The role of follicular helper T cells in pemphigus vulgaris

Pemfigus is a rarely seen chronic autoimmune disease. Recent stuides have findings that Tfh cells may play a role in autoimmnune diseases. In this study Tfh cells, BCL6 gene expression, IL-21 and IL-6 cytokines were studied and aimed to understand the role of Tfh cells in pemphigus vulgaris disease. 20 pemphigus vulgaris patients and 20 healthy controls who have not any autoimmnune diseases that admitted to Dermatology and Venereology Outpatient Clinic of Akdeniz University School of Medicine were included. Peripheral blood sample is taken from all individuals and studied to analyze Tfh cell distribution, IL-21 and IL-6 distribution in CD3+CD4+CXCR5+ lymphocytes with flow cytometry, plasma IL-21 levels with ELISA, mRNA levels that refers BCL6 expression with PCR. Circulating Tfh cell distribution, IL-21 and IL-6 distribution in CD3+CD4+CXCR5+ lymphocytes and mRNA levels that refers BCL6 expression showed no difference between patient and healthy control groups. But in patients who had taken ritüximab treatment there was a significant reduction at Tfh cells compared to other groups. Plasma IL-21 levels were significantly higher in patient group. In result, although higher results of plasma IL-21 levels in patient group and Tfh cell reduction in patients who had taken ritüximab treatment are findings that may support the role of Tfh cells in pathogenisis of pemphigus vulgaris; there were no significant difference in Tfh cell percentages between patient and healthy control group. Further studies are required to enlighten the role of Tfh cells in pemphigus vulgaris disease.