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静脉注射免疫球蛋白在黏膜类天疱疮治疗中的作用:文献综述

The role of intravenous immunoglobulin in treatment of mucous membrane pemphigoid: A review of literature.

作者信息

Tavakolpour Soheil

机构信息

Department of Dermatology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran; Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

J Res Med Sci. 2016 Jun 14;21:37. doi: 10.4103/1735-1995.183992. eCollection 2016.

DOI:10.4103/1735-1995.183992
PMID:27904583
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5122191/
Abstract

BACKGROUND

Mucous membrane pemphigoid (MMP) is considered an autoimmune blistering disease that predominantly affects mucous membranes. Various treatments are available for controlling the diseases, but not all of them may respond.

MATERIALS AND METHODS

PubMed and Google Scholar were searched for all the associated studies until 2015, using the keywords such as "cicatricial pemphigoid" or "ocular pemphigoid" or "mucous membrane pemphigoid" or "MMP" and "intravenous immunoglobulin" or "IVIg" to find all the relevant studies. The last search update was for September 2, 2015. Among the searched items, only English studies were included in the review.

RESULTS

After excluding nonrelevant studies, 13 studies with a total number of seventy patients with MMP who were under treatment with IVIg were analyzed. The 65 patients responded completely, one did not respond, two had partially responded, and the remaining two patients stopped IVIg therapy, which resulted in ocular cicatricial pemphigoid progression. Majority of the studies reported mild adverse effects while two of them did not report any unwanted side effect. The most common side effect was headache, followed by nausea. Most of the patients who had a cessation of IVIg therapy before achieving clinical remission experienced the disease progression.

CONCLUSION

Overall, it can be concluded that IVIg therapy was very helpful in treatment of MMP patients who did not respond to conventional therapy or stopped using them for various side effects. Adverse effects associated with IVIg therapy were considerably lower than conventional therapy that can lead toward treatment with this agent in patients who suffer from severe side effects.

摘要

背景

黏膜类天疱疮(MMP)被认为是一种主要累及黏膜的自身免疫性水疱病。有多种治疗方法可用于控制该病,但并非所有患者都会有反应。

材料与方法

检索了PubMed和谷歌学术中截至2015年的所有相关研究,使用了“瘢痕性类天疱疮”或“眼部类天疱疮”或“黏膜类天疱疮”或“MMP”以及“静脉注射免疫球蛋白”或“IVIg”等关键词来查找所有相关研究。最后一次检索更新时间为2015年9月2日。在所检索的文献中,纳入综述的仅为英文研究。

结果

排除不相关研究后,分析了13项研究,共有70例接受IVIg治疗的MMP患者。65例患者完全缓解,1例无反应,2例部分缓解,其余2例患者停止IVIg治疗,导致眼部瘢痕性类天疱疮进展。大多数研究报告了轻度不良反应,其中两项未报告任何不良副作用。最常见的副作用是头痛,其次是恶心。大多数在临床缓解前停止IVIg治疗的患者病情进展。

结论

总体而言,可以得出结论,IVIg治疗对那些对传统治疗无反应或因各种副作用而停止使用传统治疗的MMP患者非常有帮助。与IVIg治疗相关的不良反应明显低于传统治疗,这使得该药物可用于有严重副作用的患者。

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本文引用的文献

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Semin Oncol. 2002 Feb;29(1S2):2-9. doi: 10.1053/sonc.2002.30156.
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Dupilumab: a revolutionary emerging drug in atopic dermatitis and its possible role in pemphigus.度普利尤单抗:一种治疗特应性皮炎的革命性新药及其在天疱疮中的潜在作用。
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Interleukin 4 inhibition as a potential therapeutic in pemphigus.白细胞介素4抑制作为天疱疮的一种潜在治疗方法。
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Unilateral oral mucous membrane pemphigoid: refractory atypical presentation successfully treated with intravenous immunoglobulins.单侧口腔黏膜类天疱疮:静脉注射免疫球蛋白成功治疗难治性非典型表现
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Case report: passive transfer of hepatitis B antibodies from intravenous immunoglobulin.病例报告:静脉注射免疫球蛋白导致乙肝抗体的被动转移。
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