The behavior of membrane receptors of peripheral blood lymphocytes in bullous pemphigoid

In 35 patients with bullous pemphigoid (BP) various parameters of the cellular immune system were studied. It was shown that the average 29% decrease in the number rosette-forming lymphocytes in sheep red blood cells is converted by the immune complexes and by a second serum factor in the acute stage of BP that has not yet been characterized precisely. These changes were reversible in patients who were placed on immunosuppressants. Obviously, this mechanism is partly due to the binding of immune complexes via Fc receptors on T-lymphocytes and is consequently due to the steral blocking of sheep erythrocyte receptors. No decrease in the number of T-cells was found by means of monoclonal antibodies (CD2, CD3), and the number of suppressor cells was also normal (CD8). On the other hand, the number of T-helper cells increased by an average of 15% (CD4). In addition, in the acute stage, there is a significant increase in the number of activation antigen Tac (CD25) and DR-bearing lymphocytes: 29% and 37% respectively (the normal values are 2% and 11%, respectively). Double staining permitted the phenotype of activated lymphocytes to be detected within the T-cells and the T-helper cell subpopulation, respectively. The number of activated T-helper cells correlates with the disease activity, and from that point it seems to be useful as a marker of activity in follow-up studies.