Serum SERPINB3/4 in Moderate‐to‐Severe Prurigo Nodularis: A Potential Biomarker for Disease Severity and Eosinophil‐Related Parameters

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BACKGROUND: The available evidence increasingly indicates that SERPINB3/4 plays a pivotal role in the progression of inflammatory diseases and may serve as a valuable biomarker for atopic dermatitis and psoriasis. However, the expression of SERPINB3/4 in the serum of patients with moderate-to-severe prurigo nodularis (PN) remains poorly understood. OBJECTIVE: To find a promising biomarker for monitoring the severity and activity of moderate-to-severe PN patients. METHODS: A total of 41 patients with moderate-to-severe PN and 20 healthy subjects were included in the study. Enzyme-linked immunosorbent assay (ELISA) was performed to determine serum SERPINB3/4 expression. Cutaneous SERPINB3/4 expression was evaluated by immunohistochemistry (IHC). Serum SERPINB3/4 levels were correlated with PN disease severity and activity scores, hematological parameters, and systemic inflammatory markers. RESULTS: SERPINB3/4 expression was found to be significantly increased in the serum and lesions of PN in comparison to healthy subjects. In patients with PN, the expression of serum SERPINB3/4 was significantly elevated in subjects with higher investigator global assessment (IGA) scores, while exhibiting a notable decline in patients with higher pruritus numeric rating scale (P-NRS) scores. Positive correlations were observed between serum SERPINB3/4 levels and peripheral eosinophil count, eosinophil ratio, and eosinophil-to-lymphocyte ratio (ELR) in patients with PN. CONCLUSION: SERPINB3/4 expression was increased in PN sera and lesions. Serum SERPINB3/4 expression was positively correlated with PN severity and peripheral eosinophil-related parameters, suggesting its potential as a promising biomarker for PN.

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