Defining therapeutic responsiveness in patients with bullous pemphigoid by immunophenotyping (KS02*)

• Subject Area: Dermatology
• Term: since 2023
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 246807620

A prospective multicentre therapy study is planned to better characterize the pathogenicity and clinical phenotype of different IgG-mediated autoimmune responses present in bullous pemphigoid (BP) patients. Precise immunophenotyping will allow us to recruit BP patients with selective IgG-autoreactivity against BP230 (BP230+-only BP), the NC16A region of BP180, or the non-NC16A region of BP180. All study participants will receive the same topical BP treatment so that differences in the therapeutic responsiveness (primary endpoint) between these collectives can be identified. To characterize the clinical phenotype in more detail, we will analyze the extent of disease, the subjective impairment due to BP and the relapse rate over a one-year observation period. Molecular analyses in case of relapse will reveal relevant "epitope-spreading" phenomena and will increase our knowledge of the pathophysiological mechanisms present in disease progression. Last, molecular binding analysis of BP230 autoantibodies and characterization of the blister-inducing potential of BP230+-only BP sera on human skin equivalents will serve to better characterize the role of anti-BP230-induced autoimmunity in humans.

• DFG Programme: CRC/Transregios
• Subproject of: TRR 156: The skin as sensor and effector orchestrating local and systemic immunity
• Applicant Institution: Ruprecht-Karls-Universität Heidelberg
• Project Heads: Professor Dr. Alexander Enk; Dr. Katharina Kommoss; Dr. Torben Ramcke