{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T23:16:14Z","timestamp":1789168574626,"version":"build-2803163510"},"reference-count":33,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T00:00:00Z","timestamp":1771200000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T00:00:00Z","timestamp":1771200000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Dermatology"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Proteolytic enzymes, including matrix metalloproteinase\u20109 (MMP\u20109) and granzyme B, contribute to dermal\u2013epidermal separation, but their expression in human skin lesions is not fully quantified. We aimed to quantify tissue levels of MMP\u20109 and granzyme B in bullous pemphigoid (BP) lesional skin compared to healthy controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In a case\u2013control 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\u20109 (MMP\u20109) and granzyme B levels were quantified using enzyme\u2010linked immunosorbent assay (ELISA). Mann\u2013Whitney\n                      <jats:italic>U<\/jats:italic>\n                      tests, linear regression, and receiver operating characteristic (ROC) analyses were conducted to assess group differences, clinical associations, and diagnostic performance.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Forty\u2010eight BP patients and 21 healthy controls were included in our study. The median level of MMP\u20109 was 216.4\u2009pg\/mL\/mg (interquartile range [IQR]: 74.6\u2013570.0) in BP patients vs. 58.7\u2009pg\/mL\/mg (IQR: 16.6\u2013154.2) in controls (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0031). Granzyme B level was 2.16\u2009pg\/mL\/mg (IQR: 1.26\u20135.13) in BP patients compared to 0.40\u2009pg\/mL\/mg (IQR: 0.19\u20131.67) in the control group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001). ROC analysis showed areas under the curve (AUCs) of 0.722 for MMP\u20109 and 0.781 for granzyme B, while the combined model reached 0.799. MMP\u20109 level was correlated with body weight (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.32,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.023) and leukocyte counts (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.29,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.037), whereas granzyme B level was correlated with disease duration (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.30,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.032).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our study underscores that tissue levels of MMP\u20109 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ijd.70310","type":"journal-article","created":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T03:49:51Z","timestamp":1771300191000},"page":"2074-2080","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Tissue Levels of MMP\u20109 and Granzyme B in Patients With Bullous Pemphigoid: A Case\u2013Control Study"],"prefix":"10.1111","volume":"65","author":[{"given":"Hoa Dinh","family":"Pham","sequence":"first","affiliation":[{"name":"Department of Dermatology Hanoi Medical University  Ton That Tung Hanoi Vietnam"},{"name":"National Hospital of Dermatology and Venereology  Hanoi Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doanh Huu","family":"Le","sequence":"additional","affiliation":[{"name":"Department of Dermatology Hanoi Medical University  Ton That Tung Hanoi Vietnam"},{"name":"National Hospital of Dermatology and Venereology  Hanoi Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3535-9712","authenticated-orcid":false,"given":"Tung Son","family":"Tran","sequence":"additional","affiliation":[{"name":"Department of Dermatology Hanoi Medical University  Ton That Tung Hanoi Vietnam"},{"name":"National Hospital of Dermatology and Venereology  Hanoi Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2572-3650","authenticated-orcid":false,"given":"Son Duc","family":"Le","sequence":"additional","affiliation":[{"name":"Faculty of Biology University of Science, Vietnam National University  Hanoi Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sho","family":"Hiroyasu","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Graduate School of Medicine Osaka Metropolitan University  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1162-8066","authenticated-orcid":false,"given":"An Thi Vinh","family":"Do","sequence":"additional","affiliation":[{"name":"Center of Hematology and Blood Transfusion Bach Mai Hospital  Hanoi Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5505-277X","authenticated-orcid":false,"given":"Giang Thi Ha","family":"Quach","sequence":"additional","affiliation":[{"name":"National Hospital of Dermatology and Venereology  Hanoi Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6283-0251","authenticated-orcid":false,"given":"Daisuke","family":"Tsuruta","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Graduate School of Medicine Osaka Metropolitan University  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lan Thi","family":"Pham","sequence":"additional","affiliation":[{"name":"Department of Dermatology Hanoi Medical University  Ton That Tung Hanoi Vietnam"},{"name":"National Hospital of Dermatology and Venereology  Hanoi Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luong Huy","family":"Vu","sequence":"additional","affiliation":[{"name":"Department of Dermatology Hanoi Medical University  Ton That Tung Hanoi Vietnam"},{"name":"National Hospital of Dermatology and Venereology  Hanoi Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,16]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-025-00595-5"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms26136076"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijd.15589"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijd.17926"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2025.1530407"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-1747.2002.19529.x"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.912876"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/1346-8138.16654"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1080\/07853890.2023.2280991"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-024-50283-3"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2019.01454"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.3390\/biom11101506"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2019.01506"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2016.08.012"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1159\/000090385"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.0022-202x.2001.01521.x"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-020-20604-3"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-018-28070-0"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2019.01858"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.19611"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2019.01972"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.3109\/10409238.2013.770819"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.2300080"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-025-62495-2"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI117196"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.molcel.2011.07.037"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jid.2024.02.029"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.3390\/biom13020388"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2024.3425"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1080\/07853890.2020.1742367"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/exd.70067"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-97202-w"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2016.3357"}],"container-title":["International Journal of Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ijd.70310","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ijd.70310","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ijd.70310","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T22:53:55Z","timestamp":1789167235000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ijd.70310"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,16]]},"references-count":33,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1111\/ijd.70310"],"URL":"https:\/\/doi.org\/10.1111\/ijd.70310","archive":["Portico"],"relation":{},"ISSN":["0011-9059","1365-4632"],"issn-type":[{"value":"0011-9059","type":"print"},{"value":"1365-4632","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,16]]},"assertion":[{"value":"2025-10-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-16","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}