Critical appraisal of different triggering pathways for the pathobiology of pemphigus vulgaris-A review

Implications of innate lymphoid cells in oral diseases

Innate lymphoid cells (ILCs), as newly discovered antigen-independent innate immune cells, respond promptly to stimuli by secreting effector cytokines to exert effector functions similar to those of T cells. ILCs predominantly reside at mucosal sites and play critical roles in defending against infections, maintaining mucosal homeostasis, regulating inflammatory and immune responses, and participating in tumorigenesis. Recently, there has been a growing interest in the role of ILCs in oral diseases. This review outlines the classifications and the major characteristics of ILCs, and then comprehensively expatiates the research on ILCs in oral cancer, primary Sjogren's syndrome, periodontal diseases, oral lichen planus, oral candidiasis, Behcet's disease, and pemphigus vulgaris, aiming at summarising the implications of ILCs in oral diseases and providing new ideas for further research.

Pemphigus and pemphigoid research by dermatologists and stomatologists: A scientometric and comparative study

Background/purpose

Pemphigus and pemphigoid are systemic bullous autoimmune diseases affecting skin and/or mucosal membranes with the life-threatening nature, especially pemphigus vulgaris. The papers published by dermatologists and stomatologists preferentially represent their concerns of a mucocutaneous disease.

Materials and methods

The objective of this study was to compare the scientometric characteristics of pemphigus and pemphigoid publications by dermatologists and stomatologists in the Scopus database.

Results

There are 9276 and 760 papers published by dermatologists and stomatologists, respectively. The annual number of the publications by dermatologists stably raised from 218 to 526 during 2007-2022; while the number by stomatologists raised with a small amount from 18 to 51 during this period. For the most-cited top-200 papers, the total citation count is 42,766 and the h index is 148 for pemphigus publications by dermatologists; whereas the count is 14,689 and h index is 63 for publications by stomatologists. Notably, first signs of pemphigus often appear in oral mucosa, manifesting as erythema, blisters, as well as mouth ulcer, gingivitis, lichen planus-like pemphigus.

Conclusion

This study firstly reports the scientometric characteristics of pemphigus publications by dermatologists and stomatologists. The scale and citations of dermatologists' publications greatly outweigh stomatologists' ones, suggesting stomatologists can learn from and more cooperate with dermatologists regarding pemphigus research.

Chronic exposure to the anti-m3 muscarinic acetylcholine receptor autoantibody in pemphigus vulgaris contributes to disease pathophysiology

Pemphigus vulgaris (PV) is a potentially lethal autoimmune mucocutaneous blistering disease characterized by binding of IgG autoantibodies (AuAbs) to keratinocytes (KCs). In addition to AuAbs against adhesion molecules desmogleins 1 and 3, PV patients also produce an AuAb against the M3 muscarinic acetylcholine (ACh) receptor (M3AR) that plays an important role in regulation of vital functions of KCs upon binding endogenous ACh. This anti-M3AR AuAb is pathogenic because its adsorption eliminates the acantholytic activity of PV IgG; however, the molecular mechanism of its action is unclear. In the present study, we sought to elucidate the mode of immunopharmacologic action of the anti-M3AR AuAb in PV. Short-term exposures of cultured KCs to PV IgG or the muscarinic agonist muscarine both induced changes in the expression of keratins 5 and 10, consistent with the inhibition of proliferation and upregulated differentiation and in keeping with the biological function of M3AR. In contrast, long-term incubations induced a keratin expression pattern consistent with upregulated proliferation and decreased differentiation, in keeping with the hyperproliferative state of KCs in PV. This change could result from desensitization of the M3AR, representing the net antagonist-like effect of the AuAb. Therefore, chronic exposure of KCs to the anti-M3AR AuAb interrupts the physiological regulation of KCs by endogenous ACh, contributing to the onset of acantholysis. Since cholinergic agents have already demonstrated antiacantholytic activity in a mouse model of PV and in PV patients, our results have translational significance and can guide future development of therapies for PV patients employing cholinergic drugs.