利妥昔单抗治疗顽固性大疱性皮肤病
Rituximab therapy of recalcitrant bullous dermatoses.
作者信息
Wollina Uwe, Koch André, Hansel Gesina
机构信息
Department of Dermatology and Allergology, Hospital Dresden-Friedrichstadt, Academic Teaching Hospital of the Technical University of Dresden, Friedrichstrasse 41, 01067 Dresden, Germany.
出版信息
J Dermatol Case Rep. 2008 Mar 29;2(1):4-7. doi: 10.3315/jdcr.2008.1007.
BACKGROUND
Rituximab is a monoclonal antibody directed against CD20 cell surface antigen of B-lymphocytes. Recent studies have demonstrated effectivity in recalcitrant bullous pemphigoid. The data available on other types of autoimmune bullous disease is more scant.
MAIN OBSERVATION
Here we report on the successful adjuvant use of rituximab in mucous membrane pemphigoid and pemphigus vulgaris in two patients with the most refractory course of disease. Both patients achieved a good clinical response.
CONCLUSIONS
Rituximab is a third line treatment of patients with pemphigus vulgaris and mucous membrane pemphigoid. In contrast to bullous pemphigoid, other bullous diseases do not always respond to a monotherapy with this monoclonal antibody. Nevertheless, biological therapy seems to work faster than established treatment in such cases. Risks and benefits of the treatment are discussed.
背景
利妥昔单抗是一种针对B淋巴细胞CD20细胞表面抗原的单克隆抗体。近期研究已证明其对顽固性大疱性类天疱疮有效。关于其他类型自身免疫性大疱性疾病的可用数据则更为稀少。
主要观察结果
在此，我们报告了利妥昔单抗在两名疾病病程最为难治的黏膜类天疱疮和寻常型天疱疮患者中成功作为辅助治疗的应用情况。两名患者均取得了良好的临床反应。
结论
利妥昔单抗是寻常型天疱疮和黏膜类天疱疮患者的三线治疗药物。与大疱性类天疱疮不同，其他大疱性疾病并不总是对这种单克隆抗体单一疗法有反应。然而，在这类病例中，生物疗法似乎比既定治疗起效更快。文中讨论了该治疗的风险和益处。
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