Treatment of pemphigus with intravenous immunoglobulin

Pemphigus Vulgaris IgG and Methylprednisolone Exhibit Reciprocal Effects on Keratinocytes

“…Therefore, the results of phosphorylation experiments elucidate the role for protein phosphorylation in the signal transduction pathway mediating both the pro-acantholytic effects of PV IgG and the anti-acantholytic effects of MP. The fact that normal human IgG, just like MP, also decreased the level of phosphorylation of adhesion molecules may provide a novel mechanism that helps explain therapeutic activity of IVIg in patients with pemphigus (114,115).…”

Novel Mechanisms of Target Cell Death and Survival and of Therapeutic Action of IVIg in Pemphigus

“…15 More recently, determination of caspase 3 activity in the HaCaT culture treated with PVIgG has been proposed as a test for pathogenic activity of the autoantibodies. 16 It is now well established that intravenous immunoglobulin (IVIg) therapy is an effective treatment modality of PV, 17,18 but the mechanism of therapeutic action of IVIg has not been fully elucidated. The IVIg drug contains purified preparations of immunoglobulins from plasma of healthy human donors, containing predominantly polyclonal IgG, and various immunomodulatory contaminants.…”

“…The IVIg drug contains purified preparations of immunoglobulins from plasma of healthy human donors, containing predominantly polyclonal IgG, and various immunomodulatory contaminants. IVIg exhibits a plethora of biological effects, including acceleration of the clearance of autoantibod-ies, 18 modulation of serum levels of pro-inflammatory cytokines, 19 induction of immune-competent cell death, 20 and an array of anti-apoptotic effects. In addition to inactivation of lytically active Fas ligand (Fas-L) in patients' serum, 21 IVIg has been shown to protect target cells from apoptosis by up-regulating Bcl-2 expression, 22 interfering with the tumor necrosis factor-␣ (TNF-␣) 23 and interferon-␥ 24 signaling pathways, and increasing sensitivity to corticosteroid action.…”

Current Management of Pemphigus

“…Hasta serumunda bulunan ve pemfigusa yol açan antikorların seviyesini hızlı ve selektif olarak azaltmaktadır (25,26). Akut hastalık tedavisinde klasik tedaviye yanıt alınamamış hastalarda, kronik hastalık tedavisinde ise remisyonu sağlamak ve sistemik kortikosteroid dozunu relaps olmadan azaltmak için kullanılır.…”