New insights into pyroptosis in pemphigus: from cellular structure to therapeutic targeting.

Background: Pemphigus is an autoimmune blistering disease where autoantibodies target desmoglein (Dsg) antigens on keratinocytes, triggering the p38 MAPK pathway, Dsg internalization, desmosomal dissolution, and keratinocyte apoptosis, are essential for blister formation. Recent research indicates keratinocyte pyroptosis may exacerbate acantholysis and delay wound healing. Current treatments, including corticosteroids and immunosuppressants, are effective but have significant side effects, such as prolonged wound healing and increased infection risk. Understanding these inflammatory processes is crucial for developing effective treatments for pemphigus.

Methods: The authors conducted a comprehensive review of the literature, analyzing recent findings regarding the upregulation of pyroptosis-related proteins in pemphigus.

Results: The present findings highlight a significant upregulation of pyroptosis-related proteins, which play a crucial role in the inflammatory response and blister formation characteristic of pemphigus. Key proteins such as cytokines IL-1β, IL-18, High Mobility Group Box-1 (HMGB1), and Parkin, along with NOD-like receptors and P2×7 receptors, were identified as pivotal in facilitating pyroptosis. The study also discusses potential therapeutic approaches targeting these proteins to modulate the disease pathway effectively.

Study limitations: This study aimed to investigate the role of pyroptosis in the pathogenesis of pemphigus, focusing on its potential as a novel therapeutic target.

Conclusions: Pyroptosis significantly contributes to the pathogenesis of pemphigus and presents a promising target for therapy. Targeting specific molecules involved in the pyroptosis pathway offers the potential for developing more precise and less toxic treatments, allowing the shift from traditional therapies towards targeted therapeutic strategies.