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Vafaeian A, Mahmoudi H, Daneshpazhooh M. What is novel in the clinical management of pemphigus vulgaris? Expert Rev Clin Pharmacol 2024; 17:489-503. [PMID: 38712540 DOI: 10.1080/17512433.2024.2350943] [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: 02/17/2024] [Accepted: 04/30/2024] [Indexed: 05/08/2024]
Abstract
INTRODUCTION Pemphigus, an uncommon autoimmune blistering disorder affecting the skin and mucous membranes, currently with mortality primarily attributed to adverse reactions resulting from treatment protocols. Additionally, the existing treatments exhibit a notable recurrence rate. The high incidence of relapse and the considerable adverse effects associated with treatment underscore the imperative to explore safer and more effective therapeutic approaches. Numerous potential therapeutic targets have demonstrated promising outcomes in trials or preliminary research stages. These encompass anti-CD-20 agents, anti-CD-25 agents, TNF-α inhibition, FAS Ligand Inhibition, FcRn inhibition, BAFF inhibition, Bruton's tyrosine kinase (BTK) inhibition, CAAR T Cells, JAK inhibition, mTOR inhibition, abatacept, IL-4 inhibition, IL-17 inhibition, IL-6 inhibition, polyclonal Regulatory T Cells, and autologous hematopoietic stem cell transplantation. AREAS COVERED The most significant studies regarding the impact and efficacy of the mentioned treatments on pemphigus were meticulously curated through a comprehensive search conducted on the PubMed database. Moreover, the investigations of interest cited in these studies were also integrated. EXPERT OPINION The efficacy and safety profiles of the other treatments under discussion do not exhibit the same level of robustness as anti-CD20 therapy, which is anticipated to endure as a critical element in pemphigus treatment well into the foreseeable future.
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Affiliation(s)
- Ahmad Vafaeian
- Autoimmune Bullous Diseases Research Center, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamidreza Mahmoudi
- Autoimmune Bullous Diseases Research Center, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Daneshpazhooh
- Autoimmune Bullous Diseases Research Center, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
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2
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Mahmoudi H, Toosi R, Salehi Farid A, Daneshpazhooh M. Pemphigus Disease and Area Index: Unmet needs in the real-world management of pemphigus. Oral Dis 2024; 30:2275-2277. [PMID: 37602935 DOI: 10.1111/odi.14713] [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: 05/10/2023] [Revised: 07/06/2023] [Accepted: 08/02/2023] [Indexed: 08/22/2023]
Abstract
Over the past few decades, a number of scoring instruments have been developed to assess the severity and activity of autoimmune bullous diseases (AIBDs) (Daneshpazhooh et al., 2019; Nili et al., 2020; Nili et al., 2021; Nili et al., 2022). The Pemphigus Disease Area Index (PDAI), developed by the International Pemphigus Definitions Group, is an easy-to-use, quick, and reliable method for determining pemphigus severity. As a reliable and effective tool in clinical trials, PDAI may also have some limitations and might require some revisions to be used on a daily basis. Here, we propose some recommendations to improve the use of PDAI in the clinical setting.
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Affiliation(s)
- Hamidreza Mahmoudi
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Roja Toosi
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Salehi Farid
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Daneshpazhooh
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
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3
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Valei Lopes de Oliveira E, Tremeschin de Almeida Vieira F, de Souza Pinhel MA, Gripp AC, Marzocchi-Machado CM, Donadi EA, Roselino AM. Differential FCGR2A and FCGR3A Alleles/Genotypes in Pemphigus Vulgaris and Pemphigus Foliaceus in Southeastern Brazil. J Invest Dermatol 2024; 144:702-705.e1. [PMID: 37806444 DOI: 10.1016/j.jid.2023.09.268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 08/14/2023] [Accepted: 09/06/2023] [Indexed: 10/10/2023]
Affiliation(s)
- Ederson Valei Lopes de Oliveira
- University Hospital, Division of Dermatology, Department of Medical Clinics, Ribeirão Preto Medical School, University of São Paulo, Avenida dos Bandeirantes Ribeirão Preto, Brazil; Biology Molecular Laboratory, Department of Medical Clinics, Ribeirão Preto Medical School, University of São Paulo, Avenida dos Bandeirantes, Ribeirão Preto, Brazil
| | - Flavia Tremeschin de Almeida Vieira
- Biology Molecular Laboratory, Department of Medical Clinics, Ribeirão Preto Medical School, University of São Paulo, Avenida dos Bandeirantes, Ribeirão Preto, Brazil
| | - Marcela Augusta de Souza Pinhel
- Laboratory of Studies in Nutrigenomic, Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Avenida dos Bandeirantes, Ribeirão Preto, Brazil
| | - Alexandre Carlos Gripp
- Dermatologia, Hospital Universitário Pedro Ernesto, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Cleni Mara Marzocchi-Machado
- Department of Clinical Analyses, Toxicology and Food Sciences, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Avenida dos Bandeirantes, Ribeirão Preto, Brazil
| | - Eduardo Antonio Donadi
- Biology Molecular Laboratory, Department of Medical Clinics, Ribeirão Preto Medical School, University of São Paulo, Avenida dos Bandeirantes, Ribeirão Preto, Brazil; Division of Clinical Immunology, Department of Medical Clinics, Ribeirão Preto Medical School, University of São Paulo, Avenida dos Bandeirantes, Ribeirão Preto, Brazil
| | - Ana Maria Roselino
- University Hospital, Division of Dermatology, Department of Medical Clinics, Ribeirão Preto Medical School, University of São Paulo, Avenida dos Bandeirantes Ribeirão Preto, Brazil; Biology Molecular Laboratory, Department of Medical Clinics, Ribeirão Preto Medical School, University of São Paulo, Avenida dos Bandeirantes, Ribeirão Preto, Brazil.
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Zhang H, Chen Y, Jiang X, Gu Q, Yao J, Wang X, Wu J. Unveiling the landscape of cytokine research in glioma immunotherapy: a scientometrics analysis. Front Pharmacol 2024; 14:1333124. [PMID: 38259287 PMCID: PMC10800575 DOI: 10.3389/fphar.2023.1333124] [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: 11/04/2023] [Accepted: 12/18/2023] [Indexed: 01/24/2024] Open
Abstract
Background: Cytokines modulate the glioma tumor microenvironment, influencing occurrence, progression, and treatment response. Strategic cytokine application may improve glioma immunotherapy outcomes. Gliomas remain refractory to standard therapeutic modalities, but immunotherapy shows promise given the integral immunomodulatory roles of cytokines. However, systematic evaluation of cytokine glioma immunotherapy research is absent. Bibliometric mapping of the research landscape, recognition of impactful contributions, and elucidation of evolutive trajectories and hot topics has yet to occur, potentially guiding future efforts. Here, we analyzed the structure, evolution, trends, and hotspots of the cytokine glioma immunotherapy research field, subsequently focusing on avenues for future investigation. Methods: This investigation conducted comprehensive bibliometric analyses on a corpus of 1529 English-language publications, from 1 January 2000, to 4 October 2023, extracted from the Web of Science database. The study employed tools including Microsoft Excel, Origin, VOSviewer, CiteSpace, and the Bibliometrix R package, to systematically assess trends in publication, contributions from various countries, institutions, authors, and journals, as well as to examine literature co-citation and keyword distributions within the domain of cytokines for glioma immunotherapy. The application of these methodologies facilitated a detailed exploration of the hotspots, the underlying knowledge structure, and the developments in the field of cytokines for glioma immunotherapy. Results: This bibliometric analysis revealed an exponential growth in annual publications, with the United States, China, and Germany as top contributors. Reviews constituted 17% and research articles 83% of total publications. Analysis of keywords like "interleukin-13," "TGF-beta," and "dendritic cells" indicated progression from foundational cytokine therapies to sophisticated understanding of the tumor microenvironment and immune dynamics. Key research avenues encompassed the tumor microenvironment, epidermal growth factor receptor, clinical trials, and interleukin pathways. This comprehensive quantitative mapping of the glioma immunotherapy cytokine literature provides valuable insights to advance future research and therapeutic development. Conclusion: This study has identified remaining knowledge gaps regarding the role of cytokines in glioma immunotherapy. Future research will likely focus on the tumor microenvironment, cancer vaccines, epidermal growth factor receptor, and interleukin-13 receptor alpha 2. Glioma immunotherapy development will continue through investigations into resistance mechanisms, microglia and macrophage biology, and interactions within the complex tumor microenvironment.
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Affiliation(s)
- Hongyu Zhang
- Department of Neurosurgery, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Ying Chen
- Gamma Knife Center, Department of Oncology, Department of Neurological Surgery, Tianjin Huanhu Hospital, Tianjin Medical University, Tianjin, China
| | - Xinzhan Jiang
- Department of Neurobiology, Harbin Medical University, Harbin, China
| | - Qiang Gu
- Department of Neurosurgery, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Jiahao Yao
- Department of Neurosurgery, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Xuefeng Wang
- Department of Neurosurgery, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Jianghua Wu
- School of Nursing, Shandong First Medical University and Shandong Academy of Medical Sciences, Taian, Shandong, China
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5
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Al-Hasnawi ZA, AL-Drobie B. Cut-off values for IL-21 and IL-23 as biochemical markers for pemphigus vulgaris. J Med Life 2023; 16:1407-1414. [PMID: 38107713 PMCID: PMC10719779 DOI: 10.25122/jml-2023-0226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 08/20/2023] [Indexed: 12/19/2023] Open
Abstract
Pemphigus vulgaris (PV) is a potentially fatal mucocutaneous autoimmune disease characterized by severe skin lesions. Interleukin-21 (IL-21) and IL-23 have been linked to several autoimmune inflammatory diseases that may have a critical role in PV immunopathogenesis, including T-helper 17 (Th17) development. This study aimed to compare the serum levels of IL-21 and IL-23 in patients with PV and healthy controls. This case-control study included 90 participants (45 patients and 45 controls). Serum IL-21 and IL-23 were measured using the Sandwich-ELISA method provided by Sunlong Biotech, China. The findings revealed statistically significant results for IL-21 O.D. and Conc. (p=0.012*) and highly significant results for IL-23 O.D. and Conc. (p=0.000**). Furthermore, cut-off values were established for IL-21 (O.D.=0.071 pg/mL, Conc.=6.468 pg/mL) and IL-23 (O.D.=0.141 pg/mL, Conc.=6.745 pg/mL). These results indicate a potential association between PV and IL-21, IL-23, and the identified cut-off values. The particular roles of cytokines and how they can be utilized to treat PV require more investigation. To our knowledge, this was the first study to detect a cut-off point for IL-21 and IL-23 that may be used as novel and cost-effective biochemical markers for disease diagnosis.
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Affiliation(s)
- Zahra Ali Al-Hasnawi
- Department of Oral Medicine, College of Dentistry, University of Baghdad, Baghdad, Iraq
| | - Ban AL-Drobie
- Department of Oral Diagnosis, College of Dentistry, University of Baghdad, Baghdad, Iraq
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Andrew K, Dhariwal SK, Szczecinska W. Sarilumab (interleukin-6 receptor monoclonal antibody) for the treatment of pemphigus vulgaris. Clin Exp Dermatol 2023; 48:1055-1056. [PMID: 37146158 DOI: 10.1093/ced/llad173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 04/28/2023] [Indexed: 05/07/2023]
Affiliation(s)
- Kashini Andrew
- Dermatology Department, University Hospital Coventry, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | | | - Weronika Szczecinska
- Dermatology Department, University Hospital Coventry, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
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Araghi F, Dadkhahfar S, Robati RM, Tabary M, Shahidi-Dadras M. The emerging role of T cells in pemphigus vulgaris: a systematic review. Clin Exp Med 2023; 23:1045-1054. [PMID: 35925475 DOI: 10.1007/s10238-022-00855-8] [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: 04/08/2022] [Accepted: 06/20/2022] [Indexed: 11/03/2022]
Abstract
Pemphigus vulgaris is a potential life-threatening autoimmune bullous disorder. The significant role of autoreactive B cells in the pathogenesis of PV has been explained extensively by producing autoantibodies. Recently, attention has been directed toward the role of T cells in the pathogenesis of PV; in other words, the underlying etiology of PV depends on the interaction between T cells and B cells resulting in antibody secretion. Herein, we systematically review the current literature on the emerging role of T cells in PV. To perform this systematic review, an extensive search through EMBASE, PubMed, Scopus, and ISI databases was performed from 1976 through 2021. Articles investigating the function of T cell subgroups in the pathogenesis or treatment of pemphigus vulgaris were included and reviewed. It is evidenced that T cells play a pivotal role in PV pathogenesis. Th1 and Th2 dichotomy including Th1 suppression and Th2 elevation may induce antibody production against desmoglein in keratinocytes. Furthermore, increased level of Th17 and decreased level of regulatory T cells have been detected in PV patients. However, further studies on the exact role of γδ-T cells in PV are required in order to clarify the pathogenesis of PV. T cells and their subtypes can be involved in the pathogenesis of PV. Thus, they can be considered as tentative targets of novel therapies for PV.
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Affiliation(s)
- Farnaz Araghi
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sahar Dadkhahfar
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Reza M Robati
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Dermatology, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Tabary
- Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA
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Takahashi H, Iriki H, Asahina Y. T cell autoimmunity and immune regulation to desmoglein 3, a pemphigus autoantigen. J Dermatol 2023; 50:112-123. [PMID: 36539957 PMCID: PMC10107879 DOI: 10.1111/1346-8138.16663] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 11/11/2022] [Accepted: 11/20/2022] [Indexed: 12/24/2022]
Abstract
Pemphigus is a life-threatening autoimmune bullous disease mediated by anti-desmoglein IgG autoantibodies. Pemphigus is mainly classified into three subtypes: pemphigus vulgaris, pemphigus foliaceus, and paraneoplastic pemphigus. The pathogenicity of autoantibodies has been extensively studied. Anti-human CD20 antibody therapy targeting B cells emerged as a more effective treatment option compared to conventional therapy for patients with an intractable disease. On the other hand, autoreactive T cells are considered to be involved in the pathogenesis based on the test results of human leukocyte antigen association, autoreactive T cell detection, and cytokine profile analysis. Research on the role of T cells in pemphigus has continued to progress, including that on T follicular helper cells, which initiate molecular mechanisms involved in antibody production in B cells. Autoreactive T cell research in mice has highlighted the crucial roles of cellular autoimmunity and improved the understanding of its pathogenesis, especially in paraneoplastic pemphigus. The mouse research has helped elucidate novel regulatory mechanisms of autoreactive T cells, such as thymic tolerance to desmoglein 3 and the essential roles of regulatory T cells, Langerhans cells, and other molecules in peripheral tissues. This review focuses on the immunological aspects of autoreactive T cells in pemphigus by providing detailed information on various related topics.
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Affiliation(s)
- Hayato Takahashi
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
| | - Hisato Iriki
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
| | - Yasuhiko Asahina
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
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9
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Systemic Diseases with Oral Manifestations and Their Impact on Health-Related Quality of Life. SERBIAN JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2022. [DOI: 10.2478/sjecr-2021-0074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Abstract
Health-related quality of life is a multidimensional concept established to evaluate the physical, psychological, and social impacts of health conditions on individuals’ well-being. Various tools for measuring health-related quality of life can be categorized into two subsets: generic and disease–specific instruments. The oral cavity can be stricken by a broad range of local and systemic diseases and their systemic treatment modalities. The most common systemic illnesses associated with oral lesions are hematologic disorders, endocrinopathies, neurological disorders, gastrointestinal conditions, mucocutaneous and rheumatic diseases, and neoplastic processes. Their manifestations in the oral cavity are, in most cases, rather nonspecific but should not be overlooked. Oral health is one of the most important parts of overall health, thus it has been proposed that poor oral health may affect health–related quality of life. The presence of oral manifestations of systemic diseases has a negative impact on the daily functioning of patients, decreasing their overall well-being. This article will review the most common systemic diseases with oral manifestations and their impact on the health–related quality of life. Oral health researchers should put a stronger emphasis on the patient-reported quality of life as a primary outcome in future clinical trials. The significance of this area has still not been widely understood in the current dental literature even though it could help improve patients’ health-related quality of life.
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BOCH K, LANGAN EA, VAN BEEK N, KRIDIN K, SCHMIDT E, ZILLIKENS D, LUDWIG RJ, HAMMERS CM, BIEBER K. Faster IgG4 Depletion Kinetics Observed for Anti-Desmoglein 3 Autoantibodies Following Rituximab Treatment in Patients with Pemphigus Vulgaris. Acta Derm Venereol 2022; 102:adv00835. [PMID: 36511332 PMCID: PMC9811284 DOI: 10.2340/actadv.v102.4490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Abstract is missing (Short communication)
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Affiliation(s)
- Katharina BOCH
- Department of Dermatology, University of Luebeck, Ratzeburger Allee 160, DE-23562 Luebeck, Germany
| | - Ewan A. LANGAN
- Department of Dermatology, University of Luebeck, Ratzeburger Allee 160, DE-23562 Luebeck, Germany,Manchester Sciences, University of Manchester, Manchester, UK
| | - Nina VAN BEEK
- Department of Dermatology, University of Luebeck, Ratzeburger Allee 160, DE-23562 Luebeck, Germany,Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany
| | - Khalaf KRIDIN
- Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany,Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Enno SCHMIDT
- Department of Dermatology, University of Luebeck, Ratzeburger Allee 160, DE-23562 Luebeck, Germany,Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany
| | - Detlef ZILLIKENS
- Department of Dermatology, University of Luebeck, Ratzeburger Allee 160, DE-23562 Luebeck, Germany
| | - Ralf J. LUDWIG
- Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany
| | - Christoph M. HAMMERS
- Department of Dermatology, University of Luebeck, Ratzeburger Allee 160, DE-23562 Luebeck, Germany,Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany,Department of Dermatology, Christian-Albrechts-University, Kiel, Germany
| | - Katja BIEBER
- Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany
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Eichkorn RA, Schmidt MF, Walter E, Hertl M, Baron JM, Waschke J, Yazdi AS. Innate immune activation as cofactor in pemphigus disease manifestation. Front Immunol 2022; 13:898819. [PMID: 35928825 PMCID: PMC9343989 DOI: 10.3389/fimmu.2022.898819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 06/28/2022] [Indexed: 11/23/2022] Open
Abstract
Molecular mechanisms underlying auto-antibody-induced acantholysis in pemphigus vulgaris are subject of current research to date. To decipher the discrepancy between ubiquitous antibody binding to the epidermal desmosomes, but discontinuous disease manifestation, we were able to identify Ultraviolet A (UVA) as a cofactor for acantholysis. UVA induces interleukin (IL)-1 secretion in keratinocytes, mirroring innate immune system activation. In an in vitro keratinocyte dissociation assay increased fragmentation was observed when UVA was added to anti-Desmoglein 3 Immunoglobulins (anti-Dsg3 IgG). These results were confirmed in skin explants where UVA enhanced anti-Dsg3-mediated loss of epidermal adhesion. The UVA-mediated effect was blocked in vitro by the pan-caspase-inhibitor zVAD-fmk. Thus, we introduce UVA as a caspase-dependent exogenous cofactor for acantholysis which suggests that local innate immune responses largely contribute to overt clinical blister formation upon autoantibody binding to epidermal cells in pemphigus vulgaris.
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Affiliation(s)
- Ramona A. Eichkorn
- Department of Dermatology, Eberhard Karl University of Tuebingen, Tuebingen, Germany
| | - Morna F. Schmidt
- Department of Dermatology, Rheinisch-Westfälische Technische Hochschule Aachen (RWTH) Aachen University, Aachen, Germany
| | - Elias Walter
- Department I, Institute of Anatomy and Cell Biology, Ludwig Maximilian University of Munich (LMU), Munich, Germany
| | - Michael Hertl
- Department of Dermatology and Allergology, Philipps University of Marburg, Marburg, Germany
| | - Jens Malte Baron
- Department of Dermatology, Rheinisch-Westfälische Technische Hochschule Aachen (RWTH) Aachen University, Aachen, Germany
| | - Jens Waschke
- Department I, Institute of Anatomy and Cell Biology, Ludwig Maximilian University of Munich (LMU), Munich, Germany
| | - Amir S. Yazdi
- Department of Dermatology, Eberhard Karl University of Tuebingen, Tuebingen, Germany
- Department of Dermatology, Rheinisch-Westfälische Technische Hochschule Aachen (RWTH) Aachen University, Aachen, Germany
- *Correspondence: Amir S. Yazdi,
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12
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Shirzad Moghadam F, Kianfar N, Dasdar S, Samii R, Farimani Z, Azar PM, Balighi K, Abedini R, Soori T, Salehi Farid A, Mahmoudi H, Daneshpazhooh M. Adverse outcome and severity of COVID-19 in patients with autoimmune bullous diseases: a historical cohort study. Dermatol Ther 2022; 35:e15672. [PMID: 35768959 PMCID: PMC9349909 DOI: 10.1111/dth.15672] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 06/22/2022] [Accepted: 06/25/2022] [Indexed: 11/28/2022]
Abstract
The ongoing COVID‐19 pandemic has raised concerns regarding the outcome of this infection in patients with autoimmune bullous dermatoses (AIBDs) due to effect of drugs used to treat these disorders. This investigation was performed from the onset of the pandemic to June 1, 2021. Patients with AIBDs who contracted COVID‐19 were evaluated. A generalized linear model was employed to find the predictors of severe COVID‐19 among patients with AIBDs. Ninety‐three patients with AIBDs with a mean age of 50.3 years were evaluated. The most COVID‐19 related symptoms were tiredness (76.3%) myalgia (69%), and cough (63.4%). During follow‐up, the rate of hospitalization and death were 45.2% and 4.3%, respectively. Previous comorbidities (β = 0.61) and mean prednisolone dosage above 10 mg/day in the last 3 months (β = 1.10) significantly increased COVID‐19 severity. Also, vaccination against SARS‐CoV‐2 (β = −1.50) and each passing month from the last rituximab dose decreased severity (β = −0.02). Notably, 19.3% of the patients developed AIBD flare‐ups following COVID‐19 infection. Higher prednisone dose and the shorter interval from the last rituximab infusion were determinants of severe COVID‐19. Physicians should assess the risk versus the benefits when prescribing the medications. Moreover, vaccination could successfully attenuate COVID‐19 severity.
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Affiliation(s)
- Fateme Shirzad Moghadam
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Nika Kianfar
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Shayan Dasdar
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Rana Samii
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Zeinab Farimani
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Pedram Molhem Azar
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Kamran Balighi
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Robabeh Abedini
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Tahereh Soori
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Salehi Farid
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamidreza Mahmoudi
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Daneshpazhooh
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
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13
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Cho YT, Fu KT, Chen KL, Chang YL, Chu CY. Clinical, Histopathologic, and Immunohistochemical Features of Patients with IgG/IgA Pemphigus. Biomedicines 2022; 10:1197. [PMID: 35625932 PMCID: PMC9138426 DOI: 10.3390/biomedicines10051197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/19/2022] [Accepted: 05/20/2022] [Indexed: 02/01/2023] Open
Abstract
Pemphigus is an autoantibody-mediated blistering disease. In addition to conventional pemphigus vulgaris and pemphigus foliaceus, several other types have been reported. Among them, IgG/IgA pemphigus is less well defined and seldom reported. To characterize the clinical, histopathologic, and immunohistochemical presentation of IgG/IgA pemphigus, we retrospectively identified 22 patients with the disease at a referral center in Taiwan. These patients showed two types of skin lesion: annular or arciform erythemas with blisters or erosions (45.5%) and discrete erosions or blisters such as those in conventional pemphigus (54.5%). Mucosal involvement was found in 40.9%. Histopathologic analysis identified acantholysis (77.3%) and intra-epidermal aggregates of neutrophils (40.9%) and eosinophils (31.8%). Direct immunofluorescence studies showed IgG/IgA (100%) and C3 (81.8%) depositions in the intercellular space of the epidermis. In immunohistochemical staining, patients with IgG/IgA pemphigus demonstrated significantly higher levels of epidermal expression of interleukin-8 and matrix metalloproteinase-9 than those with conventional pemphigus (p < 0.05). In conclusion, although IgG/IgA pemphigus is heterogeneous in presentation, it shows characteristic features that are different from other forms of pemphigus and should be considered a distinct type of pemphigus.
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Affiliation(s)
- Yung-Tsu Cho
- Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 100, Taiwan; (Y.-T.C.); (K.-T.F.); (K.-L.C.)
- Graduate Institute of Pathology, National Taiwan University College of Medicine, Taipei 100, Taiwan
- Department of Dermatology, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City 243, Taiwan
| | - Ko-Ting Fu
- Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 100, Taiwan; (Y.-T.C.); (K.-T.F.); (K.-L.C.)
| | - Kai-Lung Chen
- Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 100, Taiwan; (Y.-T.C.); (K.-T.F.); (K.-L.C.)
| | - Yih-Leong Chang
- Graduate Institute of Pathology, National Taiwan University College of Medicine, Taipei 100, Taiwan
- Department of Pathology, National Taiwan University Cancer Center, Taipei 106, Taiwan
| | - Chia-Yu Chu
- Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 100, Taiwan; (Y.-T.C.); (K.-T.F.); (K.-L.C.)
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14
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Lin J, Chen H, Bai Y, Li S, Liang G, Fan T, Gao N, Wu X, Li H, Chen G, Gao Y, Fan J. Ganoderma immunomodulatory proteins: mushrooming functional FIPs. Appl Microbiol Biotechnol 2022; 106:2367-2380. [PMID: 35348851 DOI: 10.1007/s00253-022-11839-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 02/11/2022] [Accepted: 02/14/2022] [Indexed: 12/12/2022]
Abstract
Fungal immunomodulatory protein (FIP) is a novel functional protein family with specific immunomodulatory activity identified from several macro-fungi. A variety of biological activities of FIPs have been reported, such as anti-allergy, anti-tumor, mitogenic activity, and immunomodulation. Among all known FIPs, the firstly discovered FIP was isolated from Ganoderma lucidum, and most FIP members were from Ganoderma genus. Compared with other FIPs, Ganoderma FIPs possess some advantageous bioactivities, like stronger anti-tumor activity. Therein, gene sequences, protein structural features, biofunctions, and recombinant expression of Ganoderma FIPs were summarized and addressed, focusing on elucidating their anti-tumor activity and molecular mechanisms. Combined with current advances, development potential and application of Ganoderma FIPs were also prospected. KEY POINTS: • More than a dozen of reported FIPs are identified from Ganoderma species. • Ganoderma immunomodulatory proteins have superior anti-tumor activity with promising prospects and application. • Current review comprehensively addresses characterization, biofunctions, and anti-tumor mechanisms of Ganoderma FIPs.
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Affiliation(s)
- Jingwei Lin
- College of Bioscience and Biotechnology, Shenyang Agricultural University, Shenyang, 110032, China.,Liaoning Province Key Laboratory of Agricultural Technology, Shenyang, 110866, China.,Liaoning Province Academy of Forest Sciences, Shenyang Agricultural University, Shenyang, 110866, China
| | - Huan Chen
- College of Bioscience and Biotechnology, Shenyang Agricultural University, Shenyang, 110032, China.,Liaoning Province Key Laboratory of Agricultural Technology, Shenyang, 110866, China
| | - Yudong Bai
- College of Bioscience and Biotechnology, Shenyang Agricultural University, Shenyang, 110032, China.,Liaoning Province Key Laboratory of Agricultural Technology, Shenyang, 110866, China
| | - Shoukun Li
- College of Bioscience and Biotechnology, Shenyang Agricultural University, Shenyang, 110032, China.,Liaoning Province Key Laboratory of Agricultural Technology, Shenyang, 110866, China
| | - Gengyuan Liang
- College of Bioscience and Biotechnology, Shenyang Agricultural University, Shenyang, 110032, China.,Liaoning Province Key Laboratory of Agricultural Technology, Shenyang, 110866, China
| | - Tianning Fan
- College of Bioscience and Biotechnology, Shenyang Agricultural University, Shenyang, 110032, China.,Liaoning Province Key Laboratory of Agricultural Technology, Shenyang, 110866, China
| | - Ningyuan Gao
- College of Bioscience and Biotechnology, Shenyang Agricultural University, Shenyang, 110032, China.,Liaoning Province Key Laboratory of Agricultural Technology, Shenyang, 110866, China
| | - Xiupeng Wu
- College of Bioscience and Biotechnology, Shenyang Agricultural University, Shenyang, 110032, China.,Liaoning Province Key Laboratory of Agricultural Technology, Shenyang, 110866, China
| | - Hui Li
- College of Bioscience and Biotechnology, Shenyang Agricultural University, Shenyang, 110032, China.,Liaoning Province Key Laboratory of Agricultural Technology, Shenyang, 110866, China
| | - Gang Chen
- Liaoning Province Academy of Forest Sciences, Shenyang Agricultural University, Shenyang, 110866, China
| | - Yingxu Gao
- Liaoning Province Academy of Forest Sciences, Shenyang Agricultural University, Shenyang, 110866, China.
| | - Jungang Fan
- Liaoning Province Academy of Forest Sciences, Shenyang Agricultural University, Shenyang, 110866, China.
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15
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Bumiller-Bini Hoch V, Schneider L, Pumpe AE, Lüders E, Hundt JE, Boldt ABW. Marked to Die-Cell Death Mechanisms for Keratinocyte Acantholysis in Pemphigus Diseases. Life (Basel) 2022; 12:life12030329. [PMID: 35330080 PMCID: PMC8948972 DOI: 10.3390/life12030329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 02/15/2022] [Accepted: 02/18/2022] [Indexed: 11/17/2022] Open
Abstract
Pemphigus is a group of blistering autoimmune diseases causing painful skin lesions, characterized by acantholysis and by the production of autoantibodies against, mainly, adhesion proteins. We reviewed the literature for molecules and/ or features involved in the 12 cell death pathways described by Nomenclature Committee on Cell Death, taking place in pemphigus patients, cell lines, or human skin organ cultures treated with sera or IgG from pemphigus patients or in pemphigus mouse models, and found 61 studies mentioning 97 molecules involved in cell death pathways. Among the molecules, most investigated were pleiotropic molecules such as TNF and CASP3, followed by FASL and CASP8, and then by FAS, BAX, BCL2, and TP53, all involved in more than one pathway but interpreted to function only within apoptosis. Most of these previous investigations focused only on apoptosis, but four recent studies, using TUNEL assays and/or electron microscopy, disqualified this pathway as a previous event of acantholysis. For PV, apoptolysis was suggested as a cell death mechanism based on pathogenic autoantibodies diversity, mitochondrial dysfunction, and p38 MAPK signaling. To answer those many questions that remain on cell death and pemphigus, we propose well-controlled, statistically relevant investigations on pemphigus and cell death pathways besides apoptosis, to overcome the challenges of understanding the etiopathology of pemphigus diseases.
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Affiliation(s)
- Valéria Bumiller-Bini Hoch
- Laboratory of Human Molecular Genetics, Department of Genetics, Federal University of Paraná, Curitiba 81531-980, Brazil; (V.B.-B.H.); (L.S.)
- Postgraduate Program in Genetics, Department of Genetics, Federal University of Paraná (UFPR), Curitiba 81531-980, Brazil
- Lübeck Institute of Experimental Dermatology, University of Lübeck, 23562 Lübeck, Germany; (A.E.P.); (E.L.); (J.E.H.)
| | - Larissa Schneider
- Laboratory of Human Molecular Genetics, Department of Genetics, Federal University of Paraná, Curitiba 81531-980, Brazil; (V.B.-B.H.); (L.S.)
| | - Anna Elisabeth Pumpe
- Lübeck Institute of Experimental Dermatology, University of Lübeck, 23562 Lübeck, Germany; (A.E.P.); (E.L.); (J.E.H.)
| | - Emelie Lüders
- Lübeck Institute of Experimental Dermatology, University of Lübeck, 23562 Lübeck, Germany; (A.E.P.); (E.L.); (J.E.H.)
| | - Jennifer Elisabeth Hundt
- Lübeck Institute of Experimental Dermatology, University of Lübeck, 23562 Lübeck, Germany; (A.E.P.); (E.L.); (J.E.H.)
| | - Angelica Beate Winter Boldt
- Laboratory of Human Molecular Genetics, Department of Genetics, Federal University of Paraná, Curitiba 81531-980, Brazil; (V.B.-B.H.); (L.S.)
- Correspondence:
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16
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Aya B, Rofaida S, Alaa AE, Amira K, Fatma AE, Ahmed G. Trappin-2/Elafin and Clusterin serum levels in pemphigus vulgaris and correlation with the severity score: a case–control study. EGYPTIAN JOURNAL OF DERMATOLOGY AND VENEROLOGY 2022; 42:53. [DOI: 10.4103/ejdv.ejdv_7_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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17
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Liu T, Feng M, Wen Z, He Y, Lin W, Zhang M. Comparison of the Characteristics of Cytokine Storm and Immune Response Induced by SARS-CoV, MERS-CoV, and SARS-CoV-2 Infections. J Inflamm Res 2021; 14:5475-5487. [PMID: 34720596 PMCID: PMC8550203 DOI: 10.2147/jir.s329697] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 09/30/2021] [Indexed: 12/12/2022] Open
Abstract
Cytokine storm (CS) is a significant cause of death in patients with severe coronavirus pneumonia. Excessive immune-inflammatory reaction, many inflammatory cell infiltration, and extreme increase of proinflammatory cytokines and chemokines lead to acute lung injury and acute respiratory distress syndrome (ARDS). This review compares the characters of cytokine storms and immune responses caused by three highly pathogenic and infectious coronaviruses (HCoVs), including severe acute respiratory syndrome coronavirus (SARS-CoV), Middle East respiratory syndrome-coronavirus (MERS-CoV), and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and analyzes the possible mechanisms to guide clinical treatment in the future.
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Affiliation(s)
- Tong Liu
- Department of Medicine, Xizang Minzu University, Xianyang, Shaanxi, People’s Republic of China
| | - Meng Feng
- School of Basic Medicine, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, People’s Republic of China
| | - Zexin Wen
- Department of Clinical Medicine, Fujian Medical University, Fuzhou, Fujian, People’s Republic of China
| | - Yijie He
- Department of Medicine, Xizang Minzu University, Xianyang, Shaanxi, People’s Republic of China
| | - Wei Lin
- School of Basic Medicine, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, People’s Republic of China
| | - Min Zhang
- Department of Medicine, Xizang Minzu University, Xianyang, Shaanxi, People’s Republic of China
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18
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Nili A, Salehi Farid A, Asgari M, Tavakolpour S, Mahmoudi H, Daneshpazhooh M. Current status and prospects for the diagnosis of pemphigus vulgaris. Expert Rev Clin Immunol 2021; 17:819-834. [PMID: 34162306 DOI: 10.1080/1744666x.2021.1945925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Introduction: Pemphigus vulgaris (PV) is an intraepidermal autoimmune bullous disease (AIBD) characterized by autoantibodies against desmosomal adhesion proteins, most commonly desmoglein (Dsg)3, leading to the suprabasal cleft formation and acantholysis.Areas covered: Direct immunofluorescence (DIF) and indirect immunofluorescence (IIF) studies display the intercellular deposition of IgG/C3 throughout the epidermis and presence of circulating autoantibodies respectively, as a net-like pattern. However, the target antigen remains unknown using immunofluorescence techniques. Thanks to the development of Dsg ELISA, using recombinant technology, circulating antibodies against Dsg1 and 3 could be detected sensitively. It is possible to differentiate PV from pemphigus foliaceus (PF) using this assay. BIOCHIP mosaic and multivariant ELISA are two novel serologic methods with the added value of the ability to screen several AIBDs simultaneously.Non-Dsg1/3 antigens are also involved in the pathogenesis of PV and investigated more deeply thanks to the protein microarrays technique. Additionally, patients with high values of anti-Dsg1/3 may be lesion-free, suggesting the presence of nonpathogenic autoantibodies.Expert opinion: Newer diagnostic methods to replace traditional techniques should possess high sensitivity and specificity and be widely available, noninvasive, and relatively cheap. The newly developed methods need to be further evaluated before being recommended for routine use.
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Affiliation(s)
- Ali Nili
- Department of Dermatology, Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Salehi Farid
- Department of Dermatology, Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoud Asgari
- Department of Pathology and Laboratory Medicine, Yosemite Pathology Medical Group, San Ramon Regional Medical Center, San Ramon, CA, USA
| | - Soheil Tavakolpour
- Department of Dermatology, Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Hamidreza Mahmoudi
- Department of Dermatology, Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Daneshpazhooh
- Department of Dermatology, Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
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19
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Shahbazian P, Izad M, Daneshpazhooh M, Mortazavi H, Salehi Z, Behruzifar S, Tavakolpour S, Azizpour A. Decreased Serum Levels of Interleukin-4 and Interleukin-21 in New Pemphigus Vulgaris Patients, but Not Chronic Patients With Inactive Disease Compared to Healthy Controls. Dermatol Pract Concept 2021; 11:e2021035. [PMID: 33954018 DOI: 10.5826/dpc.1102a35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2020] [Indexed: 10/31/2022] Open
Abstract
Background Pemphigus is a rare group of autoimmune blistering diseases with unknown etiology and unclear pathogenesis. Pemphigus vulgaris (PV) is the most common subtype, and is characterized by ulcerations or flaccid blisters on mucous membranes and on the skin. It is accepted that cytokines have a critical role in the pathogenesis of PV, while their exact roles remain to be elucidated. Objectives This study assessed serum levels of interleukin (IL)-4 and IL-21 in different phases of the disease in comparison with healthy controls. Methods In a case-control cohort design, serum levels of IL-4 and IL-21 were determined by ELISA in three groups: patients with newly diagnosed PV, patients with chronic, inactive PV (PV in remission), and healthy controls. Results The study included 88 individuals (58 women and 30 men), including 26 with newly diagnosed PV, 33 with PV in remission, and 29 healthy controls. A significant difference was found among the groups for IL-21 (P = .044), but not for IL-4 (P = .374). Serum levels of IL-4 and IL-21 in newly diagnosed patients were significantly lower than in healthy controls (P = .005 for both), but these cytokine levels in patients with PV in remission were not different from those of controls (P = .343 and P = .221, respectively). Also, no differences in cytokine levels were detected between the newly diagnosed patients and patients with PV in remission. Regardless of disease phase, we detected significantly lower levels of IL-21 in patients than controls (P = .027), but no differences for IL-4 (P = .374). Conclusions IL-4 and IL-21 are involved in PV pathogenesis and disease severity. More studies are required to clarify the role of IL-4 and IL-21 in immunopathogenesis and immune response during PV.
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Affiliation(s)
- Pegah Shahbazian
- Autoimmune Bullous Diseases Research Center, Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Izad
- Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,MS Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Daneshpazhooh
- Autoimmune Bullous Diseases Research Center, Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Mortazavi
- MS Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Salehi
- Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Shirin Behruzifar
- Autoimmune Bullous Diseases Research Center, Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Soheil Tavakolpour
- Autoimmune Bullous Diseases Research Center, Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran.,Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA
| | - Arghavan Azizpour
- Autoimmune Bullous Diseases Research Center, Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
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20
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Bakr RM, Sayed DS, Abd-Elkader AS, Kamel AA, Badran AY. Does interleukin-33 level correlate with the activity of Pemphigus vulgaris?: A case-control study. Dermatol Ther 2020; 34:e14605. [PMID: 33249704 DOI: 10.1111/dth.14605] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 11/09/2020] [Accepted: 11/26/2020] [Indexed: 11/28/2022]
Abstract
Pemphigus is a group of immune-mediated blistering diseases of skin and mucus membrane caused by destruction of the intercellular junction (desmosomes) by autoantibodies. Pemphigus vulgaris (PV) is considered the most common type of all pemphigus family. Various cytokines play a major role in pemphigus pathogenesis. Interleukin-33 (IL-33) role has been studied in various autoimmune diseases as; psoriasis and rheumatoid arthritis, yet it has not been studied in Egyptian patients with PV. The study aimed to evaluate the possible role of IL-33 in PV by assessing its level in the serum using ELISA and to detect its correlation with activity score using Pemphigus Disease Area Index (PDAI). Forty-four patients with PV and 36 age and sex-matched healthy controls were enrolled in the study. After full history taking and complete dermatological examination, the severity score was calculated using PDAI, then serum samples were taken from each patient and control subjects and subjected to quantitative measurement of serum IL-33 using ELISA. Serum level of IL-33 is significantly raised in PV patients compared to control subjects (P-value = .007). The level of IL-33 was found to be strongly correlated with the activity of the disease measured by PDAI. IL-33 might have a role in PV pathogenesis as shown by its rising level in PV patients. In addition, serum level of IL-33 is strongly correlated with the activity of PV. Thus, we suspect that IL-33 can be used as marker for monitoring PV severity and measuring treatment efficacy.
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Affiliation(s)
- Radwa M Bakr
- Department of Dermatology, Venereology and Andrology, Assiut University, Assiut, Egypt
| | - Doaa S Sayed
- Department of Dermatology, Venereology and Andrology, Assiut University, Assiut, Egypt
| | | | - Amira A Kamel
- Department of Medical Biochemistry, Assiut University, Assiut, Egypt
| | - Aya Y Badran
- Department of Dermatology, Venereology and Andrology, Assiut University, Assiut, Egypt
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21
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Assaf S, Malki L, Mayer T, Mohamad J, Peled A, Pavlovsky M, Malovitski K, Sarig O, Vodo D, Sprecher E. ST18 affects cell-cell adhesion in pemphigus vulgaris in a tumour necrosis factor-α-dependent fashion. Br J Dermatol 2020; 184:1153-1160. [PMID: 33205400 DOI: 10.1111/bjd.19679] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Pemphigus vulgaris (PV) is a life-threatening mucocutaneous autoimmune blistering disease. We previously showed that genetic variants within the ST18 gene promoter area confer a sixfold increase in the propensity to develop PV. ST18, a transcription factor, was found to be overexpressed in the epidermis of patients with PV. In addition, it was found to promote autoantibody-mediated abnormal epidermal cell-cell adhesion and secretion of proinflammatory mediators by keratinocytes. OBJECTIVES To delineate the mechanism through which ST18 contributes to destabilization of cell-cell adhesion. METHODS We used quantitative reverse-transcriptase polymerase chain reaction, immunofluorescence microscopy, a luciferase reporter system, site-directed mutagenesis, chromatin immunoprecipitation (ChIP) and the dispase dissociation assay. RESULTS The ChIP and luciferase reporter assays showed that ST18 directly binds and activates the TNF promoter. Accordingly, increased ST18 expression contributes to PV pathogenesis by destabilizing cell-cell adhesion in a tumour necrosis factor (TNF)-α-dependent fashion. In addition, dual immunofluorescence staining showed increased expression of both ST18 and TNF-α in the skin of patients with PV carrying an ST18-associated PV risk variant, which was found to be associated with a more extensive PV phenotype. CONCLUSIONS Our findings suggest a role for TNF-α in mediating the deleterious effect of increased ST18 expression in PV skin.
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Affiliation(s)
- S Assaf
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Department of Human Molecular Genetics and Biochemistry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - L Malki
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Department of Human Molecular Genetics and Biochemistry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - T Mayer
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - J Mohamad
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Department of Human Molecular Genetics and Biochemistry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - A Peled
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Department of Human Molecular Genetics and Biochemistry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - M Pavlovsky
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - K Malovitski
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - O Sarig
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - D Vodo
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Department of Human Molecular Genetics and Biochemistry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - E Sprecher
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Department of Human Molecular Genetics and Biochemistry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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22
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Abedini R, Mahmoudi H, Kordestani S, Habib FN, Abyaneh M, Rahemi H. Comparison of topical nanocolloidal silver formulation use with eosin 2% solution in management of hard-to-heal ulcers in patients with pemphigus vulgaris. J Wound Care 2020; 29:664-668. [PMID: 33175623 DOI: 10.12968/jowc.2020.29.11.664] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To examine the effect of a nanocolloidal silver-based gel called SilvoGel (ChitoTech, Iran) versus eosin (prepared by Razi Hospital, Iran) among patients with immunobullous disease. METHOD This blind, randomised controlled study was carried out on patients with pemphigus vulgaris who had hard-to-heal ulcers, divided into two equal-sized groups: one treatment group receiving the nanocolloidal silver-based gel and the control group receiving the conventional eosin. RESULTS A total of 32 patients participated in the study. In both the treatment and control groups, ulcer area, exudate and tissue type improved significantly (p<0.001 for all measures). A significantly higher rate of improvement in ulcer area was observed in the treatment group compared with the control group (p<0.001). Both patient and physician satisfaction were significantly higher in the treatment group compared with the control group (p=0.003 and p=0.01, respectively). CONCLUSION The results of this study indicate that use of the nanocolloidal silver-based gel for treating patients with immunobullous disease including pemphigus could potentially increase the rate and quality of wound healing.
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Affiliation(s)
- Robabeh Abedini
- 1 Tehran University of Medical Sciences, Dermatology Department, Razi Hospital, Iran
| | - Hamidreza Mahmoudi
- 1 Tehran University of Medical Sciences, Dermatology Department, Razi Hospital, Iran
| | - Soheila Kordestani
- 2 Medical Engineering Department, Amirkabir University of Technology, Tehran, Iran.,3 ChitoTech Inc, Unit 9&11, East Wing, No. 83, Khaghani Building, Somayeh Avenue, Tehran, Iran
| | - Farzaneh Nayeb Habib
- 2 Medical Engineering Department, Amirkabir University of Technology, Tehran, Iran
| | - Mitra Abyaneh
- 3 ChitoTech Inc, Unit 9&11, East Wing, No. 83, Khaghani Building, Somayeh Avenue, Tehran, Iran
| | - Homayoun Rahemi
- 3 ChitoTech Inc, Unit 9&11, East Wing, No. 83, Khaghani Building, Somayeh Avenue, Tehran, Iran
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23
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Tavakolpour S, Mahmoudi H, Karami F, Elikaei Behjati S, Balighi K, Abbasi M, Salehi Farid A, Masoudi J, Balali M, Daneshpazhooh M, Modarressi MH. Investigating expression pattern of eight immune‐related genes in pemphigus patients compared with the healthy controls and after rituximab therapy: Potential roles of
CTLA4
and
FCGR3A
genes expression in outcomes of rituximab therapy. Dermatol Ther 2020; 33:e14380. [DOI: 10.1111/dth.14380] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 09/22/2020] [Accepted: 09/25/2020] [Indexed: 12/17/2022]
Affiliation(s)
- Soheil Tavakolpour
- Autoimmune Bullous Diseases Research Center Tehran University of Medical Sciences Tehran Iran
| | - Hamidreza Mahmoudi
- Autoimmune Bullous Diseases Research Center Tehran University of Medical Sciences Tehran Iran
| | - Fatemeh Karami
- Department of Medical Genetics, Applied Biophotonics Research Center, Science and Research Branch Islamic Azad University Tehran Iran
| | - Somayeh Elikaei Behjati
- Department of Biology, School of Basic Science, Science and Research Branch Islamic Azad University Tehran Iran
| | - Kamran Balighi
- Autoimmune Bullous Diseases Research Center Tehran University of Medical Sciences Tehran Iran
| | - Maryam Abbasi
- Zhino‐Gene‐Pazhoohan research services co. Tehran Iran
| | - Ali Salehi Farid
- Autoimmune Bullous Diseases Research Center Tehran University of Medical Sciences Tehran Iran
| | - Jamileh Masoudi
- Autoimmune Bullous Diseases Research Center Tehran University of Medical Sciences Tehran Iran
| | - Mansour Balali
- Department of Biology, School of Basic Science, Science and Research Branch Islamic Azad University Tehran Iran
| | - Maryam Daneshpazhooh
- Autoimmune Bullous Diseases Research Center Tehran University of Medical Sciences Tehran Iran
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Gholibeigian Z, Izad M, Daneshpazhooh M, Mortazavi H, Salehi Z, Behruzifar S, Akhdar M, Tavakolpour S, Azizpour A. Decreased serum levels of interleukin-17, interleukin-23, TGF-β in pemphigus vulgaris patients, and their association with disease phase. Dermatol Ther 2020; 33:e14071. [PMID: 32713112 DOI: 10.1111/dth.14071] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 07/05/2020] [Accepted: 07/18/2020] [Indexed: 12/14/2022]
Abstract
The exact pathogenesis of Pemphigus Vulgaris (PV) has remained unclear, but it seems that cytokines play critical roles in this disease. This study aims to assess the serum levels of interleukin (IL)-6, IL-17, IL-23, and TGF-β in PV patients and compare the results to the healthy controls. Serum levels of IL6, IL-17, IL-23, and TGF-β were successfully determined by enzyme-linked immunosorbent assay (ELISA) in 27 newly diagnosed PV, 32 patients in remission, and 29 healthy controls. It was shown that the mean serum levels of IL-17, IL-23, and TGF-β serum are significantly different among the PV patients and healthy controls (P values: <.001, .001, and .003, respectively). It was found that new PV patients have lower serum levels of IL-17, IL-23, and TGF-β as compared to healthy controls (P values: <.001, <.001, and .003, respectively). Regarding IL-6, no significant difference was observed between the healthy controls and the other two groups of patients. IL-17, IL-23, and TGF-β are involved in the pathogenesis of PV. However, more studies are required to clarify their exact roles in the immunopathogenesis of PV.
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Affiliation(s)
- Zeinab Gholibeigian
- Autoimmune Bullous Disease Research Center, Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Izad
- Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,MS Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Daneshpazhooh
- Autoimmune Bullous Disease Research Center, Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Mortazavi
- Autoimmune Bullous Disease Research Center, Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Salehi
- Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Shirin Behruzifar
- Autoimmune Bullous Disease Research Center, Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Marwa Akhdar
- Autoimmune Bullous Disease Research Center, Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Soheil Tavakolpour
- Autoimmune Bullous Disease Research Center, Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Arghavan Azizpour
- Autoimmune Bullous Disease Research Center, Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
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