国际口腔医学杂志 ›› 2018, Vol. 45 ›› Issue (2): 162-169.doi: 10.7518/gjkq.2018.02.008

• 口腔黏膜专栏 • 上一篇    下一篇

除糖皮质激素及免疫抑制剂外的其他天疱疮治疗方法

姚懿桓, 王冏珂, 曾昕, 陈谦明   

  1. 口腔疾病研究国家重点实验室 国家口腔疾病临床医学研究中心
    四川大学华西口腔医院口腔黏膜病科 成都 610041
  • 收稿日期:2017-05-09 修回日期:2017-11-18 出版日期:2018-03-01 发布日期:2018-03-01
  • 通讯作者: 曾昕,教授,博士,Email:zengxin22@163.com
  • 作者简介:姚懿桓,硕士,Email:525218951@qq.com
  • 基金资助:
    国家自然科学基金(81472533); 国家卫生和计划生育委员会公益性行业专项(201502018)

Adjuvant therapy for pemphigus in addition to glucocorticoid and immunosuppressor

Yao Yihuan, Wang Jiongke, Zeng Xin, Chen Qianming   

  1. State Key Laboratory of Oral Diseases &National Clinical Research Center for Oral Diseases &Dept. of Oral Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
  • Received:2017-05-09 Revised:2017-11-18 Online:2018-03-01 Published:2018-03-01
  • Supported by:
    This study was supported by National Natural Science Foundation of China (81472533) and Nonprofit Industry Research Sepecific Fund of National Health and Family Planning Commission of China (201502018).

摘要: 天疱疮是一种累及皮肤及黏膜的严重的慢性自身免疫大疱性疾病。目前主要运用糖皮质激素和免疫抑制剂治疗天疱疮,但在控制病情的同时,亦可引起高血压、骨髓抑制等不良反应。因此,根据患者的不同情况,常需选择其他治疗方法与糖皮质激素和(或)免疫抑制剂联合用药。本文就除糖皮质激素及免疫抑制剂治疗之外的其他天疱疮疗法作一综述。

关键词: 天疱疮, 血浆置换, 生物制剂, 治疗

Abstract: Pemphigus is a severe, chronic, autoimmune bullous disease affecting the skin and mucous membranes. Recently, glucocorticoid and immunosuppressor are the most common treatments for pemphigus. However, these treatment may result in unfavorable effects, such as hypertension and marrow suppression, during treatment. Thus, the combination of other treatments with glucocorticoid and (or) immunosuppressor should be evaluated according to the patients’ condition. In this article, we reviewed the non-glucocorticoid and non-immunosuppressor therapy.

Key words: pemphigus, plasma exchange, biological agent, therapy

中图分类号: 

  • R781.5+9
[1] Bystryn JC.Adjuvant therapy of pemphigus[J]. Arch Dermatol, 1984, 120(7):941-951.
[2] Rosenberg FR, Sanders S, Nelson CT.Pemphigus: a 20-year review of 107 patients treated with corticoste-roids[J]. Arch Dermatol, 1976, 112(7):962-970.
[3] 江潞, 陈谦明. 天疱疮的糖皮质激素治疗[J]. 国外医学口腔医学分册, 2004, 31(6):478-480.
Jiang L, Chen QM.The glucocorticoid therapy of pem-phigus[J]. Foreign Med Sci: Stomatol, 2004, 31(6):478-480.
[4] Tan-Lim R, Bystryn JC.Effect of plasmapheresis the-rapy on circulating levels of pemphigus antibodies[J]. J Am Acad Dermatol, 1990, 22(1):35-40.
[5] Committee for Guidelines for the Management of Pemphigus Disease, Amagai M, Tanikawa A, et al. Japanese guidelines for the management of pemphi-gus[J]. J Dermatol, 2014, 41(6):471-486.
[6] Guillaume JC, Roujeau JC, Morel P, et al.Controlled study of plasma exchange in pemphigus[J]. Arch Der- matol, 1988, 124(11):1659-1663.
[7] Prajapati V, Mydlarski PR.Advances in pemphigus therapy[J]. Skin Therapy Lett, 2008, 13(3):4-7.
[8] Schmidt E, Zillikens D.Immunoadsorption in derma-tology[J]. Arch Dermatol Res, 2010, 302(4):241-253.
[9] Hertl M, Jedlickova H, Karpati S, et al.Pemphigus. S2 guideline for diagnosis andtreatment—guided by the European Dermatology Forum (EDF) in coopera-tion with the European Academy of Dermatology and Venereology (EADV)[J]. J Eur Acad Dermatol Venereol, 2015, 29(3):405-414.
[10] Kasperkiewicz M, Shimanovich I, Meier M, et al.Treatment of severe pemphigus with a combination of immunoadsorption, rituximab, pulsed dexametha-sone and azathioprine/mycophenolate mofetil: a pilot study of 23 patients[J]. Br J Dermatol, 2012, 166(1): 154-160.
[11] Ogata K, Yasuda K, Matsushita M, et al.Successful treatment of adolescent pemphigus vulgaris by im-munoadsorption method[J]. J Dermatol, 1999, 26(4): 236-239.
[12] Frost N, Messer G, Fierlbeck G, et al.Treatment of pemphigus vulgaris with protein A immunoadsorption: case report of long-term history showing favorable outcome[J]. Ann N Y Acad Sci, 2005, 1051:591-596.
[13] Kasperkiewicz M, Schmidt E, Zillikens D.Current therapy of the pemphigus group[J]. Clin Dermatol, 2012, 30(1):84-94.
[14] Bystryn JC, Jiao D.IVIg selectively and rapidly de-creases circulating pathogenic autoantibodies in pem-phigus vulgaris[J]. Autoimmunity, 2006, 39(7):601-607.
[15] Czernik A, Beutner EH, Bystryn JC.Intravenous im-munoglobulin selectively decreases circulating auto-antibodies in pemphigus[J]. J Am Acad Dermatol, 2008, 58(5):796-801.
[16] Amagai M, Ikeda S, Shimizu H, et al.A randomized double-blind trial of intravenous immunoglobulin for pemphigus[J]. J Am Acad Dermatol, 2009, 60(4): 595-603.
[17] Arnold DF, Burton J, Shine B, et al.An ‘n-of-1’ pla-cebo-controlled crossover trial of intravenous immuno-globulin as adjuvant therapy in refractory pemphigus vulgaris[J]. Br J Dermatol, 2009, 160(5):1098-1102.
[18] Schiavo AL, Puca RV, Ruocco V, et al.Adjuvant drugs in autoimmune bullous diseases, efficacy versus safety: facts and controversies[J]. Clin Dermatol, 2010, 28(3):337-343.
[19] Perosa F, Favoino E, Caragnano MA, et al.CD20: a target antigen for immunotherapy of autoimmune diseases[J]. Autoimmun Rev, 2005, 4(8):526-531.
[20] Cooper HL, Healy E, Theaker JM, et al.Treatment of resistant pemphigus vulgaris with an anti-CD20 monoclonal antibody (Rituximab)[J]. Clin Exp Der-matol, 2003, 28(4):366-368.
[21] Morrison LH.Therapy of refractory pemphigus vul-garis with monoclonal anti-CD20 antibody (rituximab)[J]. J Am Acad Dermatol, 2004, 51(5):817-819.
[22] Mamelak AJ, Eid MP, Cohen BA, et al.Rituximab therapy in severe juvenile pemphigus vulgaris[J]. Cutis, 2007, 80(4):335-340.
[23] Reguiai Z, Tabary T, Maizières M, et al.Rituximab treatment of severepemphigus: long-term results inclu-ding immunologic follow-up[J]. J Am Acad Derma-tol, 2012, 67(4):623-629.
[24] Ahmed AR, Shetty S.A comprehensive analysis of treatment outcomes in patients with pemphigus vul-garis treated with rituximab[J]. Autoimmun Rev, 2015, 14(4):323-331.
[25] Vinay K, Kanwar AJ, Mittal A, et al.Intralesional rituximab in the treatment of refractory oral pemphi-gus vulgaris[J]. JAMA Dermatol, 2015, 151(8):878-882.
[26] Ruocco E, Wolf R, Ruocco V, et al.Pemphigus: as-sociations and management guidelines: facts and con-troversies[J]. Clin Dermatol, 2013, 31(4):382-390.
[27] Feliciani C, Toto P, Amerio P, et al.In vitro and in vivo expression of interleukin-1α and tumor necrosis fac-tor-α mRNA in pemphigus vulgaris: interleukin-1α and tumor necrosis factor-α are involved in acantho-lysis[J]. J Invest Dermatol, 2000, 114(1):71-77.
[28] Mao X, Payne AS.Seeking approval: present and fu-ture therapies for pemphigus vulgaris[J]. Curr Opin Investig Drugs, 2008, 9(5):497-504.
[29] Hall RP 3rd, Fairley J, Woodley D, et al. A multicen-tre randomized trial of the treatment of patients with-pemphigus vulgaris with infliximab and prednisone compared with prednisone alone[J]. Br J Dermatol, 2015, 172(3):760-768.
[30] Pardo J, Mercader P, Mahiques L, et al.Infliximab in the management of severe pemphigus vulgaris[J]. Br J Dermatol, 2005, 153(1):222-223.
[31] Berookhim B, Fischer HD, Weinberg JM.Treatment of recalcitrant pemphigus vulgaris with the tumor necrosis factor alpha antagonist etanercept[J]. Cutis, 2004, 74(4):245-247.
[32] Shetty A, Marcum CB, Glass LF, et al.Successful treatment of pemphigus vulgaris with etanercept in four patients[J]. J Drugs Dermatol, 2009, 8(10):940-943.
[33] Fiorentino DF, Garcia MS, Rehmus W, et al.A pilot study of etanercept treatment for pemphigus vulgaris[J]. Arch Dermatol, 2011, 147(1):117-118.
[34] Sandborn WJ.State-of-the-art: immunosuppression and biologic therapy[J]. Dig Dis, 2010, 28(3):536-542.
[35] Sinha AA, Hoffman MB, Janicke EC.Pemphigus vul-garis: approach to treatment[J]. Eur J Dermatol, 2015, 25(2):103-113.
[36] Heaphy MR, Albrecht J, Werth VP.Dapsone as a glu-cocorticoid-sparing agent in maintenance-phase pem-phigus vulgaris[J]. Arch Dermatol, 2005, 141(6):699-702.
[37] Wolf R, Matz H, Orion E, et al.Dapsone[J]. Derma-tol Online J, 2002, 8(1):2.
[38] McCarty M, Fivenson D. Two decades of using the combination of tetracycline derivatives and niacina-mide as steroid-sparing agents in the management of pemphigus: defining a niche for these low toxicity agents[J]. J Am Acad Dermatol, 2014, 71(3):475-479.
[39] Martin TA, Jiang WG.Anti-cancer agents in medici-nal chemistry (formerlycurrent medicinal chemistry-anti-cancer agents)[J]. Anticancer Agents Med Chem, 2010, 10(1):1.
[40] Harman KE, Albert S, Black MM, et al.Guidelines for the management of pemphigus vulgaris[J]. Br J Dermatol, 2003, 149(5):926-937.
[41] Calebotta A, Sáenz AM, González F, et al.Pemphigus vulgaris: benefits of tetracycline as adjuvant therapy in a series of thirteen patients[J]. Int J Dermatol, 1999, 38(3):217-221.
[42] Chaffins ML, Collison D, Fivenson DP.Treatment of pemphigus and linear IgA dermatosis with nicotina-mide and tetracycline: a review of 13 cases[J]. J Am Acad Dermatol, 1993, 28(6):998-1000.
[43] Pandya AG, Dyke C.Treatment of pemphigus with gold[J]. Arch Dermatol, 1998, 134(9):1104-1107.
[44] Iranzo P, Alsina MM, Martínez-De Pablo I, et al. Gold: an old drug still working in refractory pemphigus[J]. J Eur Acad Dermatol Venereol, 2007, 21(7):902-907.
[45] Bystryn JC, Steinman NM.The adjuvant therapy of pemphigus. An update[J]. Arch Dermatol, 1996, 132(2):203-212.
[46] el-Darouti M, Marzouk S, Abdel Hay R, et al. The use of sulfasalazine and pentoxifylline (low-cost antitumour necrosis factor drugs) as adjuvant therapy for the treatment of pemphigus vulgaris: a compara-tive study[J]. Br J Dermatol, 2009, 161(2):313-319.
[47] Hymes SR, Jordon RE.Pemphigus foliaceus. Use of antimalarial agents asadjuvant therapy[J]. Arch Der-matol, 1992, 128(11):1462-1464.
[48] Ruocco V, Vitale O, Astarita C.Transient pemphigus induced by sunburn[J]. J Cutan Pathol, 1980, 7(6): 429-430.
[49] Aghassi D, Dover JS.Pemphigus foliaceus induced by psoralen-UV-A[J]. Arch Dermatol, 1998, 134(10): 1300-1301.
[50] Ghaffarpour G, Jalali MH, Yaghmaii B, et al.Chloro-quine/hydroxychloroquine-induced pemphigus[J]. Int J Dermatol, 2006, 45(10):1261-1263.
[51] Fardet L, Revuz J.Synthetic antimalarials[J]. Ann Dermatol Venereol, 2005, 132(8/9 Pt 1):665-674.
[52] Herrmann ML, Schleyerbach R, Kirschbaum BJ.Leflu-nomide: an immunomodulatory drug for the treatment of rheumatoid arthritis and other autoimmune diseases[J]. Immunopharmacology, 2000, 47(2/3):273-289.
[53] Valikhani M, Kavusi S, Chams-Davatchi C, et al.Impact of smoking on pemphigus[J]. Int J Dermatol, 2008, 47(6):567-570.
[54] Berkowitz P, Hu P, Liu Z, et al.Desmosome signaling. Inhibition of p38MAPK prevents pemphigus vulgaris IgG-induced cytoskeleton reorganization[J]. J Biol Chem, 2005, 280(25):23778-23784.
[55] Berkowitz P, Hu P, Warren S, et al.p38MAPK inhi-bition prevents disease in pemphigus vulgaris mice[J]. Proc Natl Acad Sci U S A, 2006, 103(34):12855-12860.
[56] Rook AH, Jegasothy BV, Heald P, et al.Extracorpo-real photochemotherapy for drug-resistant pemphigus vulgaris[J]. Ann Intern Med, 1990, 112(4):303-305.
[57] Liang G, Nahass G, Kerdel FA.Pemphigus vulgaris treated with photopheresis[J]. J Am Acad Dermatol, 1992, 26(5 Pt 1):779-780.
[58] Gollnick HP, Owsianowski M, Taube KM, et al.Un-responsive severe generalized pemphigus vulgaris successfully controlled by extracorporeal photopheresis[J]. J Am Acad Dermatol, 1993, 28(1):122-124.
[59] Wollina U, Lange D, Looks A.Short-time extracor-poreal photochemotherapy in the treatment of drug-resistant autoimmune bullous diseases[J]. Dermato-logy, 1999, 198(2):140-144.
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