What's New in the Pathogenesis and Triggering Factors of Bullous Pemphigoid

The document reviewed the pathogenesis and triggering factors of bullous pemphigoid (BP), an autoimmune blistering disease affecting the elderly, characterized by autoantibodies targeting COL17 and BP230. It highlighted the role of regulatory T-cell (Treg) dysfunction, particularly due to Foxp3 mutation, in the production of autoantibodies, and the involvement of autoreactive CD4+ Th2 and follicular helper T cells in BP. The study examined 70 studies with 127 ICI-BP cases, noting that BP often occurred during or after immunotherapy, with anti-COL17 autoantibodies prevalent in 80.7% of patients. Treatment typically involved corticosteroids, with 81.4% of patients improving. The document suggested that genetic background, Treg cell dysfunction, aging, and various triggers might synergistically induce BP, and understanding these mechanisms could lead to new therapeutic strategies.