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MicroRNA (miRNA), dynamic regulators of immune function, have been identified as potential biomarkers for some autoimmune diseases. This study aimed to assess the miRNA expression of miR\u201017\u20105p, miR\u201021\u20105p, miR\u2010146a\u20105p, miR\u2010155\u20105p and miR\u2010338\u20103p using quantitative real\u2010time PCR in peripheral blood mononuclear cells (PBMC) and lesional skin samples from untreated and treated PF patients (both remittent and chronic) over 3\u2009months. Overall, miRNA expression was significantly higher in PBMC than in biopsy samples. Blood miR\u201021 expression was increased in untreated patients compared to controls and had a diagnostic value with an AUC of 0.78. After 6\u2009weeks, it decreased significantly, similar to anti\u2010Dsg1 antibodies and the PDAI score. In addition, a positive correlation was observed between cutaneous miR\u201021 expression and the disease activity score. Conversely, cutaneous expressions of miR\u201017, miR\u2010146a and miR\u2010155 were significantly higher in treated chronic patients compared to remittent ones. The cutaneous level of miR\u2010155 positively correlated with pemphigus activity, making it a potential predictive marker for patients' clinical stratification with an AUC of 0.86.These findings suggest that blood miR\u201021 and cutaneous miR\u2010155 can be used as supplemental markers for PF diagnosis and activity, respectively in addition to classical parameters.<\/jats:p>","DOI":"10.1111\/exd.14821","type":"journal-article","created":{"date-parts":[[2023,4,28]],"date-time":"2023-04-28T07:14:10Z","timestamp":1682666050000},"page":"1132-1142","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["<scp>miRNA<\/scp> implication in the pathogenesis and the outcome of Tunisian endemic pemphigus foliaceus"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1129-8776","authenticated-orcid":false,"given":"Boudour","family":"Khabou","sequence":"first","affiliation":[{"name":"Autoimmunity, 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