Department of Dermatology, University of Muenster, Von-Esmarch-Str. 58, D-48149 Muenster, Germany.
Immunol Allergy Clin North Am. 2012 May;32(2):295-307, vii-viii. doi: 10.1016/j.iac.2012.04.009.
Although there are no standard guidelines for the treatment of autoimmune blistering diseases, azathioprine has shown good efficacy in acquired autoimmune blistering diseases, and is well tolerated. Side effects of azathioprine normally occur in mild variants. Severe reactions are due to reduced thiopurine S-methyltransferase (TPMT) or inosine triphosphate pyrophosphohydrolase (ITPA) activity. Therefore, screening for TPMT activity should be conducted in white patients and Africans, whereas Japanese should be screened for ITPA activity before therapy with azathioprine is started. Azathioprine is clinically meaningful for the treatment of pemphigus.
尽管目前对于自身免疫性疱病尚无标准治疗指南，但巯嘌呤在获得性自身免疫性疱病中的疗效较好，且具有良好的耐受性。巯嘌呤的副作用通常为轻度变异。严重反应是由于硫嘌呤 S-甲基转移酶（TPMT）或肌苷三磷酸焦磷酸水解酶（ITPA）活性降低所致。因此，应在白种人和非洲人患者中进行 TPMT 活性筛查，而日本人在开始使用巯嘌呤治疗前应筛查 ITPA 活性。巯嘌呤对于治疗天疱疮具有重要的临床意义。
