الفهرس 
PATHOGENESIS OF PEMPHIGUS VULGARISOnly 14 pages are availabe for public view
 |  | from | 341 |  |  |
| | | from | 341 | | |
Abstract
PV (PV) represents a potentially life threatening autoimmune blistering disease in
which pemphigus autoantibodies are targeted against pemphigus antigens. Tumor
necrosis factor (TNF) seems to have a crucial role in the production of blisters in PV, and
several studies have demonstrated in vitro acantholysis inhibition by anti-TNF-α
antibodies.
Aim of the work:
This comparative double blinded study was carried to estimate the use of both
sulfasalazine (SSZ) and pentoxiphylline (PTX) as an adjuvant therapy for PV. The
rationale of using SSZ and PTX is that they are cheap, effective anti TNF drugs and have
minimal side effects and interactions. The reason of the combined use of SSZ and PTX is
to produce synergistic effect as the two drugs have different modes of actions.
Patients and methods:
This study included 64 PV patients; 42 patients received the full regimen of
therapy (with SSZ and PTX) and 22 patients followed the same regimen of treatment
except that they received placebo instead of PTX and SSZ. Ten healthy subjects were
included as control. Serum samples were taken to measure TNF-α in the control group
and before starting treatment in all patients groups and this was repeated every 2 weeks
for 8 weeks and clinical assessment was made every week for all patients.
Results:
The level of TNF-α was statistically higher in both groups of patients than in
healthy individuals. There was a highly statistically significant decrease in the level of
TNF-α in patients taking full regimen (with PTX and SSZ) than in patients taking
placebo, regarding the 4th and 5th samples (P value was 0.000 and 0.000 respectively). There was also a significant clinical improvement in patients taking anti-TNF than in
patients not receiving anti-TNF (P value was 0.000).
Conclusion:
The synergistic use of PTX and SSZ as adjuvant therapy in treatment of PV gave
a faster and more significant decrease in the level of TNF-α, and that this decrease was
associated with rapid clinical improvement than in patients who did not receive anti TNF
in their treatment regimen.