This letter contextualizes recent findings linking tumour necrosis factor-like weak inducer of apoptosis (TWEAK) to inflammation and disease severity in pemphigus, highlighting the potential relevance of the TWEAK–Fn14 axis to keratinocyte injury and downstream cytokine/chemokine signalling. We outline key considerations for clinical interpretability – including treatment status in ‘new-onset’ cohorts, incremental value beyond established serology and routine inflammatory indices, and appropriate handling of multiplicity – and propose priorities for prospective validation of TWEAK as a biomarker and therapeutic target.
Liu et al. (Mon,) studied this question.