Research review

Spanish, Jewish PV
has a single source?

In each issue of Recovery we review and summarize a few of the recently published research articles of interest to pemphigus and pemphigoid patients, as well as physicians treating these diseases.

Pemphigus

Certain genetic markers are known to exist for Jewish populations with pemphigus vulgaris. Using microsatellite markers (a short, repetitive DNA sequence), the research team found the same markers in non-Jewish patients in Spain. The report says, As Jews lived in Spain for hundreds of years, and many converted to Christianity, (the similarities) suggest Jewish and Spanish patients shared the same (source, genetic stock). The report was cited in Tissue Antigens in April 2004, from the Tel Aviv University in Tel Aviv, Israel. [Lead author Loewenthal R, Tissue Antigens. 2004 Apr;63(4):326-34.]

The first report of the recently identified variant of pemphigus, called IgA pemphigus, being successfully treated with mycophenolate mofetil (CellCept) was released by the Universitatskinikum Dusseldorf in Dusseldorf, Germany. The report was presented in the April 2004 issue of Hautarzt. [Lead author Burchards T, Hautarzt. 2004 Apr;55(4):387-9.]

A drug used to treat upper and lower staphylococci respiratory infections, including pneumonia ,tonsillitis and urinary tract infections, was reported to cause pemphigus vulgaris in a woman. Corticosteroids and systemic immunosuppressors controlled the disease. The report was released in February 2004 by the Universita degli Studi di Palermo, Palermo, Italy. [Minerva Stomatol. 2004 Feb;53(1):61-6.]

The Journal of Immunology reported in March 2004 a study of autoreactive Th cells that presumably regulate desmoglein 3-specific autoantibody production. Th cells are a subset of T cell lymphocytes (T refers to lymphocyte cells formed in the thymus) that play a significant role in the immune response. Desmoglein 3 autoanitibodies are antibodies that attack desmoglein 3. Autoantibodies against desmoglein 3 and 1 cause PV. T cell recognition of distinct desmoglein 3 peptides is restricted by distinct HLA class II molecules, and is independent from the development of pemphigus vulgaris. HLA refers to the human leukocyte antigen system, major histo-compatibility antigens (MHC), in humans. MHC molecules are on the surface of cells and T cell response to these antigens cause problems in organ transplants and certain autoimmune disease including pemphigus. [Lead author Veldman CM, J Immunol. 2004 Mar 15;172(6):3883-92.]

Pemphigoid

Scientists can now study bullous pemphigoid using mice. The mice develop the symptoms of BP when IgG (One of five types of immunoglobulins; the main antibody defense against bacteria) is transfered by administering rabbit BP antibodies. By using live mouse models several key cellular and molecular events leading to the bullous pemphigus disease phenotype were identified. (Phenotypes are the typical traits of an individual organism, either all or specific, such as eye color.) The phenotypes identified include IgG binding, complement activation, mast cell degranulation, and neutrophil infiltration and activation. [Author Liu Z, J Investig Dermatol Symp Proc. 2004 Jan;9(1):41-6.]

The aim of a study at the Institute for Immunology, Clinical Pathology and Molecular Medicine (IPM), Hamburg, Germany was to develop an ELISA system for the detection of circulating pemphighoid autoantibodies. ELISA is an acromym for Enzyme-Linked ImmunoSorbent Assay, a sensitive and highly specific method to detect specific antibodies. The ELISA test developed found a specific antibody in 63% of 56 BP patients sera (blood). An epitope (antigen binding point) was also identified. An antigen is a molecule that is recognized by the immune system as foreign or toxic and elicits an immune response. [Lead author Kromminga A, Clin Immunol. 2004 Apr;111(1):146-52.]

A nine-month old child developed bullous pemphigoid while being treated for eczema by a homeopathic doctor. The homeopath used a treatment regimen of sulfur, mercury, canhtharides and Rhus (Toxicodendron). As a result of this treatment the child suffered a worsening of her general health, dehydration and malnutrition.

According to the report from the Department of Dermatology, University Hospital, Geneva, Switzerland, While the role of homeopathy in triggering the disease remains unclear, our observation attests to the potential life-threatening course of childhood BP in instances where appropriate treatment is withheld. [Lead researcher Kuenzli S, Pediatr Dermatol. 2004 Mar-Apr;21(2):160-3.]

A study to suggest that ocular-cicatricial pemphigoid (OCP) and drug-induced ocular-cicatricial pemphigoid can be treated with low-dose methotrexate was reported in the journal Ophthalmology in April 2004. Seventeen patients with OCP (five with drug induced OCP) were studied. After a mean follow-up duration of 30.2 months (range, 6-78 months), complete control or suppression, or both, of conjunctival (the moist parts of the eye) inflammation was achieved in 89% of eyes with ocular-cicatricial pemphigoid and in 100% of eyes with drug-induced ocular-cicatricial pemphigoid using methotrexate monotherapy as the first-line systemic agent.

Progression of conjunctival cicatrization was prevented in 72% of eyes with OCP and 90% of eyes with drug-induced OCP. Visual acuity was maintained or improved in 85% of total eyes treated with methotrexate monotherapy, and a final visual acuity of 6/18 or better was achieved in 74% of the eyes. Methotrexate was generally well tolerated, but four stopped treatment due to side effects. The study was performed at the Department of Ophthalmology, St Vincents Hospital, Sydney, Australia. [Lead researcher McCluskey P, Ophthalmology. 2004 Apr;111(4):796-801.]

Return to news menu page