Paradoxical phenomena of bullous pemphigoid induced and treated by identical biologics
ObjectiveThis study aimed to investigate the clinical features of biologics-induced bullous pemphigoid (BP) and the therapeutic effects of those agents for BP, exploring the underlying pathophysiological mechanisms.MethodsWe searched PubMed, Web of Science, and Elsevier for studies involving pemphig...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2023-01-01
|
| Series: | Frontiers in Immunology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2022.1050373/full |
| _version_ | 1797960468793393152 |
|---|---|
| author | Jie Zhang Si-Hang Wang Ya-Gang Zuo |
| author_facet | Jie Zhang Si-Hang Wang Ya-Gang Zuo |
| author_sort | Jie Zhang |
| collection | DOAJ |
| description | ObjectiveThis study aimed to investigate the clinical features of biologics-induced bullous pemphigoid (BP) and the therapeutic effects of those agents for BP, exploring the underlying pathophysiological mechanisms.MethodsWe searched PubMed, Web of Science, and Elsevier for studies involving pemphigoid patients treated with or induced by identical biologics published in English from January 2009 to April 2022.ResultsSeventeen cases of drug-induced BP associated with anti-tumor necrosis factor (aTNF)-α therapies, one with interleukin (IL)-17 inhibitors, and seven with IL-12/IL-23 or IL-23 inhibitors were enrolled. Time to cutaneous toxicity varied among different types of agents, and the characteristics of clinical examinations were similar to idiopathic BP. Discontinuation of the culprit drugs and initiation of topical or systemic corticosteroids were adequate in most cases. Several monoclonal antibodies above have also been reported for the treatment of refractory or recurrent BP, especially concurrent with psoriasis.ConclusionBiologics for immune-related diseases, including TNF-α, IL-17, and IL-12/IL-23 or IL-23 inhibitors, can both induce and treat BP, which might be associated with a helper T cells Th1/Th2 imbalance, complicated inflammatory networks, and a specific individual microenvironment, suggestive of a new perspective on the therapeutic algorithms of BP. There have been numerous reports about biologics inducing or treating BP. We have taken note of this phenomenon and focused on biologics with both pathogenetic and therapeutic effects on BP. Our review summarized the clinical characteristics of associated cases, trying to figure out the underlying mechanisms of this paradoxical phenomenon and to provide an integrated perspective and new therapeutic alternatives for BP. |
| first_indexed | 2024-04-11T00:45:26Z |
| format | Article |
| id | doaj.art-2711118c06c544cb943dad516f7efa61 |
| institution | Directory Open Access Journal |
| issn | 1664-3224 |
| language | English |
| last_indexed | 2024-04-11T00:45:26Z |
| publishDate | 2023-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Immunology |
| spelling | doaj.art-2711118c06c544cb943dad516f7efa612023-01-05T15:20:34ZengFrontiers Media S.A.Frontiers in Immunology1664-32242023-01-011310.3389/fimmu.2022.10503731050373Paradoxical phenomena of bullous pemphigoid induced and treated by identical biologicsJie ZhangSi-Hang WangYa-Gang ZuoObjectiveThis study aimed to investigate the clinical features of biologics-induced bullous pemphigoid (BP) and the therapeutic effects of those agents for BP, exploring the underlying pathophysiological mechanisms.MethodsWe searched PubMed, Web of Science, and Elsevier for studies involving pemphigoid patients treated with or induced by identical biologics published in English from January 2009 to April 2022.ResultsSeventeen cases of drug-induced BP associated with anti-tumor necrosis factor (aTNF)-α therapies, one with interleukin (IL)-17 inhibitors, and seven with IL-12/IL-23 or IL-23 inhibitors were enrolled. Time to cutaneous toxicity varied among different types of agents, and the characteristics of clinical examinations were similar to idiopathic BP. Discontinuation of the culprit drugs and initiation of topical or systemic corticosteroids were adequate in most cases. Several monoclonal antibodies above have also been reported for the treatment of refractory or recurrent BP, especially concurrent with psoriasis.ConclusionBiologics for immune-related diseases, including TNF-α, IL-17, and IL-12/IL-23 or IL-23 inhibitors, can both induce and treat BP, which might be associated with a helper T cells Th1/Th2 imbalance, complicated inflammatory networks, and a specific individual microenvironment, suggestive of a new perspective on the therapeutic algorithms of BP. There have been numerous reports about biologics inducing or treating BP. We have taken note of this phenomenon and focused on biologics with both pathogenetic and therapeutic effects on BP. Our review summarized the clinical characteristics of associated cases, trying to figure out the underlying mechanisms of this paradoxical phenomenon and to provide an integrated perspective and new therapeutic alternatives for BP.https://www.frontiersin.org/articles/10.3389/fimmu.2022.1050373/fullbullous pemphigoidTNF-α inhibitorIL-17 inhibitorIL12/IL23 inhibitorparadoxical phenomena |
| spellingShingle | Jie Zhang Si-Hang Wang Ya-Gang Zuo Paradoxical phenomena of bullous pemphigoid induced and treated by identical biologics Frontiers in Immunology bullous pemphigoid TNF-α inhibitor IL-17 inhibitor IL12/IL23 inhibitor paradoxical phenomena |
| title | Paradoxical phenomena of bullous pemphigoid induced and treated by identical biologics |
| title_full | Paradoxical phenomena of bullous pemphigoid induced and treated by identical biologics |
| title_fullStr | Paradoxical phenomena of bullous pemphigoid induced and treated by identical biologics |
| title_full_unstemmed | Paradoxical phenomena of bullous pemphigoid induced and treated by identical biologics |
| title_short | Paradoxical phenomena of bullous pemphigoid induced and treated by identical biologics |
| title_sort | paradoxical phenomena of bullous pemphigoid induced and treated by identical biologics |
| topic | bullous pemphigoid TNF-α inhibitor IL-17 inhibitor IL12/IL23 inhibitor paradoxical phenomena |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2022.1050373/full |
| work_keys_str_mv | AT jiezhang paradoxicalphenomenaofbullouspemphigoidinducedandtreatedbyidenticalbiologics AT sihangwang paradoxicalphenomenaofbullouspemphigoidinducedandtreatedbyidenticalbiologics AT yagangzuo paradoxicalphenomenaofbullouspemphigoidinducedandtreatedbyidenticalbiologics |