Modern approaches to treatment of acantholytic pemphigus

Karacheva Iu.V.; Prokhorenkov V.I.; Guzeĭ T.N.; Iakovleva T.A.

doi:https://doi.org/

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Abstract:

The article provides the literature review on the pathogenesis of acantholytic pemphigus (AP) being a representative of Th2-type autoimmune diseases. The role of autoantigens is played by desmogleins (Dsg) 1 and 3, plakoglobin, type XVII collagen, envoplakin, periplakin, receptors of biologically active compounds and cholinergic receptor groups. We discuss the controversial issue related to the role of apoptosis in the AP morphogenesis. The paper presents modern methods of treatment of AP patients, including combination of systemic glucocorticosteroids (GCSs) and azathioprine; stepwise treatment algorithm using GCS; intravenous pulse injection of methylprednisolone or dexamethasone; administration of azathioprine, cyclophosphamide, mycophenolate mofetil, cyclosporine, colchicine, dapsone, gold-containing drugs, biological rituximab and infliximab; administration of Dsg3-peptide and p38 MAPK protein inhibitor. The experience of administration of cyclosporine A (Sandimmune Neoral), Encad, deoxyribonucleic acid, T-activin, and polyoxidonium immunomodulator was reported. New therapies of AP, including intravenous immunoglobulin G, plasmapheresis, immunoadsorption, extracorporeal photochemotherapy, administration of chemotherapeutic agents and cholinergic receptor agonists, were discussed. Preventive measures aimed at reducing complications during the treatment with GCS were reported.

Keywords:

acantholytic pemphigus

basic pathogenesis

treatment

complications

prevention

Authors:

Karacheva Iu.V.

State Educational Institution of higher professional education "V.F. Voino-Yasenetsky Krasnoyarsk State Medical University"

Prokhorenkov V.I.

V.F. Voino-Yasenetsky Krasnoyarsk State Medical University

Guzeĭ T.N.

Medical College, University of the Ministry of Defense, Addis Ababa;
V.F. Voyno-Yasenetsky Krasnoyarsk State Medical University

Iakovleva T.A.

GBOU VPO "Krasnoiarskiĭ gosudarstvennyĭ meditsinskiĭ universitet im. prof. V.F. Voĭno-Iasenetskogo" Minzdrava Rossii, 660099, Krasnoiarsk, Rossiĭskaia Federatsiia

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References:

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