Advancing Treatment in Bullous Pemphigoid: A Comprehensive Review of Novel Therapeutic Targets and Approaches.

IF 8.4 2区 医学 Q1 ALLERGY
Clinical Reviews in Allergy & Immunology Pub Date : 2023-12-01 Epub Date: 2023-10-28 DOI:10.1007/s12016-023-08973-1
Hsuan-Chi Chen, Chuang-Wei Wang, Wu Han Toh, Hua-En Lee, Wen-Hung Chung, Chun-Bing Chen
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引用次数: 0

Abstract

Bullous pemphigoid is one of the most common autoimmune bullous diseases occurring primarily in the elderly. Pathogenic autoantibodies against BP180 and BP230 at the dermal-epidermal junction cause subepidermal blisters, erosions, and intense pruritus, all of which adversely affect the patients' quality of life and may increase their morbidity and mortality. Current systemic treatment options for bullous pemphigoid are limited to corticosteroids and immunosuppressants, which can have substantial side effects on these vulnerable patients that even exceed their therapeutic benefits. Therefore, more precisely, targeting therapies to the pathogenic cells and molecules in bullous pemphigoid is an urgent issue. In this review, we describe the pathophysiology of bullous pemphigoid, focusing on autoantibodies, complements, eosinophils, neutrophils, proteases, and the T helper 2 and 17 axes since they are crucial in promoting proinflammatory environments. We also highlight the emerging therapeutic targets for bullous pemphigoid and their latest discoveries in clinical trials or experimental studies. Further well-designed studies are required to establish the efficacy and safety of these prospective therapeutic options.

Abstract Image

大疱性类天疱疮治疗进展:新的治疗靶点和方法综述。
大疱性类天疱疮是最常见的自身免疫性大疱性疾病之一,主要发生在老年人身上。真皮-表皮交界处的针对BP180和BP230的致病性自身抗体会导致皮下水泡、糜烂和严重瘙痒,所有这些都会对患者的生活质量产生不利影响,并可能增加其发病率和死亡率。目前大疱性类天疱疮的全身治疗选择仅限于皮质类固醇和免疫抑制剂,这可能对这些易受感染的患者产生严重的副作用,甚至超过其治疗益处。因此,更准确地说,靶向治疗大疱性类天疱疮的致病细胞和分子是一个紧迫的问题。在这篇综述中,我们描述了大疱性类天疱疮的病理生理学,重点关注自身抗体、补体、嗜酸性粒细胞、中性粒细胞、蛋白酶以及辅助T细胞2和17轴,因为它们在促进促炎环境中至关重要。我们还强调了大疱性类天疱疮的新治疗靶点及其在临床试验或实验研究中的最新发现。需要进一步精心设计的研究来确定这些前瞻性治疗方案的有效性和安全性。
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来源期刊
CiteScore
22.30
自引率
1.10%
发文量
58
审稿时长
6-12 weeks
期刊介绍: Clinical Reviews in Allergy & Immunology is a scholarly journal that focuses on the advancement of clinical management in allergic and immunologic diseases. The journal publishes both scholarly reviews and experimental papers that address the current state of managing these diseases, placing new data into perspective. Each issue of the journal is dedicated to a specific theme of critical importance to allergists and immunologists, aiming to provide a comprehensive understanding of the subject matter for a wide readership. The journal is particularly helpful in explaining how novel data impacts clinical management, along with advancements such as standardized protocols for allergy skin testing and challenge procedures, as well as improved understanding of cell biology. Ultimately, the journal aims to contribute to the improvement of care and management for patients with immune-mediated diseases.
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