2000
DOI: 10.1001/archderm.136.5.663
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Epitope Spreading in Paraneoplastic Pemphigus

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Cited by 45 publications
(7 citation statements)
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“…IIF shows ICS autoantibodies on normal human skin substrates, monkey oesophagus and especially rat urinary bladder. 31,32 In comparison with classic PNP a localized erythematous plaque instead of widespread skin disease was observed in our patient and there was a lack of mucous membrane involvement. 26,27 In addition autoantibodies directed against Dsg1 and Dsg3 have been detected by immunoprecipitation or ELISA, 28 and are known to cause acantholysis in vivo in the neonatal mouse model.…”
Section: Discussionmentioning
confidence: 54%
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“…IIF shows ICS autoantibodies on normal human skin substrates, monkey oesophagus and especially rat urinary bladder. 31,32 In comparison with classic PNP a localized erythematous plaque instead of widespread skin disease was observed in our patient and there was a lack of mucous membrane involvement. 26,27 In addition autoantibodies directed against Dsg1 and Dsg3 have been detected by immunoprecipitation or ELISA, 28 and are known to cause acantholysis in vivo in the neonatal mouse model.…”
Section: Discussionmentioning
confidence: 54%
“…30 A new theory of the pathogenesis of PNP is the phenomenon of epitope spreading, defined as the initial recognition of an epitope by an autoantibody followed by induction of further autoantibodies directed against related epitopes on the same protein or other epitopes in the same tissue. 31,32 In comparison with classic PNP a localized erythematous plaque instead of widespread skin disease was observed in our patient and there was a lack of mucous membrane involvement. Routine histopathology did not reveal typical interface changes of PNP but a sparse lymphocytic infiltrate and fibrosis.…”
Section: Discussionmentioning
confidence: 54%
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“…Paraneoplastic pemphigus (PNP) is a rare, autoimmune bullous disease which was first described by Anhalt et al in 1990 (1, 2). The pathogenic mechanisms for PNP are not determined and some hypotheses have been proposed (3–5). It is clinically characterized by lesions resembling pemphigus vulgaris, lichen planus or erythema multiforme, and histologically by suprabasal acantholysis, dyskeratotic keratinocytes, vacuolar alteration of basal cells and of mononuclear cell infiltration in a lichenoid pattern.…”
Section: Introductionmentioning
confidence: 99%
“…These autoantibodies have shown cross reactivity to proteins present in sand fly saliva (45), which may represent epitope spreading from foreign proteins to similar autoantigens. Epitope spreading is also thought to be involved in paraneoplastic (PNP) pemphigus (46) where tumor-associated antigens may become targeted in an effort to destroy the tumor, however similar antigens may also be shared by keratinocytes (47). PNP pemphigus is most commonly associated with lymphatic malignancies, including non-Hodgkin's lymphoma and chronic lymphocytic leukemia.…”
Section: Induction Of Autoimmunity Against Skin Antigensmentioning
confidence: 99%