Journal Article Epublish
PubMed: 42039158 DOI: 10.3389/fimmu.2026.1804103
CXCL13 as a simple and promising blood biomarker for differentiating Sézary syndrome from mycosis fungoides and other confounding chronic inflammatory skin diseases.
Front Immunol 17:1804103
Authors: Giulia Salvatore, Ylenia Aura Minafò, Nicoletta Croce, Francesca Passarelli, Cristina Cristofoletti, Maria Cristina Picchio, Laura Bonmassar, Stefania Madonna, Laura Mercurio, Alessandro Monopoli, Filomena Russo, Gaia Moretta, Enrico Scala, Stefania D'Atri, Maria Grazia Narducci
Affiliations
- Laboratory of Molecular Oncology, Istituto Dermopatico dell'Immacolata IDI-IRCCS, Rome, Italy.
- Pathology Unit, Istituto Dermopatico dell'Immacolata IDI-IRCCS, Rome, Italy.
- Laboratory of Experimental Immunology, Istituto Dermopatico dell'Immacolata IDI-IRCCS, Rome, Italy.
- Department of Dermatology, Istituto Dermopatico dell'Immacolata IDI-IRCCS, Rome, Italy.
- Clinical and Laboratory Molecular Allergy Unit, Istituto Dermopatico dell'Immacolata IDI-IRCCS, Rome, Italy.
Abstract
Sézary syndrome (SS) is a rare and aggressive type of cutaneous T-cell lymphoma (CTCL). Due to its rarity and marked biological heterogeneity, SS diagnosis is frequently delayed, as it requires the integration of multiple complex diagnostic tests interpreted by highly specialized biomedical figures. In this context, we investigated the expression of CXCL13-increasingly implicated in several inflammatory and neoplastic skin disorders-as a potential screening biomarker to discriminate SS from mycosis fungoides (MF), the most common CTCL subtype, and from clinically overlapping inflammatory skin diseases, i.e. atopic dermatitis (AD), psoriasis (PS) and eczema (EC). Real-time PCR analysis of CXCL13 mRNA expression in 51 samples showed a significant upregulation in peripheral blood mononuclear cells (PBMCs) from SS patients compared with MF, AD and healthy donors (HD). Protein-level analysis in a larger cohort (n = 142), including allergic and atopic EC patients, revealed significantly higher plasma CXCL13 concentrations in SS than in all other conditions and HD, as assessed by ELISA. Receiver operating characteristic (ROC) analysis confirmed the excellent performance of plasma CXCL13 as a differential marker (AUC = 93%). In contrast, CXCL13 immunohistochemical expression in skin biopsies was broadly detected across all conditions, limiting its diagnostic value. In conclusion, quantification of CXCL13 expression in PBMCs and, more robustly, measurement of its plasma levels by widely available techniques such as RT-qPCR and ELISA may represent practical screening tools to identify patients with suspected SS. These assays could facilitate earlier referral to specialized centres for confirmatory testing and prompt initiation of appropriate therapy.
MeSH
Skin, Cells, Research Design, Mycosis Fungoides, Blood, Sezary Syndrome, Skin Diseases, Biomarkers, Plasma