(H)1 and T(H)2 cells as inflammatory infiltrate in the modulation of
acantholysis and production of
pemphigus lesions. Seventy PV, 13 PF and 50 healthy, age-matched individuals without any generalized
skin diseases were included in this study. The diagnosis of PV and PF patients was confirmed by histopathology (
hematoxylin and
eosin) and / direct immunofluorescence. The levels of T(H)1
cytokines (IL-2 and IFN-gamma) and T(H)2
cytokine markers (IL-4 and IL-10) were estimated by high sensitivity ELISA kits. All patients with PV and PF showed significantly (p < 0.000) elevated levels of T(H)2
cytokines (IL-10 and IL-4) as compared with healthy controls. However, the mean concentration of T(H)1
cytokines (IL-2 and IFN-gamma) was significantly decreased in patients as compared to healthy individuals. Both T(H)1 and T(H)2
cytokines did not show any significant difference between PV and PF cases. Current concepts support the idea that PV, induced by
autoantibodies against Dsg3, is the consequence of an imbalance between Dsg3-reactive T(H)2 and T(H)1 cells that may be critical for the maintenance of tolerance against Dsg3.
Cytokine profile for confirmed PV cases showed direct evidences for involvement of T cell responses. Increase in
IL-4 and
IL-10 shows induction of T(H)2 cells in the pathogenesis of autoimmune disorders
Pemphigus vulgaris. The decreased levels of
IL-2 and IFN-gamma might demonstrate the inhibitory effects by
IL-4 and
IL-10, which suppress the expansion of T(H)1 population.