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Pemfigus vulgaris tedavisinde yenilikler

Year 2013, Volume: 30 Issue: 1s, 1 - 8, 28.11.2013

Abstract

Pemfigus vulgaris mortalitesi, tedavi edilmediğinde % 90’a kadar ulaşabilmektedir. Bu yüksek mortalite oranı sistemik kortikosteroidlerin kullanılmaya başlanmasıyla belirgin olarak düşmekle birlikte, şiddetli yan etkiler ve dirençli olguların varlığı nedeniyle adjuvan tedavi kullanımı hemen her zaman gerekmektedir. Son yıllarda pemfigus tedavisinde yeni bir yön vermeyi amaçlayan çok fazla çalışma yayınlanmaktadır. Amaçlanan, ölümcül sonuçları olmayan yan etkilere sahip, düşük dozda kullanılabilen ve uzun süre remisyon sağlayan tedavi seçenekleri bulmaktır. Sistemik steroidler hızlı remisyon sağlamaları nedeniyle halen ilk tedavi seçeneğidir. Ancak bu tedavinin yan etkileri oldukça fazladır ve dozu azaltabilmek amacıyla bir çok toksik yan etkilere sahip adjuvan tedavi eklenmesine gerek duyulmaktadır. Son yıllarda pemfigus tedavisine yeni bir yön veren yeni tedaviler; intravenöz immünglobulin (IVIg), plazmaferez, immünoadsorbsiyon (İA), ekstrakorporeal fotokemoterapi (EKP), rituksimab, tümör nekrozis faktör alfa (TNF-α) inhibitörleri (infliksimab ve etanercept), kolinerjik agonistler, dezmoglein 3 peptitleri ve KC706 gibi deneysel ajanlardır.

Improvements in the treatment of Pemhigus vulgarism

The mortality of Pemphigus vulgaris can reach up to 90% when it is not treated. Although this ratio has declined together with the use of systemic corticosteroids, there is almost always a need to administer adjuvant treatment because of severe adverse effects and resistant cases. There are many publishings aiming to find a new way for pemphigus treatment, recently. No side effects that lead to fatal results and low-dose treatment with long-term remission have become the issue to find. Systemic steroids due to provide fast remission is still the first treatment option. However, depending on the dose and time, side effects are too much. Therefore, almost always an adjuvan treatment is needed to reduce the dose which have many toxic side effects. Pemphigus treatments giving a new direction in recent years are, intravenous immunoglobulin, plasmapheresis, immunoadsorbtion, ekstracorporeal photochemoterapy, rituximab, tumor necrosis factor alpha inhibitors (infliximab and etanercept), cholinergic agonists and experimental agents such as desmoglein 3 peptides and KC706.

References

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  • Berkowitz, P., Hu, P., Warren, S., Liu, Z., Diaz, L.A., Rubenstein, D.S., 2006. p38MAPK inhibition prevents disease in Pemphigus vulgaris mice P. Natl. Acad. Sci. USA. 103, 12855-12860.
  • Berookhim, B., Fischer, H.D., Weinberg, J.M., 2004. Treatment of recalcitrant 44. Pemphigus vulgaris with tumor necrosis factor alpha antagonist etanercept. Cutis. 74, 245-247.
  • Bhol, K., Natarajan, K., Nagarwalla, N., Mohimen, A., Aoki, V., Ahmed, A.R., 1995. Correlation of peptide specificity and IgG subclass with pathogenic and nonpathogenic autoantibodies in Pemphigus vulgaris: A model for autoimmunity. Proc. Natl. Acad. Sci. USA. 92, 5239-5243.
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  • Chams-Davatchi, C., Esmaili, N., Daneshpazhooh, M., Valikhani, M., Balighi, K., Hallaji, Z., Barzegari, M., Akhyani, M., Ghodsi, S.Z., Seirafi, H., Nazemi, M.J., Mortazavi, H., Mirshams-Shahshahani, M. 2007. Randomized controlled open-label trial of four treatment regimens for Pemphigus vulgaris. J. Am. Acad. Dermatol. 57, 622-628.
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  • Grando, S.A., 2004. New approaches to the treatment of pemphigus. J. Invest. Derm. Symp. P. 9, 84-91.
  • Green, M.G., Bystryn, J.C., 2008. Effect of intravenous immunoglobulin therapy on serum levels of IgG1 and IgG4 antidesmoglein 1 and antidesmoglein 3 antibodies in Pemphigus vulgaris. Arch Dermatol. 144, 1621-1624.
  • Harman, K.E., Albert, S., Black, M.M., 2003. Guidelines for the management of Pemphigus vulgaris. Brit. J. Dermatol. 149, 926-937.
  • Herbst, A., Bystryn, J.C., 2000. Patterns of remission in Pemphigus vulgaris. J. Am. Acad Dermatol. 42, 422-427.
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  • Jablonska, S., Chorzelski, T., Blaszczyk, M., 1970. Immunosuppressants in the treatment of pemphigus. Brit. J. Dermatol. 83, 315-323.
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  • Jolles, S., Sewell, W.A., Misbah, S.A., 2005. Clinical uses of intravenous immunoglobulin. Clin. Exp. Immunol. 142, 1-11.
  • Joly, P., Mouquet, H., Roujeau, J.C., D’Incan, M., Gilbert, D., Jacquot, S., Gougeon, M.L., Bedane, C., Muller, R., Dreno, B., Doutre, M.S., Delaporte, E., Pauwels, C., Franck, N., Caux, F., Picard, C., Tancrede-Bohin, E., Bernard, P., Tron, F., Hertl, M., Musette, P. 2007. A single cycle of rituximab for the treatment of severe pemphigus. New. Eng. J. Med. 357, 545-552.
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  • Marakli, S.S., Uzun, S., Ozbek, S., Tuncer, I., 2008. Dermatitis herpetiformis in a patient receiving infliximab for ankylosing spondylitis. Eur. J. Dermatol. 18, 88-89.
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Year 2013, Volume: 30 Issue: 1s, 1 - 8, 28.11.2013

Abstract

Makale geçmişi

References

  • Ahmed, A.R., Spigelman, Z., Cavacini, L.A., Posner, M.R., 2006. Treatment of 39 Pemphigus vulgaris with rituximab and intravenous immune globulin. New. Engl. J. Med. 355, 1772-1779.
  • Amagai, M., Ikeda, S., Shimizu, H., Iizuka, H., Hanada, K., Aiba, S., Kaneko, F., Izaki, S., Tamaki, K., Ikezawa, Z., Takigawa, M., Seishima, M., Tanaka, T., Miyachi, Y., Katayama, I., Horiguchi, Y., Miyagawa, S., Furukawa, F., Iwatsuki, K., Hide, M., Tokura, Y., Furue, M., Hashimoto, T., Ihn, H., Fujiwara, S., Nishikawa, T., Ogawa, H., Kitajima, Y., Hashimoto, K., Pemphigus Study Group., 2009. A randomized double-blind trial of intravenous immunoglobulin for pemphigus. J. Am. Acad. Dermatol. 60, 595-603.
  • Anhalt, G., Werth, V., Strober, B., 2005. An open-label phase I clinical study to assess the safety of PI-0824 in patients with Pemphigus vulgaris. J. Invest. Dermatol. 125, 1088-1092.
  • Berkowitz, P., Hu, P., Warren, S., Liu, Z., Diaz, L.A., Rubenstein, D.S., 2006. p38MAPK inhibition prevents disease in Pemphigus vulgaris mice P. Natl. Acad. Sci. USA. 103, 12855-12860.
  • Berookhim, B., Fischer, H.D., Weinberg, J.M., 2004. Treatment of recalcitrant 44. Pemphigus vulgaris with tumor necrosis factor alpha antagonist etanercept. Cutis. 74, 245-247.
  • Bhol, K., Natarajan, K., Nagarwalla, N., Mohimen, A., Aoki, V., Ahmed, A.R., 1995. Correlation of peptide specificity and IgG subclass with pathogenic and nonpathogenic autoantibodies in Pemphigus vulgaris: A model for autoimmunity. Proc. Natl. Acad. Sci. USA. 92, 5239-5243.
  • Bolognia, J.L., Jorizzo, J.L., Rapini, R.P., 2008. Dermatology. Lee T Nesbitt Jr. Glucocorticosteroids. Mosby Elsevier, New York, USA. 1925.
  • Bystryn, J.C., Rudolph, J.L., 2005a. Pemphigus. Lancet. 366, 61-73.
  • Bystryn, J.C., Rudolph, J.L., 2005b. IVI g treatment of pemphigus: How it works and how to use it. J. Invest. Dermatol. 125, 1093-1098.
  • Chams-Davatchi, C., Esmaili, N., Daneshpazhooh, M., Valikhani, M., Balighi, K., Hallaji, Z., Barzegari, M., Akhyani, M., Ghodsi, S.Z., Seirafi, H., Nazemi, M.J., Mortazavi, H., Mirshams-Shahshahani, M. 2007. Randomized controlled open-label trial of four treatment regimens for Pemphigus vulgaris. J. Am. Acad. Dermatol. 57, 622-628.
  • Daulat, S., Detweiler, J.G., Pandya, A.G., 2009. Development of Pemphigus vulgaris in a patient with psoriasis treated with etanercept. J. Eur. Acad. Dermatol. 23, 483-484.
  • Demirçay, Z., 2005. Developments in the treatment of Pemphigus vulgaris. Turkiye Klinikleri J. Inter. Med. Sci. 1, 23-24.
  • Edelson, R.L., 1999. Sézary syndrome, cutaneous T-cell lymphoma, and extracorporeal photopheresis. Arch. Dermatol. 135, 600-601.
  • El Tal, A.K., Posner, M.R., Spigelman, Z., Ahmed, A.R., 2006. Rituximab: A monoclonal antibody to CD20 used in the treatment of Pemphigus vulgaris. J. Am. Acad. Dermatol. 55, 449-459.
  • Eming, R., Hertl, M., 2006. Immunoadsorption in pemphigus. Autoimmunity. 39, 609-616.
  • Femiano, F., Gombos, F., Scully, C. 2002. Pemphigus vulgaris with oral involvement: evaluation of two different systemic corticosteroid therapeutic protocols. J. Eur. Acad. Dermatol. 16, 353-356.
  • Frusic-Zlotkin, M., Pergamentz, R., Michel, B., David, M., Mimouni, D., Brégégère, F., Milner, Y., 2005. The interaction of pemphigus autoimmunoglobulins with epidermal cells: Activation of the fas apoptotic pathway and the use of caspase activity for pathogenicity tests of pemphigus patients. Ann. NY. Acad. Sci. 1050, 371-379.
  • Grando, S.A., 2004. New approaches to the treatment of pemphigus. J. Invest. Derm. Symp. P. 9, 84-91.
  • Green, M.G., Bystryn, J.C., 2008. Effect of intravenous immunoglobulin therapy on serum levels of IgG1 and IgG4 antidesmoglein 1 and antidesmoglein 3 antibodies in Pemphigus vulgaris. Arch Dermatol. 144, 1621-1624.
  • Harman, K.E., Albert, S., Black, M.M., 2003. Guidelines for the management of Pemphigus vulgaris. Brit. J. Dermatol. 149, 926-937.
  • Herbst, A., Bystryn, J.C., 2000. Patterns of remission in Pemphigus vulgaris. J. Am. Acad Dermatol. 42, 422-427.
  • Hertl, M., Zillikens, D., Borradori, L., Bruckner-Tuderman, L., Burckhard, H., Eming, R., Engert, A., Goebeler, M., Hofmann, S., Hunzelmann,
  • N., Karlhofer, F., Kautz, O., Lippert, U., Niedermeier, A., Nitschke, M., Pfütze, M., Reiser, M., Rose, C., Schmidt, E., Shimanovich, I., Sticherling, M., Wolff-Franke, S., 2008. Recommendations for the use of rituximab (anti-CD20 antibody) in the treatment of autoimmune bullous skin diseases. J. Dtsch. Dermatol. Ges. 6, 366-373.
  • Ikeda, S., Imamura, S., Hashimoto, I., Morioka, S., Sakuma, M., Ogawa, H., 2003. History of the establishment and revision of diagnostic criteria, severity index and therapeutic guidelines for pemphigus in Japan. Arch. Dermatol. Res. 295, 12-16.
  • Iraji, F., Yoosefi, A., 2006. Healing effect of pilocarpine gel 4% on skin lesions of Pemphigus vulgaris. Int. J. Dermatol. 45, 743-746.
  • Jablonska, S., Chorzelski, T., Blaszczyk, M., 1970. Immunosuppressants in the treatment of pemphigus. Brit. J. Dermatol. 83, 315-323.
  • Jacobi, A., Shuler, G., Hertl, M., 2005. Rapid control of therapy-refractory Pemphigus vulgaris by treatment with the tumour necrosis factoralpha inhibitor infliximab. Brit. J. Dermatol. 153, 448-449.
  • Jessop, S., Khumalo, N.P., 2008. Pemphigus: A treatment update. Am. J. Clin. Dermatol. 9, 147-154.
  • Jolles, S., Sewell, W.A., Misbah, S.A., 2005. Clinical uses of intravenous immunoglobulin. Clin. Exp. Immunol. 142, 1-11.
  • Joly, P., Mouquet, H., Roujeau, J.C., D’Incan, M., Gilbert, D., Jacquot, S., Gougeon, M.L., Bedane, C., Muller, R., Dreno, B., Doutre, M.S., Delaporte, E., Pauwels, C., Franck, N., Caux, F., Picard, C., Tancrede-Bohin, E., Bernard, P., Tron, F., Hertl, M., Musette, P. 2007. A single cycle of rituximab for the treatment of severe pemphigus. New. Eng. J. Med. 357, 545-552.
  • Küçükoğlu, R., Babuna, G., 2008. Pemphigus-Etiology, Pemphigus Vulgaris, Pemphigus Vegetans, Paraneoplastic Pemphigus: Clinic and Treatment. J. Dermatol-Special. Topics. 1, 16-24.
  • Liang, G., Nahass, G., Kerdel, F.A., 1992. Pemphigus vulgaris treated with photopheresis. J. Am. Acad. Dermatol. 26, 779-780.
  • Lin, M.H., Hsu, C.K., Lee, J.Y. 2005. Successful treatment of the recalcitrant Pemphigus vulgaris and Pemphigus vegetans with etanercept and carbon dioxide laser. Arch. Dermatol. 141, 680-682.
  • Marakli, S.S., Uzun, S., Ozbek, S., Tuncer, I., 2008. Dermatitis herpetiformis in a patient receiving infliximab for ankylosing spondylitis. Eur. J. Dermatol. 18, 88-89.
  • McKenna, K.E., Whittaker, S., Rhodes, L.E., Taylor, P., Lloyd, J., Ibbotson, S., Russell-Jones, R., British Photodermatology Group, UK SkinLymphoma Group., 2006. Evidence-based practice of photopheresis 1987-2001: A report of a workshop of the British Photodermatology Group and the U.K. Skin Lymphoma Group. Brit. J. Dermatol. 154, 7-20.
  • Mentink, L.F., Mackenzie, M.W., Tóth, G.G., Laseur, M., Lambert, F.P., Veeger, N.J., Cianchini, G., Pavlovic, M.D., Jonkman, M.F., 2006. Randomized controlled trial of adjuvant oral dexamethasone pulse therapy in Pemphigus vulgaris: PEMPULS trial. Arch. Dermatol. 142, 570-576.
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There are 60 citations in total.

Details

Primary Language English
Journal Section Internal Medical Sciences
Authors

Müge Güler Özden

Ahmet Turanlı This is me

Publication Date November 28, 2013
Submission Date July 8, 2011
Published in Issue Year 2013 Volume: 30 Issue: 1s

Cite

APA Güler Özden, M., & Turanlı, A. (2013). Pemfigus vulgaris tedavisinde yenilikler. Journal of Experimental and Clinical Medicine, 30(1s), 1-8. https://doi.org/10.5835/jecm.omu.30.s1.001
AMA Güler Özden M, Turanlı A. Pemfigus vulgaris tedavisinde yenilikler. J. Exp. Clin. Med. November 2013;30(1s):1-8. doi:10.5835/jecm.omu.30.s1.001
Chicago Güler Özden, Müge, and Ahmet Turanlı. “Pemfigus Vulgaris Tedavisinde Yenilikler”. Journal of Experimental and Clinical Medicine 30, no. 1s (November 2013): 1-8. https://doi.org/10.5835/jecm.omu.30.s1.001.
EndNote Güler Özden M, Turanlı A (November 1, 2013) Pemfigus vulgaris tedavisinde yenilikler. Journal of Experimental and Clinical Medicine 30 1s 1–8.
IEEE M. Güler Özden and A. Turanlı, “Pemfigus vulgaris tedavisinde yenilikler”, J. Exp. Clin. Med., vol. 30, no. 1s, pp. 1–8, 2013, doi: 10.5835/jecm.omu.30.s1.001.
ISNAD Güler Özden, Müge - Turanlı, Ahmet. “Pemfigus Vulgaris Tedavisinde Yenilikler”. Journal of Experimental and Clinical Medicine 30/1s (November 2013), 1-8. https://doi.org/10.5835/jecm.omu.30.s1.001.
JAMA Güler Özden M, Turanlı A. Pemfigus vulgaris tedavisinde yenilikler. J. Exp. Clin. Med. 2013;30:1–8.
MLA Güler Özden, Müge and Ahmet Turanlı. “Pemfigus Vulgaris Tedavisinde Yenilikler”. Journal of Experimental and Clinical Medicine, vol. 30, no. 1s, 2013, pp. 1-8, doi:10.5835/jecm.omu.30.s1.001.
Vancouver Güler Özden M, Turanlı A. Pemfigus vulgaris tedavisinde yenilikler. J. Exp. Clin. Med. 2013;30(1s):1-8.