自己免疫性水疱症に対する免疫吸着療法 : 免疫吸着療法とステロイドパルス療法を併用した天疱瘡治療(<特集>皮膚疾患とアフェレシス)

概要

論文の詳細を見る
Pemphigus is an autoimmune blistering skin disease usually treated with high-dose systemic corticosteroids and other immunosuppressants that may cause severe side effects. Anti-desmoglein antibodies play an essential part in the pathogenesis in pemphigus. Immunoadsorption also has been demonstrated to be of benefit in the treatment of pemphigus. The principle of extracorporeal immunoadsorption is based on affinity adsorption of pathogenic antibodies and circulating immune complexes which bind to an immobilized ligand of the absorber. We have treated 4 patients with pemphigus foliaceus and 1 patient with pemphigus vulgaris by the combination of corticosteroid pulse therapy and immunoadsorption. In 4 patients, a dramatic clinical improvement was seen after this combination therapy. We consider that the excellent therapic effect of this therapy depends on the direct removal of the anti-desmoglein antibodies by immunoadsorption and the suppression of inflammation and acantholysis by corticosteroid pulse therapy. We recommend this combination therapy as the initial therapy for pemphigus. We also report recent case studies of autoimmune blistering skin disease treated with immunoadsorption. Immunoadsorption may represent a therapeutic option for patients with autoimmune blistering skin disease.
日本アフェレシス学会の論文
2008-05-31