Witte Mareike, Koga Hiroshi, Hashimoto Takashi, Ludwig Ralf J, Bieber Katja
a Lübeck Institute of Experimental Dermatology (LIED) , University of Lübeck , Lübeck , Germany.
b Institute of Cutaneous Cell Biology , Kurume University , Kurume , Japan.
Expert Opin Ther Targets. 2016 Aug;20(8):985-98. doi: 10.1517/14728222.2016.1148686. Epub 2016 Feb 19.
Epidermolysis bullosa acquisita (EBA) is a chronic autoimmune bullous dermatosis (AIBD). Treatment of EBA is challenging and mostly relies on systemic immunosuppression. During the last decade, intensive research led to the identification of new potential therapeutic targets that interfere in different phases of disease progression. Therapeutic interventions acting upon these candidate drug targets in animal models of EBA, such as cytokine-modulating biologics and small molecules, have validated them as potential new therapeutic strategies for EBA patients.
In this paper, we review the current treatments for EBA, describe the pathogenesis of the disease, and finally specify new drug candidates for the development of a more specific therapy with minimized side-effects for EBA and potentially other autoimmune diseases.
We currently understand EBA as a disease that evolves from the interplay of many different signaling pathways. These signaling pathways, which are described in this review, provide new targets for EBA treatment. The ultimate goal of this research field is the development of specific, pathogenesis-based therapeutic strategies. Through identification of up- or downregulated pathways that dominate disease progression in individual patients, we expect therapy in EBA to become more and more precise and move towards a patient-based therapy.
获得性大疱性表皮松解症(EBA)是一种慢性自身免疫性大疱性皮肤病(AIBD)。EBA的治疗具有挑战性,主要依赖于全身免疫抑制。在过去十年中,深入的研究导致了新的潜在治疗靶点的发现,这些靶点在疾病进展的不同阶段发挥作用。在EBA动物模型中作用于这些候选药物靶点的治疗干预措施,如细胞因子调节生物制剂和小分子,已证实它们是EBA患者潜在的新治疗策略。
在本文中,我们回顾了EBA的当前治疗方法,描述了该疾病的发病机制,最后确定了新的候选药物,以开发一种对EBA及可能的其他自身免疫性疾病副作用最小的更特异性治疗方法。
我们目前将EBA理解为一种由许多不同信号通路相互作用演变而来的疾病。本综述中描述的这些信号通路为EBA治疗提供了新的靶点。该研究领域的最终目标是开发基于发病机制的特异性治疗策略。通过识别在个体患者中主导疾病进展的上调或下调通路,我们期望EBA的治疗将变得越来越精确,并朝着基于患者的治疗方向发展。