Elucidation of the mechanism of action for establishing novel strategies of plasmapheresis

血浆置换（PP）是治疗严重药疹和自身免疫性水疱疾病最有效的选择之一。PE在这些疾病和其他自身抗体介导的疾病中的作用机制尚不清楚。在这项研究中，我们询问了PE或皮质类固醇脉冲治疗后血清细胞因子水平和调节性T细胞（Treg）的改变是否可能是PE比其他选择更有效治疗严重药疹和顽固性自身免疫性疾病的机制。在自身免疫性水疱疾病中，双滤过血浆置换（DFPP）已被主要使用，而血清置换（PE）则比DFPP更常用于严重的药疹。我们发现，PP后高水平的血清IL-10与其在两种疾病条件下的显著疗效相关，血清IL-10水平可能是一种更有价值的生物标志物，用于识别自身免疫性水疱疾病中可能对PP有反应的患者，而不是严重药物疹。

Plasmapheresis (PP) is one of the most effective option for treatment of severe drug eruption and autoimmune blistering disorders. The mechanism of action of PE in these diseases as in other autoantibody-mediated disease remains unknown. In this study, we asked whether alterations of serum cytokine levels and regulatory T cells (Treg) after PE or corticosteroid pulse therapy could be the mechanism of why PE is a much more effective option for treatment of severe drug eruptions and recalcitrant autoimmune diseases than other options. In autoimmune blistering disorders, double-filtration plasmapheresis (DFPP) has been predominantly used, while serum exchange (PE) has been more frequently used for severe drug eruptions than DFPP. We found that high levels of serum IL-10 after PP was associated with its remarkable efficacy in both disease conditions and that serum IL-10 levels may be a more valuable biomarker to identify patients likely to respond to PP in autoimmune blistering disorders than in severe drug eruptions.