Problem: We studied chemotactic cytokines and activation of skin-homed eosinophils in pemphigoid gestationis, a rare autoimmune bullous disease of late pregnancy.
Method of study: Eotaxin and interleukin (IL)-5 were analysed in patients' blister fluid and serum by enzyme-linked immunosorbent assay. Lesional tissue was investigated for eotaxin deposition by immunohistochemistry. Adhesion molecules and activation markers on tissue eosinophils were analysed by immunofluorescence staining.
Results: Eotaxin was elevated in serum of two pemphigoid gestationis patients compared with nine healthy pregnant women. Blister fluid contained even higher amounts of eotaxin and in addition IL-5. Eotaxin was mainly expressed in subepidermal tissue in close proximity to eosinophils that expressed high levels of adhesion molecules (CD11b, CD11c, CD18 and CD49d) and the activation marker HLA-DR.
Conclusions: High local levels of eotaxin and IL-5 as present in the blister fluid correspond to the high state of activation of the infiltrated eosinophils.