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however, the molecular pathogenesis of the Janus kinase\/signal transducer and activator of transcription (JAK\/STAT) pathway in BP is not fully understood.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To characterize the immune profiles of and the key JAK\/STAT pathway in patients with BP. The clinical efficacy of JAK inhibition in patients with BP was also assessed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Skin transcriptome profiling, measurement of plasma cytokine\/chemokine levels, and an in vitro T-cell activation and JAK inhibitor (JAKi) blocking assay were performed for patients with BP. The clinical improvement in steroid-resistant patients with BP treated with JAKi was evaluated.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Fifty patients with BP and 31 healthy donor individuals were enrolled in this study. JAK3 and STAT3 mRNA levels were increased in skin lesions from patients with BP. BP-related inflammatory-mediated cytokines\/chemokines, including interleukin 5, CCL22, CCL17, CCL18, matrix metalloproteinase 9 and granzyme B, were significantly elevated in patients with BP compared with the healthy donors (all P &amp;lt; 0.001). An in vitro T-cell activation and JAKi blocking assay revealed that tofacitinib (JAK1\/3i) and ritlecitinib (JAK3i) had better inhibitory effects than upadacitinib on granzyme B and CCL17 in patients with BP. Eight patients with steroid-resistant BP were treated with oral tofacitinib. Of these patients, five had a rapid reduction in their Bullous Pemphigoid Disease Area Index (from 104.2 to 34.8) within 5 weeks.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>JAK3i can attenuate JAK3\/STAT3-mediated inflammatory factors, providing an alternative treatment strategy for patients with refractory BP in combination with low-dose steroids.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/bjd\/ljaf219","type":"journal-article","created":{"date-parts":[[2025,6,18]],"date-time":"2025-06-18T07:53:10Z","timestamp":1750233190000},"page":"521-531","source":"Crossref","is-referenced-by-count":6,"title":["Janus kinase\/signal transducer and activator of transcription signalling pathway is involved in the immune mechanism of bullous pemphigoid"],"prefix":"10.1093","volume":"193","author":[{"given":"Hsin-Yu","family":"Chung","sequence":"first","affiliation":[{"name":"Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital , Linkou, Taipei and Keelung ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7378-4235","authenticated-orcid":false,"given":"Chun-Bing","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital , Linkou, Taipei and Keelung ,","place":["Taiwan"]},{"name":"Cancer Vaccine and Immune Cell Therapy Core Laboratory, Department of Medical Research, Chang Gung Memorial Hospital , Linkou ,","place":["Taiwan"]},{"name":"Chang Gung Immunology Consortium, Chang Gung Memorial Hospital and Chang Gung University , Taoyuan ,","place":["Taiwan"]},{"name":"Department of Dermatology, Xiamen Chang Gung Hospital , Xiamen ,","place":["China"]},{"name":"Xiamen Chang Gung Allergology Consortium, Xiamen Chang Gung Hospital , Xiamen ,","place":["China"]},{"name":"School of Medicine, National Tsing Hua University , Hsinchu ,","place":["Taiwan"]},{"name":"College of Medicine, Chang Gung University , Taoyuan ,","place":["Taiwan"]},{"name":"Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University , Taoyuan ,","place":["Taiwan"]},{"name":"Immune-Oncology Center of Excellence, Chang Gung Memorial Hospital , Linkou ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hua-En","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital , Linkou, Taipei and Keelung ,","place":["Taiwan"]},{"name":"Department of Dermatology, Xiamen Chang Gung Hospital , Xiamen ,","place":["China"]},{"name":"College of Medicine, Chang Gung University , Taoyuan ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9341-4012","authenticated-orcid":false,"given":"Chun-Wei","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital , Linkou, Taipei and Keelung ,","place":["Taiwan"]},{"name":"College of Medicine, Chang Gung University , Taoyuan ,","place":["Taiwan"]},{"name":"Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University , Taoyuan ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1929-4008","authenticated-orcid":false,"given":"Wei-Ti","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital , Linkou, Taipei and Keelung ,","place":["Taiwan"]},{"name":"College of Medicine, Chang Gung University , Taoyuan ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosaline Chung-Yee","family":"Hui","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital , Linkou, Taipei and Keelung ,","place":["Taiwan"]},{"name":"College of Medicine, Chang Gung University , Taoyuan ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min-Hui","family":"Chi","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital , Linkou, Taipei and Keelung ,","place":["Taiwan"]},{"name":"Department of Dermatology, Xiamen Chang Gung Hospital , Xiamen ,","place":["China"]},{"name":"College of Medicine, Chang Gung University , Taoyuan 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,","place":["Taiwan"]},{"name":"Cancer Vaccine and Immune Cell Therapy Core Laboratory, Department of Medical Research, Chang Gung Memorial Hospital , Linkou ,","place":["Taiwan"]},{"name":"Chang Gung Immunology Consortium, Chang Gung Memorial Hospital and Chang Gung University , Taoyuan ,","place":["Taiwan"]},{"name":"Department of Dermatology, Xiamen Chang Gung Hospital , Xiamen ,","place":["China"]},{"name":"Xiamen Chang Gung Allergology Consortium, Xiamen Chang Gung Hospital , Xiamen ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1681-0959","authenticated-orcid":false,"given":"Wen-Hung","family":"Chung","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital , Linkou, Taipei and Keelung ,","place":["Taiwan"]},{"name":"Cancer Vaccine and Immune Cell Therapy Core Laboratory, Department of Medical Research, Chang Gung 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Ruijin Hospital and School of Medicine , Shanghai ,","place":["China"]},{"name":"Genomic Medicine Core Laboratory, Chang Gung Memorial Hospital , Linkou ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,6,19]]},"reference":[{"key":"2025081809374192900_ljaf219-B1","doi-asserted-by":"crossref","first-page":"50","DOI":"10.3892\/etm.2021.10972","article-title":"Bullous pemphigoid: an immune disorder related to aging (Review)","volume":"23","author":"Deotto","year":"2022","journal-title":"Exp Ther Med"},{"key":"2025081809374192900_ljaf219-B2","doi-asserted-by":"crossref","first-page":"4818","DOI":"10.1111\/jocd.14797","article-title":"Global incidence and prevalence of bullous pemphigoid: a systematic review and meta-analysis","volume":"21","author":"Lu","year":"2022","journal-title":"J\u00a0Cosmet 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