Influence of treatment on the clinical course of pemphigus vulgaris

Carson, Patrick J.; Hameed, Ahsan; Ahmed, A. Razzaque

doi:10.1016/s0190-9622(96)80066-1

Cited by 117 publications

(80 citation statements)

References 69 publications

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“…6,7 Systemic corticosteroids administered in high doses over prolonged periods of time can provide effective control of active disease and are often used for maintenance therapy. 1,8 As a consequence of the cumulative doses of systemic corticosteroids, patients often develop multiple serious adverse effects, sometimes resulting in a poor quality of life. 8,9 These adverse effects are occasionally fatal.…”

Section: Discussionmentioning

confidence: 99%

“…1,8 As a consequence of the cumulative doses of systemic corticosteroids, patients often develop multiple serious adverse effects, sometimes resulting in a poor quality of life. 8,9 These adverse effects are occasionally fatal. 10,11 Several immunosuppressive agents, dapsone, and systemic antibiotics have been used with the explicit purpose of reducing the dosage of systemic corticosteroid therapy.…”

Section: Discussionmentioning

confidence: 99%

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Corticosteroid-Sparing Effect of Intravenous Immunoglobulin Therapy in Patients With Pemphigus Vulgaris

Sami

Qureshi²,

Ruocco³

et al. 2002

Arch Dermatol

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Corticosteroid-Sparing Effect of Intravenous Immunoglobulin Therapy in Patients With Pemphigus Vulgaris

Sami

Qureshi²,

Ruocco³

et al. 2002

Arch Dermatol

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“…Corticosteroids significantly improved the prognosis of PV patients, lowering the mortality rate to 21.4% (15). More recently, the introduction of other immunosuppressive drugs such as azathioprine, cyclophosphamide, and cyclosporin A, used as adjuvant therapies, exerting a steroid-sparing effect, has further decreased the mortality rate of PV.…”

Section: P Emphigus Vulgaris (Pv)mentioning

confidence: 99%

Immune Modulation in Pemphigus Vulgaris: Role of CD28 and IL-10

Toto

Feliciani

Amerio

et al. 2000

The Journal of Immunology

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Pemphigus vulgaris (PV) is an autoimmune bullous skin disease characterized by Abs to the desmosomal cadherin desmoglein-3. Although the autoantibodies have been shown to be pathogenic, the role of the cellular immune system in the pathology of pemphigus-induced acantholysis is unclear. To further delineate the potential role of T cell-signaling pathways in the pathogenesis of PV, we performed passive transfer experiments with PV IgG in gene-targeted mutant mice. Our results demonstrated that CD28-deficient mice (lacking a costimulatory signal for T cell activation) are 5-fold more sensitive to the development of PV than wild-type mice. To evaluate whether the higher incidence of disease was due to an impairment in intercellular adhesion of keratinocytes, we performed an in vitro acantholysis, using CD28−/− mice keratinocytes. No alteration in in vitro adhesion was detected in CD28−/−-type keratinocytes. Because the CD28 molecule plays a pivotal role in the induction of Th2 cytokines, we examined the levels of a prototypic Th2 cytokine (IL-10) in CD28−/− mice. Lower levels of IL-10 mRNA were found in lesions from CD28−/− mice. To determine whether pemphigus susceptibility in CD28−/− was related to IL-10 deficiency, we performed passive transfer experiments in IL-10−/− mice that demonstrated increased blisters compared with controls. To confirm that IL-10 is involved in the pathogenesis, rIL-10 was given with PV IgG. IL-10 significantly suppressed the disease activity. These data suggest a potential role of IL-10 in PV.

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“…In the presteroid era, the vast majority of PV patients died from their disease (48). A more recent population-based study indicates the 1-year mortality for pemphigus is 12%, representing a 3.4 hazard ratio for death in PV patients compared with age-and sex-matched controls (4).…”

Section: Current Pv Treatment and Implications For The Development Ofmentioning

confidence: 99%