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Lei L, Feng S. Immune interplay from circulation to local lesion in pemphigus pathogenesis. J Autoimmun 2024; 147:103261. [PMID: 38797047 DOI: 10.1016/j.jaut.2024.103261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 04/29/2024] [Accepted: 05/21/2024] [Indexed: 05/29/2024]
Abstract
Pemphigus, a potentially lethal autoimmune skin disease, is mediated by desmoglein-specific antibodies, manifesting cutaneous and mucosal blisters and erosions. The interaction between multiple immune counterparts contributes to the progress of pemphigus. Currently, the emergence of bioinformatic analysis enables investigators to gain a global picture of the pemphigus immune network, based on the exhaustive pedigree annotation of multiple subsets. T helper subsets dominate the landscape as mentioned previously, and innate immune cells have been involved as well. Of particular interests is which phenotype of T cells orchestrates the autoimmune process and chronic inflammation in a certain condition. In this review, the circulatory and peripheral immune cells and cytokine components constituting the immune microenvironment are separately discussed to provide a perspective on pemphigus pathogenesis, with particular reference to insights provided by the bioinformation technique.
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Affiliation(s)
- Li Lei
- Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - SuYing Feng
- Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China.
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2
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Tao J, Hu W, Mu X, Ren H, Chen R. Erythema and Blisters in a Patient with Psoriasis: A Quiz. Acta Derm Venereol 2024; 104:adv40669. [PMID: 38899442 PMCID: PMC11218671 DOI: 10.2340/actadv.v104.40669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Accepted: 05/27/2024] [Indexed: 06/21/2024] Open
Abstract
Abstract is missing (Quiz)
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Affiliation(s)
- Jia Tao
- Department of Dermatology, The Affiliated Lianyungang Hospital of Xuzhou Medical University/The First People's Hospital of Lianyungang, Lianyungang, Jiangsu, China
| | - Wenlong Hu
- Department of Dermatology, The Affiliated Lianyungang Hospital of Xuzhou Medical University/The First People's Hospital of Lianyungang, Lianyungang, Jiangsu, China; Department of Dermatology, The First Affiliated Hospital of Kangda College of Nanjing Medical University, Lianyungang, Jiangsu, China
| | - Xudong Mu
- Department of Dermatology, The Affiliated Lianyungang Hospital of Xuzhou Medical University/The First People's Hospital of Lianyungang, Lianyungang, Jiangsu, China
| | - Hong Ren
- Department of Dermatology, The Affiliated Lianyungang Hospital of Xuzhou Medical University/The First People's Hospital of Lianyungang, Lianyungang, Jiangsu, China; Department of Dermatology, The First Affiliated Hospital of Kangda College of Nanjing Medical University, Lianyungang, Jiangsu, China
| | - Renqiong Chen
- Department of Dermatology, The Affiliated Lianyungang Hospital of Xuzhou Medical University/The First People's Hospital of Lianyungang, Lianyungang, Jiangsu, China; Department of Dermatology, The First Affiliated Hospital of Kangda College of Nanjing Medical University, Lianyungang, Jiangsu, China.
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3
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Moro F, Sinagra JLM, Salemme A, Fania L, Mariotti F, Pira A, Didona B, Di Zenzo G. Pemphigus: trigger and predisposing factors. Front Med (Lausanne) 2023; 10:1326359. [PMID: 38213911 PMCID: PMC10783816 DOI: 10.3389/fmed.2023.1326359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 11/29/2023] [Indexed: 01/13/2024] Open
Abstract
Pemphigus is a life-threatening autoimmune blistering disease affecting skin and mucous membranes. Despite its etiopathogenesis remains largely unknown, several trigger and predisposing factors have been reported. Pemphigus is caused by autoantibodies that target desmoglein 1 and desmoglein 3, impacting desmosome function. However, circulating autoantibodies are often the consequence of a precipitating factor that occurs in predisposed individuals. This review aims to describe and discuss almost all trigger and predisposing factors reported as possible or probable cause of the disease. Among the reported trigger factors that may induce or exacerbate pemphigus, we have found of particular interest: drug intake (especially thiol- and phenol-containing compounds), vaccines, infections, as well as some reports about pregnancy, radiations, emotional stress, pesticides and physical trauma. Moreover, we discuss the possible role of food intake in pemphigus onset and particular attention is given to dietary factors containing thiol, phenol and tannin compounds. A trigger factor is "the straw that breaks the camel's back," and often acts together with predisposing factors. Here we discuss how pemphigus onset may be influenced by genetic susceptibility and comorbidities like thyroid diseases, malignancies and other autoimmune disorders. To identify other hitherto unknown trigger and predisposing factors, well designed prospective studies are needed. In this context, future research should explore their connection with the aim to advance our understanding of pemphigus pathogenesis.
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Affiliation(s)
- Francesco Moro
- Molecular and Cell Biology Laboratory, Istituto Dermopatico dell’Immacolata (IDI)-IRCCS, Rome, Italy
- Dermatology Clinic, Istituto Dermopatico dell’Immacolata (IDI)-IRCCS, Rome, Italy
| | - Jo Linda Maria Sinagra
- Molecular and Cell Biology Laboratory, Istituto Dermopatico dell’Immacolata (IDI)-IRCCS, Rome, Italy
- Dermatology Clinic, Istituto Dermopatico dell’Immacolata (IDI)-IRCCS, Rome, Italy
| | - Adele Salemme
- Molecular and Cell Biology Laboratory, Istituto Dermopatico dell’Immacolata (IDI)-IRCCS, Rome, Italy
| | - Luca Fania
- Dermatology Clinic, Istituto Dermopatico dell’Immacolata (IDI)-IRCCS, Rome, Italy
| | - Feliciana Mariotti
- Molecular and Cell Biology Laboratory, Istituto Dermopatico dell’Immacolata (IDI)-IRCCS, Rome, Italy
| | - Anna Pira
- Molecular and Cell Biology Laboratory, Istituto Dermopatico dell’Immacolata (IDI)-IRCCS, Rome, Italy
| | - Biagio Didona
- Rare Diseases Unit, Istituto Dermopatico dell’Immacolata (IDI)-IRCCS, Rome, Italy
| | - Giovanni Di Zenzo
- Molecular and Cell Biology Laboratory, Istituto Dermopatico dell’Immacolata (IDI)-IRCCS, Rome, Italy
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Ramachandran K, Kallabbe Shridhar R, Vaidya S, Heis L, Mee J. Immunobullous Transformation of Protracted Psoriasis: A Diagnostic Dilemma. Cureus 2023; 15:e37639. [PMID: 37200636 PMCID: PMC10188275 DOI: 10.7759/cureus.37639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2023] [Indexed: 05/20/2023] Open
Abstract
Pemphigus vulgaris is a rare autoimmune disorder, characterised by the development of blistering lesions in the skin and mucosal surfaces throughout the body. It is often misdiagnosed or missed completely in many patients, prolonging their suffering for many years, as it has the ability to mimic an array of other skin diseases. Many studies have concluded that there is a strong association between pemphigus vulgaris and psoriasis, though the exact mechanism is not clearly understood. We present the case of a 77-year-old gentleman on long-term treatment for psoriasis with ultraviolet B phototherapy, steroids, and many other topical treatments who eventually went on to develop pemphigus vulgaris.
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Affiliation(s)
| | | | - Shriram Vaidya
- Intensive Therapy Unit, King George Hospital, Ilford, GBR
| | - Leen Heis
- Dermatology, Queens Hospital Center, Romford, GBR
| | - John Mee
- Histopathology, St Thomas' Hospital, London, GBR
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Gao J, Shen X, Ko R, Huang C, Shen C. Cognitive Process of Psoriasis and Its Comorbidities: From Epidemiology to Genetics. Front Genet 2021; 12:735124. [PMID: 34899832 PMCID: PMC8662384 DOI: 10.3389/fgene.2021.735124] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 10/25/2021] [Indexed: 12/16/2022] Open
Abstract
Psoriasis (PsO) is a chronic inflammatory skin disease that affects approximately 2% of the population all over the world. Comorbidities of PsO have increasingly garnered more interest in the past decades. Compared with the normal population, the incidences of comorbidities are higher among patients with PsO. In the last 20 years, researchers have focused on studying the genetic components of PsO, and genetic associations between PsO and its comorbidities were elucidated. This review provides an in-depth understanding and summarization of the connection between PsO and its comorbidities from the perspectives of epidemiology and genetics. Further understanding of PsO and its comorbidities will promote research on the pathogenesis, drug development, novel therapy methods, and personalized and precision treatment of PsO and its comorbidities.
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Affiliation(s)
- Jing Gao
- Department of Dermatology, the Second Affiliated Hospital, Anhui Medical University, Hefei, China
| | - Xue Shen
- Department of Dermatology, Chengdu Second People’s Hospital, Chengdu, China
| | - Randy Ko
- Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, United States
| | - Cong Huang
- Department of Dermatology, Peking University Shenzhen Hospital, Shenzhen, China
- Shenzhen Key Laboratory for Translational Medicine of Dermatology, Shenzhen Peking University–the Hong Kong University of Science and Technology Medical Center, Shenzhen, China
| | - Changbing Shen
- Department of Dermatology, Peking University Shenzhen Hospital, Shenzhen, China
- Shenzhen Key Laboratory for Translational Medicine of Dermatology, Shenzhen Peking University–the Hong Kong University of Science and Technology Medical Center, Shenzhen, China
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Kridin K, Schmidt E. Epidemiology of Pemphigus. JID INNOVATIONS 2021; 1:100004. [PMID: 34909708 PMCID: PMC8659392 DOI: 10.1016/j.xjidi.2021.100004] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/26/2021] [Accepted: 01/26/2021] [Indexed: 01/01/2023] Open
Abstract
Pemphigus is an epidemiologically heterogeneous group of autoimmune bullous diseases comprising pemphigus vulgaris (PV), pemphigus foliaceus, paraneoplastic pemphigus, IgA pemphigus, and pemphigus herpetiformis. Recently, our knowledge about the frequency of pemphigus, which is highly variable between different populations, has considerably expanded, and the first non-HLA genes associated with PV have been identified. In addition, a variety of comorbidities, including other autoimmune diseases, hematological malignancies, and psoriasis, have been described in this variant. Here, initial data about the impact of COVID-19 on this fragile patient population are discussed and perspectives for future epidemiological studies are outlined.
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Key Words
- ACE, angiotensin-converting enzyme
- AIBD, autoimmune bullous disease
- CAAR, chimeric autoantibody receptor
- CI, confidence interval
- DSG, desmoglein
- EADV, European Academy of Dermatology and Venereology
- EC, extracellular
- EMA, European Medicines Agency
- FS, fogo selvage
- HR, hazard ratio
- ICD, International Classification of Diseases
- PF, pemphigus foliaceus
- PNP, paraneoplastic pemphigus
- PV, pemphigus vulgaris
- SMR, standardized mortality ratio
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Affiliation(s)
- Khalaf Kridin
- Lűbeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Enno Schmidt
- Lűbeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany
- Department of Dermatology, University of Lübeck, Lübeck, Germany
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Kridin K, Jones VA, Patel PM, Zelber-Sagi S, Hammers CM, Damiani G, Amber KT, Cohen AD. Patients with pemphigus are at an increased risk of developing rheumatoid arthritis: a large-scale cohort study. Immunol Res 2020; 68:373-378. [PMID: 33159312 PMCID: PMC7674560 DOI: 10.1007/s12026-020-09160-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 10/22/2020] [Indexed: 12/11/2022]
Abstract
Data regarding the association between pemphigus and rheumatoid arthritis (RA) is inconclusive and yet to be firmly established. In the current study, we aimed to evaluate the risk of developing RA during the course of pemphigus. A large-scale population-based longitudinal cohort study was conducted to evaluate the hazard ratio (HR) of RA among 1985 patients with pemphigus relative to 9874 age-, sex-, and ethnicity-matched control subjects. A multivariate Cox regression model was utilized. The incidence of RA was 1.07 (95% CI, 0.62-1.72) and 0.36 (95% CI, 0.24-0.52) per 1000 person-years among patients with pemphigus and controls, respectively. The lifetime prevalence of RA was 2.3% (95% CI, 1.7-3.1%) among cases and 1.8% (95% CI, 1.5-2.0%) among controls. Patients with pemphigus were more than twice as likely to develop RA as compared to control subjects (adjusted HR, 2.54; 95% confidence interval [CI], 1.31-4.92). The increased risk was robust to a sensitivity analysis that included only cases managed by pemphigus-related systemic medications (adjusted HR, 2.56; 95% CI, 1.30-5.05). In conclusion, pemphigus is associated with an increased risk of RA. Physicians treating patients with pemphigus should be aware of this possible association. Further research is required to better understand the mechanism underlying this association.
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Affiliation(s)
- Khalaf Kridin
- Lübeck Institute of Experimental Dermatology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany.
| | - Virginia A Jones
- Department of Dermatology, University of Illinois at Chicago, Chicago, IL, USA
| | - Payal M Patel
- Department of Dermatology, University of Illinois at Chicago, Chicago, IL, USA
| | | | - Christoph M Hammers
- Lübeck Institute of Experimental Dermatology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
| | - Giovanni Damiani
- Clinical Dermatology, IRCCS Istituto Ortopedico Galeazzi, 20161, Milan, Italy
| | - Kyle T Amber
- Department of Dermatology, University of Illinois at Chicago, Chicago, IL, USA
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The Risk of Systemic Diseases in Those with Psoriasis and Psoriatic Arthritis: From Mechanisms to Clinic. Int J Mol Sci 2020; 21:ijms21197041. [PMID: 32987907 PMCID: PMC7583918 DOI: 10.3390/ijms21197041] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 09/15/2020] [Accepted: 09/21/2020] [Indexed: 02/08/2023] Open
Abstract
Psoriasis and psoriatic arthritis (PsA) have been recently considered as chronic systemic inflammatory disorders. Over the past decades, enormous evidence indicates that patients with psoriasis and PsA have a higher risk of developing various comorbidities including cardiovascular disease, metabolic disease, cancers, infections, autoimmune disease, and psychiatric diseases. However, reported risks of some comorbidities in those with psoriasis and PsA are somewhat different according to the research design. Moreover, pathomechanisms underlying comorbidities of those with psoriasis and PsA remain poorly elucidated. The purpose of this review is to provide the most updated comprehensive view of the risk of systemic comorbidities in those with psoriasis and PsA. Molecular mechanisms associated with the development of various comorbidities in those with psoriasis and PsA are also reviewed based on recent laboratory and clinical investigations. Identifying the risk of systemic comorbidities and its associated pathomechanisms in those with psoriasis and PsA could provide a sufficient basis to use a multi-disciplinary approach for treating patients with psoriasis and PsA.
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Hidradenitis suppurativa and pemphigus: a cross-sectional study. Arch Dermatol Res 2020; 312:501-505. [DOI: 10.1007/s00403-020-02040-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 01/23/2020] [Accepted: 01/25/2020] [Indexed: 01/01/2023]
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Ohata C, Shimizu Y, Hayashi M. Pemphigus foliaceus in a patient with psoriasis treated with brodalumab. J Dermatol 2020; 47:e455-e457. [PMID: 32860275 DOI: 10.1111/1346-8138.15584] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Chika Ohata
- Department of Dermatology, Osaka General Medical Center, Osaka, Japan
| | - Yuri Shimizu
- Department of Dermatology, Osaka General Medical Center, Osaka, Japan
| | - Misa Hayashi
- Department of Dermatology, Osaka General Medical Center, Osaka, Japan
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