Hemocarboadsorption (HCA) with the following immunosuppressive therapy was used to treat 48 patients with pemphigus vulgaris (PV) and 31 patients with bullous pemphigoid (BP) in the acute phase. The levels of autoantibodies, eicosanoids, endoproteases and their inhibitors as well as interleukin (IL) 1 and IL 2 production and absorption of exogenous IL 2 were examined in the treatment dynamics. The therapeutic effect of HCA was displayed in prompt disease remission in 43 PV and 29 BP patients. Clinical improvement was accompanied by antibody elimination and interleukin cascade reaction normalization. HCA resulted in growth of patients’ serum immunosuppressive activity. It was concluded that HCA has some immunoregulatory effect.
SneddonI.B.The management of bullous eruptions.Seminars in Dermatol1986; 5: 2–12.
2.
BeutnerE.H., KumarV.Autoantibodies in health and disease. Classification of autoimmune response using universal stratified epithelial autoantibodies and other skin-reactive autoantibodies as models. In: MilgromF., AbeyounisC.J., AlbiniB., eds. Antibodies: protective, destructive and regulatory role.Basel: Karger, 1985; 158–63.
3.
Schaumburg-LeverG.Treatment of pemphigus and pemphigoid.Z Hautkr1986; 61: 811–2.
4.
AhmedA.R., MaizeJ.C., ProvostT.T.Bullous pemphigoid. Clinical and immunologic follow-up after successful therapy.Arch Dermatol1977; 113: 1043–7.
5.
RyanJ.G.Pemphigus. 20 year survey of experience with 70 cases.Arch Dermatol1971; 104: 14–20.
6.
BystrynJ-C. Adjuvant therapy of pemphigus.Arch Dermatol1984; 120: 941–51.
7.
RoujeauJ-C. Echanges plasmatiques en therapeutique dermatologique.Ann Dermatol Venereol1982; 109: 695–702.
Blitstein-WillingerE.Behavior of cutaneous Langerhans’ cells and skin reactivity after gold sodium thiomalat treatment of pemphigus vulgaris.Dermatologica1987; 174: 68–75.
10.
Kermani-ArabV., HijriK., AhmedA.R., FaheyJ.L.Deficiency of interleukin-2 production and interleukin-2 receptor expression on peripheral blood leukocytes after phytohemagglutinin stimulation in pemphigus.J Invest Dermatol1984; 83: 101–4.
11.
AhmedA.R., HijriK., Arab-KermaniV.Interleukin-2 in bullous pemphigoid.Arch Dermatol Res1984; 276: 330–2.
12.
FitzmauriceM., DeodharS.D.Pemphigus and pemphigoid antibody production by pokeweed mitogen-stimulated peripheral blood mononuclear cell cultures in vitro.Am J Clin Pathol1983; 81: 586–90.
13.
GrandoS.A., GlukhenkyB.T., DrannikG.N., KostrominA.P., RomanenkoA.B.The effect of experimental haemocarbofiltration upon activity of mononuclear cells from normal and autoimmune patients.Immunology1989; 66: 138–42.
14.
GrandoS.A., GlukhenkyB.T.Treatment of pemphigus and pemphigoid patients with combined hemocarboadsorption followed by immunosupressive therapy. In: Dermatology in the developing world. A combined conference of the Int Soc of Dermatology with the Int Soc of Dermatopathology.Oxford, 1988; 68–9.
15.
GrandoS.A., GlukhenkyB.T., RomanenkoA.B., ChayunO.A., DolyaS.V.The mechanisms of the therapeutic action of extracorporeal detoxication in autoimmune bullous dermatoses.Vestnik Dermatol Venereol1988; 7: 6–11 (in Russian).
16.
GeriI., GershonR.K., WaksmanB.H.Potentiation of the T-lymphocyte response to mitogens. I. The responding cell.J Exp Med1972; 136: 128–42.
17.
GillisS., FermM.M., OuW., SmithK.A.T cell growth factor: parameters of production and a quantitative microassay for activity.J Immunol1978; 120: 2027–32.
18.
TakadaS., UedaY., SuzukiN.Abnormalities in autologous mixed lymphocyte reaction-activated immunologic processes in systemic lupus erythematosus and their possible correction by interleukin 2.Eur J Immunol1985; 15: 262–7.
19.
LevineL.Measurement of arachidonic acid metabolites by radioimmunoassay. In: FaheyJ.L., FriedmanH., RoseN.R., eds. Manual of clinical laboratory immunology. 3rd ed.Washington: American Society for Microbiology, 1986; 685–91.
20.
SchertG.W., TakenakaY.A spectrophotometric determination of trypsin and chymotrypsin.Bioch Biophys Acta1955; 16: 570–5.
21.
WhicherJ.T., GilbertA.M., WestacottC., HuttonC., DieppeP.A.Defective production of leucocytic endogenous mediator (interleukin 1) by peripheral blood leucocytes of patients with systemic sclerosis, systemic lupus erythematosus, rheumatoid arthritis and mixed connective tissue disease.Clin Exp Immunol1986; 65: 80–9.
22.
DjeuJ.Y., KasaharaT., BalowJ.E., TsokosG.C.Decreased interlukin 2 inhibitor in sera of patients with autoimmune disorders.Clin Exp Immunol1986; 279–85.
23.
GrandoS.A., DrannikG.N., GlukhenkyB.T., BoikoY.Y., KostrominA.P., ChernyavskyAl. Interleukin cascade reaction inhibition by supernatants of the cultures of antibody-transformed human basal keratinocytes.Immunol Invest1988; 17: 567–76.
24.
TermanD.S.Immunoadsorbents in autoimmune and neoplastic diseases.Plasma Ther Transfus Technol1983; 4: 415–33.
25.
VirellaG., GlassmanA.B.Apheresis, exchange, adsorption and filtration of plasma: four approaches to the removal of undesirable circulating substances.Biomed Pharmacother1986; 40: 286–96.
26.
BingelM., LonnemannG., ShaldonS., KochK.M., DinarelloC.A.Human interleukin-1 production during hemodialysis.Nephron1986; 161–3.
27.
BystrynJ-C, GrafM.W., UhrJ.W.Regulation of antibody formation by serum antibody. II. Removal of specific antibody by means of exchange transfusion.J Exp Med1970; 132: 1279–87.
28.
TermanD.S.Extracorporeal immunoadsorbents for extraction of circulating immune reactants. In: GiordanoC., ed. Sorbents and their clinical application.New York: Academic Press, 1980; 469–81.
29.
RuoccoV., AstaritaC., PisaniM.Plasmapheresis as an alternative or adjunctive therapy in problem cases of pemphigus.Dermatologica1984; 168: 219–23.
30.
GoodwinJ.S., CeuppensJ.L., GualdeN.Control of the immune response in humans by prostaglandins. In: OtternessI., CapetolaR., WongS., eds. Advances in inflammation research; vol 7. New York: Raven Press, 1984; 79–92.
31.
SchultzeG., WagnerK., NeumayerH-H, FitznerR., MolzahnM.Effect of dialyzer membranes on in vitro generation of eicosanoids.Int J Artif Organs1987; 10: 275–8.
32.
AdesE.W., HinsonA., Chapuis-CellierC., ArnaudP.Modulation of the immune response by plasma protease inhibitors. I. Alpha2-macroglobulin and alpha1-antitrypsin inhibit natural killing and antibody-dependent cell-mediated cytotoxicity.Scand J Immunol1982; 15: 109–13.
33.
BaumannH., JahrlisG.P., SauderD.N., KojA.Human keratinocytes and monocytes release factors which regulate the synthesis of major acute phase proteins in the hepatic cells from man, rat and mouse.J Biol Chem1984; 259: 7331–42.
34.
SingerK.H., HashimotoK., LazarusG.S.Antibody-induced proteinase activation: a proposed mechanism for pemphigus.Springer Semin Immunopathol1981; 4: 17–32.
35.
NaitoK., MoriokaS., OgawaH.The pathogenic mechanisms of blister formation in bullous pemphigoid.J Invest Dermatol1982; 79: 303–6.
36.
Homo-DelarcheF., de Saint-BasileG., Le DeistF., SmetsP., GriscelliC.Regulation of prostaglandin E2 and plasminogen activator by various immunomodulators in human monocytes.Prost Leukotr Med1986; 21: 279–97.
37.
VanherweghemJ.L., DrukkerW., SchwarzA.Clinical significance of blood-device interaction in hemodialysis. A review.Int J Artif Organs1987; 10: 219–32.
38.
GuillotB.Plasma exchanges in cutaneous disease —possibility useful but still experimental.Dermatologica1987; 175: 267–9.
39.
DiazL.A., SampaioS.A.P., MartinsC.R.An antibody in pemphigus serum, specific for the 59 kD keratin, selectively binds the surface of keratinocytes: evidence for an extracellular keratin domain.J Invest Dermatol1987; 89: 287–95.
40.
LabibR.S., AnhaltG.J., PatelH.P., MutasimD.F., DiazL.A.Molecular heterogeneity of the bullous pemphigoid antigens as detected by immunoblotting.J Immunol1986; 136: 1231–5.
