Trappin-2/Elafin and Clusterin serum levels in pemphigus vulgaris and correlation with the severity score

Abstract

Background Trappin-2/Elafin is a 9.9 KDa molecule released from its precursor Preproelafin that exists principally in immune cells, skin, the lungs, the vagina, and other organs. Clusterin is a heterodimeric glycoprotein that plays a major role in many biological processes such as interaction with lipids, apoptosis regulation, weakening of complement activation, toxin removal, response to damage, and stress as well as autoimmune damage. Both Trappin-2/Elafin and Clusterin serum levels have been studied in various immunologically mediated dermatological and nondermatological diseases. However, it still unknown whether their circulating levels are altered in pemphigus vulgaris (PV) and whether they play a role in this disease. Objective This study aimed to elucidate the potential link between both Trappin-2/Elafin and Clusterin levels and PV through a quantitative assessment of their serum levels by enzyme-linked immunosorbent assay and also to detect their possible correlations with PV severity using the pemphigus disease area index. Patients and methods Fifty patients with PV and 40 matched healthy controls were enrolled in this study. After a full assessment of history and complete dermatological examination, the severity score was calculated using pemphigus disease area index, and then serum samples were collected and subjected to quantitative measurements of serum Trappin-2/Elafin and Clusterin levels by enzyme-linked immunosorbent assay. Results Serum levels of both Trappin-2/Elafin and Clusterin were significantly higher in the patients than in the controls (P<0.001); still, their levels were not correlated with the severity of the disease. Conclusion The finding indicates that both Trappin-2/Elafin and Clusterin serum levels become elevated in patients with PV; however, the increase is not specific for the disease. None of the markers are correlated with the severity score of PV. Increased Trappin-2/Elafin levels indicate the existence of chronic inflammation, autoimmunity and skin or other system damage. Increased Clusterin levels suggest autoimmune damage, stress or transforming growth factor stimulation.