Tissue Levels of MMP‐9 and Granzyme B in Patients With Bullous Pemphigoid: A Case–Control Study

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Autores principales: Hoa Dinh Pham, Doanh Huu Le, Tung Son Tran, Son Duc Le, Sho Hiroyasu, An Thi Vinh Do, Giang Thi Ha Quach, Daisuke Tsuruta, Lan Thi Pham, Luong Huy Vu
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Publicado: Wiley 2026
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author Hoa Dinh Pham
Doanh Huu Le
Tung Son Tran
Son Duc Le
Sho Hiroyasu
An Thi Vinh Do
Giang Thi Ha Quach
Daisuke Tsuruta
Lan Thi Pham
Luong Huy Vu
author_facet Hoa Dinh Pham
Doanh Huu Le
Tung Son Tran
Son Duc Le
Sho Hiroyasu
An Thi Vinh Do
Giang Thi Ha Quach
Daisuke Tsuruta
Lan Thi Pham
Luong Huy Vu
Hoa Dinh Pham
Doanh Huu Le
Tung Son Tran
Son Duc Le
Sho Hiroyasu
An Thi Vinh Do
Giang Thi Ha Quach
Daisuke Tsuruta
Lan Thi Pham
Luong Huy Vu
collection Wiley Open Access
contents Tissue Levels of MMP‐9 and Granzyme B in Patients With Bullous Pemphigoid: A Case–Control Study Hoa Dinh Pham Doanh Huu Le Tung Son Tran Son Duc Le Sho Hiroyasu An Thi Vinh Do Giang Thi Ha Quach Daisuke Tsuruta Lan Thi Pham Luong Huy Vu International Journal of Dermatology ABSTRACT Background Proteolytic enzymes, including matrix metalloproteinase‐9 (MMP‐9) and granzyme B, contribute to dermal–epidermal separation, but their expression in human skin lesions is not fully quantified. We aimed to quantify tissue levels of MMP‐9 and granzyme B in bullous pemphigoid (BP) lesional skin compared to healthy controls. Methods In a case–control study at the National Hospital of Dermatology and Venereology in Hanoi, Vietnam, between June 2024 and June 2025, lesional skin from BP patients and normal skin from healthy controls were analyzed. Matrix metalloproteinase‐9 (MMP‐9) and granzyme B levels were quantified using enzyme‐linked immunosorbent assay (ELISA). Mann–Whitney U tests, linear regression, and receiver operating characteristic (ROC) analyses were conducted to assess group differences, clinical associations, and diagnostic performance. Results Forty‐eight BP patients and 21 healthy controls were included in our study. The median level of MMP‐9 was 216.4 pg/mL/mg (interquartile range [IQR]: 74.6–570.0) in BP patients vs. 58.7 pg/mL/mg (IQR: 16.6–154.2) in controls ( p  = 0.0031). Granzyme B level was 2.16 pg/mL/mg (IQR: 1.26–5.13) in BP patients compared to 0.40 pg/mL/mg (IQR: 0.19–1.67) in the control group ( p  < 0.0001). ROC analysis showed areas under the curve (AUCs) of 0.722 for MMP‐9 and 0.781 for granzyme B, while the combined model reached 0.799. MMP‐9 level was correlated with body weight ( r  = 0.32, p  = 0.023) and leukocyte counts ( r  = 0.29, p  = 0.037), whereas granzyme B level was correlated with disease duration ( r  = 0.30, p  = 0.032). Conclusions Our study underscores that tissue levels of MMP‐9 and granzyme B are significantly heightened compared to healthy controls. These proteases play a pivotal role in all types of skin lesions and reflect the local activity of BP. 10.1111/ijd.70310 http://onlinelibrary.wiley.com/termsAndConditions#vor
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spellingShingle Tissue Levels of MMP‐9 and Granzyme B in Patients With Bullous Pemphigoid: A Case–Control Study
Hoa Dinh Pham
Doanh Huu Le
Tung Son Tran
Son Duc Le
Sho Hiroyasu
An Thi Vinh Do
Giang Thi Ha Quach
Daisuke Tsuruta
Lan Thi Pham
Luong Huy Vu
International Journal of Dermatology
Tissue Levels of MMP‐9 and Granzyme B in Patients With Bullous Pemphigoid: A Case–Control Study Hoa Dinh Pham Doanh Huu Le Tung Son Tran Son Duc Le Sho Hiroyasu An Thi Vinh Do Giang Thi Ha Quach Daisuke Tsuruta Lan Thi Pham Luong Huy Vu International Journal of Dermatology ABSTRACT Background Proteolytic enzymes, including matrix metalloproteinase‐9 (MMP‐9) and granzyme B, contribute to dermal–epidermal separation, but their expression in human skin lesions is not fully quantified. We aimed to quantify tissue levels of MMP‐9 and granzyme B in bullous pemphigoid (BP) lesional skin compared to healthy controls. Methods In a case–control study at the National Hospital of Dermatology and Venereology in Hanoi, Vietnam, between June 2024 and June 2025, lesional skin from BP patients and normal skin from healthy controls were analyzed. Matrix metalloproteinase‐9 (MMP‐9) and granzyme B levels were quantified using enzyme‐linked immunosorbent assay (ELISA). Mann–Whitney U tests, linear regression, and receiver operating characteristic (ROC) analyses were conducted to assess group differences, clinical associations, and diagnostic performance. Results Forty‐eight BP patients and 21 healthy controls were included in our study. The median level of MMP‐9 was 216.4 pg/mL/mg (interquartile range [IQR]: 74.6–570.0) in BP patients vs. 58.7 pg/mL/mg (IQR: 16.6–154.2) in controls ( p  = 0.0031). Granzyme B level was 2.16 pg/mL/mg (IQR: 1.26–5.13) in BP patients compared to 0.40 pg/mL/mg (IQR: 0.19–1.67) in the control group ( p  < 0.0001). ROC analysis showed areas under the curve (AUCs) of 0.722 for MMP‐9 and 0.781 for granzyme B, while the combined model reached 0.799. MMP‐9 level was correlated with body weight ( r  = 0.32, p  = 0.023) and leukocyte counts ( r  = 0.29, p  = 0.037), whereas granzyme B level was correlated with disease duration ( r  = 0.30, p  = 0.032). Conclusions Our study underscores that tissue levels of MMP‐9 and granzyme B are significantly heightened compared to healthy controls. These proteases play a pivotal role in all types of skin lesions and reflect the local activity of BP. 10.1111/ijd.70310 http://onlinelibrary.wiley.com/termsAndConditions#vor
title Tissue Levels of MMP‐9 and Granzyme B in Patients With Bullous Pemphigoid: A Case–Control Study
topic International Journal of Dermatology
url https://onlinelibrary.wiley.com/doi/10.1111/ijd.70310