Inter J Stomatol ›› 2018, Vol. 45 ›› Issue (2): 155-161.doi: 10.7518/gjkq.2018.02.007

• Oral Medicine • Previous Articles     Next Articles

Immunosuppressive adjuvant therapy for pemphigus

Yao Yihuan, Wang Jiongke, Zhao Kui, Shi Yujie, 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:2017-07-31 Revised:2017-12-04 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).

Abstract: Pemphigus is a severe, chronic, autoimmune bullous disease that affects the skin and mucous membranes. To date, glucocorticoidis the first treatment medicine for pemphigus. Nevertheless, the use of glucocorticoid may result in adverse effects during treatment of this disease. Therefore, several immunosuppressive adjuvant therapies or non-medicinal therapies should be adopted to relieve the side effects of glucocorticoid. Thus, we reviewed the immunosuppressive therapy in this article.

Key words: pemphigus, immunosuppressants, therapy

CLC Number: 

  • R781.5+9

TrendMD: 
[1] Bystryn JC.Adjuvant therapy of pemphigus[J]. Arch Dermatol, 1984, 120(7):941-951.
[2] 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 pemphigus[J]. Foreign Med Sci: Stomatol, 2004, 31(6):478-480.
[3] Rosenberg FR, Sanders S, Nelson CT.Pemphigus: a 20-year review of 107 patients treated with cortico-steroids[J]. Arch Dermatol, 1976, 112(7):962-970.
[4] 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.
[5] Meurer M.Immunosuppressive therapy for autoim-mune bullous diseases[J]. Clin Dermatol, 2012, 30(1):78-83.
[6] Sandborn WJ.State-of-the-art: immunosuppression and biologic therapy[J]. Dig Dis, 2010, 28(3):536-542.
[7] Anstey AV, Wakelin S, Reynolds NJ, et al.Guidelines for prescribing azathioprine in dermatology[J]. Br J Dermatol, 2004, 151(6):1123-1132.
[8] Weinshilboum RM, Sladek SL.Mercaptopurine phar-macogenetics: monogenic inheritance of erythrocyte thiopurine methyltransferase activity[J]. Am J Hum Genet, 1980, 32(5):651-662.
[9] Hertl M, Jedlickova H, Karpati S, et al.Pemphigus. S2 guideline for diagnosis and treatment—guided by the European Dermatology Forum (EDF) in co-operation with the European Academy of Dermato-logy and Venereology (EADV)[J]. J Eur Acad Der-matol Venereol, 2015, 29(3):405-414.
[10] 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.
[11] Chams-Davatchi C, Esmaili N, Daneshpazhooh M, et al.Randomized controlled open-label trial of four treatment regimens for pemphigus vulgaris[J]. J Am Acad Dermatol, 2007, 57(4):622-628.
[12] Esmaili N, Chams-Davatchi C, Valikhani M, et al.Assessment of the therapeutic benefit of oral predni-solone and common adjuvant therapy in stage Ⅱ of randomized controlled trial study for management of pemphigus vulgaris[J]. Arch Iran Med, 2014, 17(9): 626-628.
[13] Chams-Davatchi C, Mortazavizadeh A, Daneshpa-zhooh M, et al. Randomized double blind trial of pre-dnisolone and azathioprine, vs. prednisolone and placebo, in the treatment of pemphigus vulgaris[J]. J Eur Acad Dermatol Venereol, 2013, 27(10):1285-1292.
[14] Aberer W, Wolff-Schreiner EC, Stingl G, et al.Aza-thioprine in the treatment of pemphigus vulgaris. A long-term follow-up[J]. J Am Acad Dermatol, 1987, 16(3 Pt 1):527-533.
[15] Younger IR, Harris DW, Colver GB.Azathioprine in dermatology[J]. J Am Acad Dermatol, 1991,25(2 Pt 1):281-286.
[16] Doukaki S, Pistone G, Aricò M, et al.Pharmacoki-netic evaluation of mycophenolate mofetil for pem-phigus[J]. Expert Opin Drug Metab Toxicol, 2011, 7(2):237-244.
[17] Doukaki S, Platamone A, Alaimo R, et al.Mycophe-nolate mofetil and enteric-coated mycophenolate sodium in the treatment of pemphigus vulgaris and pemphigus foliaceus[J]. J Dermatolog Treat, 2015, 26(1):67-72.
[18] Beissert S, Werfel T, Frieling U, et al.A comparison of oral methylprednisolone plus azathioprine or myco-phenolate mofetil for the treatment of pemphigus[J]. Arch Dermatol, 2006, 142(11):1447-1454.
[19] Beissert S, Mimouni D, Kanwar AJ, et al.Treating pemphigus vulgaris with prednisone and mycophe-nolate mofetil: a multicenter, randomized, placebo-controlled trial[J]. J Invest Dermatol, 2010, 130(8): 2041-2048.
[20] Ioannides D, Apalla Z, Lazaridou E, et al.Evaluation of mycophenolate mofetil as a steroid-sparing agent in pemphigus: a randomized, prospective study[J]. J Eur Acad Dermatol Venereol, 2012, 26(7):855-860.
[21] Fleming RA.An overview of cyclophosphamide and ifosfamide pharmacology[J]. Pharmacotherapy, 1997, 17(5 Pt 2):146S-154S.
[22] Sharma VK, Khandpur S.Evaluation of cyclophos-phamide pulse therapy as an adjuvant to oral cortico-steroid in the management of pemphigus vulgaris[J]. Clin Exp Dermatol, 2013, 38(6):659-664.
[23] Rose E, Wever S, Zilliken D, et al.Intravenous dexa-methasone-cyclophosphamide pulse therapy in com-parison with oral methylprednisolone-azathioprine therapy in patients with pemphigus: results of a mul-ticenter prospectively randomized study[J]. J Dtsch Dermatol Ges, 2005, 3(3):200-206.
[24] Sethy PK, Khandpur S, Sharma VK.Randomized open comparative trial of dexamethasone-cyclopho-sphamide pulse and daily oral cyclophosphamide versus cyclophosphamide pulse and daily oral pred-nisolone in pemphigus vulgaris[J]. Indian J Dermatol Venereol Leprol, 2009, 75(5):476-482.
[25] Talar-Williams C, Hijazi YM, Walther MM, et al.Cyclophosphamide-induced cystitis and bladder cancer in patients with Wegener granulomatosis[J]. Ann Intern Med, 1996, 124(5):477-484.
[26] Cummins DL, Mimouni D, Anhalt GJ, et al.Oral cyc-lophosphamide for treatment of pemphigus vulgaris and foliaceus[J]. J Am Acad Dermatol, 2003, 49(2): 276-280.
[27] Damiano S, Ciarcia R, Montagnaro S, et al.Prevention of nephrotoxicity induced by cyclosporine-A: role of antioxidants[J]. J Cell Biochem, 2015, 116(3):364-369.
[28] Lapidoth M, David M, Ben-Amitai D, et al.The effi-cacy of combined treatment with prednisone and cyc-losporine in patients with pemphigus: preliminary study[J]. J Am Acad Dermatol, 1994, 30(5 Pt 1):752-757.
[29] Mobini N, Padilla T Jr, Ahmed AR.Long-term re-mission in selected patients with pemphigus vulgaris treated with cyclosporine[J]. J Am Acad Dermatol, 1997, 36(2 Pt 1):264-266.
[30] Ioannides D, Chrysomallis F, Bystryn JC.Ineffec-tiveness of cyclosporine as an adjuvant to cortico-steroids in the treatment of pemphigus[J]. Arch Der-matol, 2000, 136(7):868-872.
[31] Genestier L, Paillot R, Quemeneur L, et al.Mecha-nisms of action of methotrexate[J]. Immunopharma-cology, 2000, 47(2/3):247-257.
[32] Gürcan HM, Ahmed AR.Analysis of current data on the use of methotrexate in the treatment of pemphigus and pemphigoid[J]. Br J Dermatol, 2009, 161(4): 723-731.
[33] Tran KD, Wolverton JE, Soter NA.Methotrexate in the treatment of pemphigus vulgaris: experience in 23 patients[J]. Br J Dermatol, 2013, 169(4):916-921.
[34] Harman KE, Albert S, Black MM, et al.Guidelines for the management of pemphigus vulgaris[J]. Br J Dermatol, 2003, 149(5):926-937.
[35] Cronstein BN.Low-dose methotrexate: a mainstay in the treatment of rheumatoid arthritis[J]. Pharmacol Rev, 2005, 57(2):163-172.
[36] Shah N, Green AR, Elgart GW, et al.The use of chlo-rambucil with prednisone in the treatment of pem-phigus[J]. J Am Acad Dermatol, 2000, 42(1 Pt 1): 85-88.
[37] Sugita K, Hirokawa H, Izu K, et al.D-penicillamine-induced pemphigus successfully treated with combi-nation therapy of mizoribine and prednisolone[J]. J Dermatolog Treat, 2004, 15(4):214-217.
[38] Turka LA, Dayton J, Sinclair G, et al.Guanine ribo-nucleotide depletion inhibits T cell activation. Me-chanism of action of the immunosuppressive drug mizoribine[J]. J Clin Invest, 1991, 87(3):940-948.
[39] Dastgheib L, Sadati MS, Baghernejhad M.Assess-ment of the adjuvant effect of tacrolimus in the ma-nagement of pemphigus vulgaris: a randomized con-trolled trial[J]. J Dermatolog Treat, 2015, 26(1):90-93.
[40] Büsing V, Kern JS, Bruckner-Tuderman L, et al.Re-calcitrant pemphigus vulgaris responding to systemic tacrolimus[J]. Dermatology, 2010, 221(2):122-126.
[41] Cohen SN, Lim RP, Paul CJ, et al.Equal efficacy of topical tacrolimus and clobetasone butyrate in pem-phigus foliaceus[J]. Int J Dermatol, 2006, 45(11): 1379.
[1] Mao Qirong,Yin Heng,Li Jingtao. Progress in the management of marginal velopharyngeal incompetence [J]. Int J Stomatol, 2024, 51(1): 116-124.
[2] Liu Shiyi, Chen Zhong, Zhang Suxin. Progress in research into programmed death-1/programmed death-ligand 1 immunotherapy strategies in human papillomavirus-positive head and neck squamous cell carcinoma [J]. Int J Stomatol, 2024, 51(1): 21-27.
[3] He Zimu, Li Fenglan. Present application of digital oral positioning stents in radiotherapy of head and neck tumor [J]. Int J Stomatol, 2024, 51(1): 28-35.
[4] Fu Yu, He Wei, Huang Lan. Ferroptosis and its implication in oral diseases [J]. Int J Stomatol, 2024, 51(1): 36-44.
[5] Yang Dongye,Zhu Ping,Wu Shuyi. The influencing factors and clinical significance of tongue position [J]. Int J Stomatol, 2023, 50(6): 723-728.
[6] Song Wenpeng,Gong Beiwen,Li Dan,Zeng Jianyu,Qiu Lingling. Research progress on the application of mechanotherapy in orthodontic treatment [J]. Int J Stomatol, 2023, 50(5): 603-612.
[7] Fan Lin,Sun Jiang.. Application of microneedles in stomatology [J]. Int J Stomatol, 2023, 50(4): 472-478.
[8] Wang Mudan,Song Dongzhe,Huang Dingming.. Research progress on fracture resistance of endodontically treated teeth with different endodontic access cavities [J]. Int J Stomatol, 2023, 50(2): 186-194.
[9] Li Tan,Liang Xin-hua.. Role of discoidin domain receptor 1 in the regulation of malignant tumor progression and therapy [J]. Int J Stomatol, 2023, 50(2): 230-236.
[10] Yang Mingyan,Zhang Fan,Zhao Lei. Research progress on oral flora changes affecting the course of radiotherapy and chemotherapy-related oral mucositis [J]. Int J Stomatol, 2023, 50(1): 43-51.
[11] Zhou Can,Zeng Qian,Wei Xi.. Prospects for the application of concentrated growth factor in vital pulp therapy [J]. Int J Stomatol, 2022, 49(6): 684-689.
[12] Li Zhouchi,Ye Ling,Wang Chenglin.. Oral diagnosis and treatment strategies for patients with gag reflex sensitivity [J]. Int J Stomatol, 2022, 49(6): 690-698.
[13] Chen Xiaoli,Zhang Fan,Liu Chengcheng. Application progress on photobiomodulation in the prevention and treatment of oral complications after radiothe-rapy [J]. Int J Stomatol, 2022, 49(6): 707-716.
[14] Li Hongfang,Chen Zhong,Zhang Suxin.. Research progress on immune checkpoint inhibitor combined with radiotherapy in head and neck squamous cell carcinoma [J]. Int J Stomatol, 2022, 49(5): 614-620.
[15] Zhao Zhihe.. Difficulty assessment of invisible orthodontic treatment based on treatment plan and tooth movement pattern [J]. Int J Stomatol, 2022, 49(4): 373-379.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
[1] . [J]. Foreign Med Sci: Stomatol, 1999, 26(06): .
[2] . [J]. Foreign Med Sci: Stomatol, 1999, 26(06): .
[3] . [J]. Foreign Med Sci: Stomatol, 1999, 26(06): .
[4] . [J]. Foreign Med Sci: Stomatol, 1999, 26(06): .
[5] . [J]. Foreign Med Sci: Stomatol, 1999, 26(05): .
[6] . [J]. Foreign Med Sci: Stomatol, 1999, 26(05): .
[7] . [J]. Foreign Med Sci: Stomatol, 1999, 26(04): .
[8] . [J]. Foreign Med Sci: Stomatol, 1999, 26(04): .
[9] . [J]. Foreign Med Sci: Stomatol, 2004, 31(02): 126 -128 .
[10] . [J]. Inter J Stomatol, 2008, 35(S1): .