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ocular pemphigoid

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https://www.readbyqxmd.com/read/27904583/the-role-of-intravenous-immunoglobulin-in-treatment-of-mucous-membrane-pemphigoid-a-review-of-literature
#1
REVIEW
Soheil Tavakolpour
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...
2016: Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences
https://www.readbyqxmd.com/read/27760272/conjunctival-neutrophils-predict-progressive-scarring-in-ocular-mucous-membrane-pemphigoid
#2
Geraint P Williams, Peter Nightingale, Sue Southworth, Alastair K O Denniston, Paul J Tomlins, Stephen Turner, John Hamburger, Simon J Bowman, S John Curnow, Saaeha Rauz
Purpose: Ocular mucous membrane pemphigoid (OcMMP) is a rare autoimmune disorder resulting in progressive conjunctival fibrosis and ocular surface failure leading to sight loss in up to 50%. This study was designed to optimize an ocular surface sampling technique for identification of novel biomarkers associated with disease activity and/or progressive fibrosis. Methods: Fifty-seven patients with OcMMP underwent detailed examination of conjunctival inflammation and fibrosis using fornix depth measurement...
October 1, 2016: Investigative Ophthalmology & Visual Science
https://www.readbyqxmd.com/read/27717107/management-of-patients-with-ocular-manifestations-in-vesiculobullous-disorders-affecting-the-mouth
#3
REVIEW
M S Hansen, O N Klefter, H O Julian, A M Lynge Pedersen, S Heegaard
Pemphigoid and pemphigus diseases as well as Stevens-Johnson syndrome present as vesiculobullous disorders of the skin and may additionally involve both the oral cavity and the ocular surface. Ocular involvement ranges from mild irritation and dry eye disease to chronic conjunctivitis, symblepharon, eyelid malposition, ocular surface scarring and severe visual loss. In addition to diagnostic assessments, ophthalmologists must treat the dry eye and meibomian gland dysfunction components of these diseases using a stepladder approach, including eyelid hygiene and lubricants...
October 7, 2016: Oral Diseases
https://www.readbyqxmd.com/read/27699226/aldehyde-dehydrogenase-inhibition-blocks-mucosal-fibrosis-in-human-and-mouse-ocular-scarring
#4
Sarah D Ahadome, David J Abraham, Suryanarayana Rayapureddi, Valerie P Saw, Daniel R Saban, Virginia L Calder, Jill T Norman, Markella Ponticos, Julie T Daniels, John K Dart
Mucous membrane pemphigoid (MMP) is a systemic mucosal scarring disease, commonly causing blindness, for which there is no antifibrotic therapy. Aldehyde dehydrogenase family 1 (ALDH1) is upregulated in both ocular MMP (OMMP) conjunctiva and cultured fibroblasts. Application of the ALDH metabolite, retinoic acid (RA), to normal human conjunctival fibroblasts in vitro induced a diseased phenotype. Conversely, application of ALDH inhibitors, including disulfiram, to OMMP fibroblasts in vitro restored their functionality to that of normal controls...
August 4, 2016: JCI Insight
https://www.readbyqxmd.com/read/27661067/combined-use-of-rituximab-and-intravenous-immunoglobulin-for-severe-autoimmune-cicatricial-conjunctivitis-an-interventional-case-series
#5
Bernhard Steger, Savitha Madhusudan, Stephen B Kaye, Amira Stylianides, Vito Romano, Sundas E Maqsood, Janice Harper, Sajjad Ahmad
PURPOSE: Despite the availability of systemic immunosuppressants, cicatricial conjunctivitis (CC) remains a potentially blinding ocular surface disease. We aim to describe the combined use of rituximab (RTX) and intravenous immunoglobulin (IVIg) for severe recalcitrant autoimmune CC. METHODS: In this single-center retrospective interventional case series with follow-up between 32 and 65 months, 3 cases with mucous membrane pemphigoid (patients 1-3) and 1 case with linear IgA disease (patient 4) were included...
September 21, 2016: Cornea
https://www.readbyqxmd.com/read/27631412/-involvement-of-mucous-membranes-in-autoimmune-bullous-diseases
#6
C Günther
Autoimmune bullous diseases are characterized by intraepidermal or subepidermal autoantibody deposition that leads to blisters and secondary erosion. Mucous membranes are frequently affected in pemphigus vulgaris and always involved in cicatricial and mucosal pemphigoid. Mucosal lesions are detected less frequently in patients with bullous pemphigoid or epidermolysis bullosa acquisita. The diagnosis of autoimmune bullous disorders is based on determination of the subtype of autoantibodies bound in the skin and the clinical picture...
October 2016: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
https://www.readbyqxmd.com/read/27595139/classical-dendritic-cells-mediate-fibrosis-directly-via-the-retinoic-acid-pathway-in-severe-eye-allergy
#7
Sarah D Ahadome, Rose Mathew, Nancy J Reyes, Priyatham S Mettu, Scott W Cousins, Virginia L Calder, Daniel R Saban
Fibrosis is a shared end-stage pathway to lung, liver, and heart failure. In the ocular mucosa (conjunctiva), fibrosis leads to blindness in trachoma, pemphigoid, and allergy. The indirect fibrogenic role of DCs via T cell activation and inflammatory cell recruitment is well documented. However, here we demonstrate that DCs can directly induce fibrosis. In the mouse model of allergic eye disease (AED), classical CD11b(+) DCs in the ocular mucosa showed increased activity of aldehyde dehydrogenase (ALDH), the enzyme required for retinoic acid synthesis...
August 4, 2016: JCI Insight
https://www.readbyqxmd.com/read/27437791/repeat-conjunctival-biopsy-after-immunomodulatory-therapy-for-ocular-mucous-membrane-pemphigoid
#8
Paul A Gaudio, John Sinard, David R Shield, John J Huang, Brett A King
PURPOSE: To evaluate whether conjunctival biopsy findings in patients with ocular mucous membrane pemphigoid (MMP) persist as positive or revert to negative following treatment with immunomodulatory therapy (IMT). METHODS: Patients with biopsy-proven MMP were treated with IMT for at least 2 years before undergoing repeat conjunctival biopsy for immunofluorescence microscopy. Their records were reviewed and findings evaluated to ascertain which patients' biopsies showed antibody deposition on the conjunctival basement membrane...
July 20, 2016: Ocular Immunology and Inflammation
https://www.readbyqxmd.com/read/27391092/incidence-risk-factors-and-surgical-management-of-boston-type-1-keratoprothesis-corneal-melts-leaks-and-extrusions
#9
Clara C Chan, Lorena LoVerde, Judy Qiang, Michael L Nordlund, Edward J Holland
PURPOSE: To determine the rate of Boston type 1 keratoprosthesis (Kpro)-related corneal melts, leaks, and extrusions requiring surgical repair and to analyze possible risk factors and visual outcomes. METHODS: Retrospective chart review of 110 patients (128 eyes) who received a Kpro between November 2004 and December 2010 (average follow-up of 29 mo). The rate of corneal complications, risk factors for melts, and postmelt repair visual outcomes were evaluated. RESULTS: Twenty eyes from 18 patients developed Kpro-related melts requiring surgical repair...
August 2016: Cornea
https://www.readbyqxmd.com/read/27275431/clinical-features-and-in-vivo-confocal-microscopy-assessment-in-12-patients-with-ocular-cicatricial-pemphigoid
#10
Qin Long, Ya-Gang Zuo, Xue Yang, Ting-Ting Gao, Jie Liu, Ying Li
AIM: To describe the clinical features and microstructural characteristics assessed by in vivo confocal microscopy (IVCM) in patients with ocular cicatricial pemphigoid (OCP). METHODS: A descriptive, uncontrolled case series study. Patients diagnosed with OCP were examined by clinical history, slit-lamp biomicroscopy features and IVCM images. The results of direct immunofluorescence (DIF) biopsies and indirect immunofluorescence (IIF) were also recorded. Local and systemic immunosuppressive therapy were administered and adjusted according to response...
2016: International Journal of Ophthalmology
https://www.readbyqxmd.com/read/27193492/integrin-%C3%AE-4-is-a-major-target-antigen-in-pure-ocular-mucous-membrane-pemphigoid
#11
Xiaoguang Li, Hua Qian, Ryosuke Sogame, Yoshiaki Hirako, Daisuke Tsuruta, Norito Ishii, Hiroshi Koga, Atsunari Tsuchisaka, Zhexiong Jin, Kazuo Tsubota, Akiko Fukumoto, Chie Sotozono, Shigeru Kinoshita, Takashi Hashimoto
Previous studies of ocular mucous membrane pemphigoid (OMMP) have identified several components of the basement membrane zone to be autoantigens, including integrin β4. However, there are no extensive or definitive reported studies that address this, particularly in pure OMMP. To clarify the major autoantigens in pure OMMP. In this study, we examined sera from 43 pure OMMP patients for both IgG and IgA antibodies using newly developed immunoblotting analyses with a hemidesmosome-rich fraction and various recombinant proteins of integrin α6β4, in addition to our routine immune-serological tests...
June 1, 2016: European Journal of Dermatology: EJD
https://www.readbyqxmd.com/read/27041284/-ocular-cicatricial-pemphigoid-a-retrospective-study
#12
E Szabó, M Palos, P Skalická
INTRODUCTION: Ocular cicatricial pemphigoid (OCP) is rare, severe, sight threatening autoimmune disease of the conjunctiva, which affects elderly patients, more often women. AIM: To evaluate the success rate of stabilisation of ocular findings in patients with OCP. METHODS: Retrospective study of patients from Centre of Conjunctival and Corneal Diseases at Department of Ophthalmology, General University Hospital and 1st Medical Faculty of Charles University in Prague in 1992-2013 was performed...
February 2016: Ceská a Slovenská Oftalmologie
https://www.readbyqxmd.com/read/26969813/case-of-paraneoplastic-pemphigus-with-immunoglobulin-ig-g-and-iga-antibodies-to-various-antigens
#13
Yohei Otsuka, Takashi Ueno, Aya Yamase, Michiko Ito, Shinichi Osada, Seiji Kawana, Yoko Funasaka, Kwesi Teye, Norito Ishii, Takashi Hashimoto, Hidehisa Saeki
A 63-year-old Japanese man with non-Hodgkin B-cell lymphoma presented with erythematous skin lesions on his entire body, with oral, ocular and anal mucosal lesions. The patient was diagnosed with paraneoplastic pemphigus. Immunofluorescence showed both immunoglobulin (Ig)G and IgA antibodies to keratinocyte cell surfaces. Various immunoblot and enzyme-linked immunosorbent assays showed both IgG and IgA antibodies to various autoantigens, including desmogleins, desmocollins, envoplakin, periplakin and bullous pemphigoid antigens...
August 2016: Journal of Dermatology
https://www.readbyqxmd.com/read/26903186/autoimmune-bullous-diseases-with-skin-and-eye-involvement-cicatricial-pemphigoid-pemphigus-vulgaris-and-pemphigus-paraneoplastica
#14
Karen C Broussard, Theresa G Leung, Ahmadreza Moradi, Jennifer E Thorne, Jo-David Fine
Autoimmune blistering diseases are a heterogeneous group of disorders that mostly affect the skin and mucous membranes. Occasionally, other organ systems may be involved, depending on the unique pathophysiology of each disease. Cicatricial pemphigoid, pemphigus vulgaris, and paraneoplastic pemphigus are distinct entities, but all have the potential to have cutaneous and ocular involvement. Awareness and early recognition of ocular involvement in these diseases is important given the increased risk for vision loss and blindness with delay in management...
March 2016: Clinics in Dermatology
https://www.readbyqxmd.com/read/26708362/update-on-ocular-cicatricial-pemphigoid-and-emerging-treatments
#15
REVIEW
Munther M Queisi, Mike Zein, Neerav Lamba, Halea Meese, Charles Stephen Foster
Mucous membrane pemphigoid is a systemic disorder that primarily affects mucous membranes. When localized to the conjunctiva, it is known as ocular cicatricial pemphigoid, a potentially blinding disease. Ocular cicatricial pemphigoid is an indication for systemic immunosuppressive treatment to achieve adequate remission. Immunosuppressive agents are selected with a "stepladder" approach, commencing with medications having the fewest side effects. We provide an update of the literature on immunomodulatory agents since 2011 as additional treatment modalities have been explored in the last 4 years...
May 2016: Survey of Ophthalmology
https://www.readbyqxmd.com/read/26632795/igm-ocular-cicatricial-pemphigoid-a-unique-insight-into-the-immune-system
#16
Noor Tazudeen, Sonoa Au, Jonathan Pewitt, Elmer Tu, Iris K Aronson
A 42-year-old man with ocular erythema and scarring had a conjunctival biopsy revealing depostion of IgM and C3 without IgG at the epithelial basement membrane zone.  Treatment with doxycyline, dapsone, and mycophenolate mofetil was unsuccessful and treatment with rituximab has led to partial remission of the conjunctival inflammation. He has undergone 4 cycles of rituximab treatment at intervals of 12 to 18 months.
October 2015: Dermatology Online Journal
https://www.readbyqxmd.com/read/26612798/diagnostic-relevance-of-direct-immunofluorescence-in-ocular-mucous-membrane-pemphigoid
#17
Tarun Mehra, Emmanuella Guenova, Frieder Dechent, Florian Würth, Manfred Zierhut, Martin Röcken, Martin Schaller, Christoph Deuter
BACKGROUND AND OBJECTIVES: The objective was to determine the diagnostic value of direct immunofluorescence (DIF) in ocular mucous membrane pemphigoid (ocular MMP), taking into account immunofluorescence patterns and biopsy sites. PATIENTS AND METHODS: DIF results and medical records of 54 patients with a suspected diagnosis of ocular MMP were reviewed. RESULTS: There was an overall prevalence of ocular MMP in 70.4 % of cases. Linear deposition of IgA, IgG, or C3 showed a high positive predictive value (84-100 %)...
December 2015: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
https://www.readbyqxmd.com/read/26583279/minocycline-inhibits-inflammation-and-squamous-metaplasia-of-conjunctival-tissue-culture-in-airlift-conditions
#18
Qiguo Xiao, Yehui Tan, Zhirong Lin, Jing Zhou, Fang Zhou, Zuguo Liu, Luosheng Tang
PURPOSE: Inflammation and squamous metaplasia is a common pathological process that occurs in many ocular surface diseases such as dry eye, Stevens-Johnson syndrome, mucous membrane pemphigoid, and chemical/thermal burns. At present, there is no ideal medicinal treatment for this abnormality. We report herein on an ex vivo conjunctival inflammation and squamous metaplasia model by culturing human conjunctival tissues at an air-liquid interface for up to 8 days to study the effects of minocycline on inflammation and squamous metaplasia...
February 2016: Cornea
https://www.readbyqxmd.com/read/26569118/ngf-modulates-trkangfr-p75ntr-in-%C3%AE-sma-expressing-conjunctival-fibroblasts-from-human-ocular-cicatricial-pemphigoid-ocp
#19
Alessandra Micera, Barbara Stampachiacchiere, Antonio Di Zazzo, Roberto Sgrulletta, Magdalena Cortes, Eduardo Maria Normando, Alessandro Lambiase, Stefano Bonini
OBJECTIVE: In a previous study, we reported the upregulation of Nerve Growth Factor (NGF) and trkANGFR expression in Ocular Cicatricial Pemphigoid (OCP), an inflammatory and remodeling eye disease. Herein, we hypothesize a potential NGF-driven mechanism on fibroblasts (FBs) during OCP remodeling events. To verify, human derived OCP-FBs were isolated and characterized either at baseline or after NGF exposure. MATERIALS AND METHODS: Conjunctival biopsies were obtained from 7 patients having OCP and 6 control subjects (cataract surgery)...
2015: PloS One
https://www.readbyqxmd.com/read/26276169/protective-effect-of-soft-contact-lenses-after-boston-keratoprosthesis
#20
Leah L Kammerdiener, Jaime Lynn Speiser, James V Aquavella, Mona Harissi-Dagher, Claes H Dohlman, James Chodosh, Joseph B Ciolino
PURPOSE: To evaluate associations between preoperative diagnosis, soft contact lens (SCL) retention and complications. METHODS: A retrospective chart review was conducted of 92 adult patients (103 eyes) who received a Boston keratoprosthesis type I at the Massachusetts's Eye and Ear Infirmary or the Flaum Eye Institute. Records were reviewed for preoperative diagnosis, SCL retention and subsequent complications. Preoperative categories included 16 autoimmune (Stevens-Johnson syndrome, ocular cicatricial pemphigoid, rheumatoid arthritis and uveitis), 9 chemical injury and 67 'other' (aniridia, postoperative infection, dystrophies, keratopathies) patients...
April 2016: British Journal of Ophthalmology
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