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Immunadsorption in der Dermatologie

  • Franziska Hübner
  • Michael Kasperkiewicz
  • Detlef Zillikens
  • Enno Schmidt
CME
  • 21 Downloads

Zusammenfassung

Den blasenbildenden Autoimmundermatosen liegen pathogenetisch relevante Autoantikörper gegen Bestandteile der Epidermis und/oder oberflächennahen Schleimhäute (beim Pemphigus) bzw. gegen Strukturproteine der dermoepidermalen Junktionszone (bei den Pemphigoiderkrankungen) zugrunde. Mittels Immunadsorption (IA) können Antikörper aus dem Plasma entfernt werden. Daten zum adjuvanten Einsatz dieser Therapie in der Dermatologie liegen insbesondere für Patienten mit einem therapierefraktären oder schweren Pemphigus vulgaris und Pemphigus foliaceus, aber auch mit Pemphigoiderkrankungen vor. In den letzten Jahren wurden zudem verschiedene Therapieprotokolle für den Einsatz der IA bei Patienten mit schwerem atopischem Ekzem und erhöhten IgE-Spiegeln publiziert. Während hauptsächlich Panimmunglobulinadsorber bzw. bei der atopischen Dermatitis auch ein spezifischer Ig(Immunglobulin)E-Adsorber eingesetzt wurden, sind in Zukunft antigenspezifische Adsorber zu erwarten, die eine gezielte Reduktion der Autoantikörper ermöglichen.

Schlüsselwörter

Pemphigus Pemphigoid Atopisches Ekzem Autoantikörper Autoimmundermatosen 

Immunoadsorption in dermatology

Abstract

Autoimmmune bullous diseases are mediated by pathogenetically relevant autoantibodies against components of the epidermis and/or superficial mucous membranes (in pemphigus) and structural proteins of the dermal-epidermal junction (in pemphigoid diseases). Using immunoadsorption (IA), an already well-established procedure in cardiac and rheumatic disorders, antibodies can be removed from the plasma. At present, most data on the adjuvant use of IA in dermatology are derived from patients with severe and/or refractory pemphigus vulgaris or pemphigus foliaceus and also from patients with pemphigoid diseases. Additionally, in the last few years different protocols for IA in patients with severe atopic dermatitis and elevated total serum IgE levels have been published. While panimmunoglobulin adsorbers are mainly used in dermatology, an IgE-specific adsorber has been used in some patients with atopic dermatitis and in the future, antigen-specific adsorbers are to be expected that will enable the specific reduction of autoantibodies.

Keywords

Pemphigus Pemphigoid Atopic dermatitis Autoantibodies Autoimmune dermatoses 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

E. Schmidt, F. Hübner, M. Kasperkiewicz und D. Zillikens haben Honorare und Reisekosten von der Fa. Fresenius Medical Care erhalten. E. Schmidt, M. Kasperkiewicz und D. Zillikens haben Honorare und Reisekosten von der Fa. Miltenyi Biotech erhalten. E. Schmidt und D. Zillikens haben eine wissenschaftliche Kooperation mit den Firmen Fresenius Medical Care, Miltenyi Biotech und Euroimmun.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren. Alle Patienten, die über Bildmaterial oder anderweitige Angaben innerhalb des Manuskripts zu identifizieren sind, haben hierzu ihre schriftliche Einwilligung gegeben. Im Falle von nicht mündigen Patienten liegt die Einwilligung eines Erziehungsberechtigten oder des gesetzlich bestellten Betreuers vor.

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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2018

Authors and Affiliations

  • Franziska Hübner
    • 1
  • Michael Kasperkiewicz
    • 1
  • Detlef Zillikens
    • 1
  • Enno Schmidt
    • 1
    • 2
  1. 1.Klinik für Dermatologie, Allergologie und VenerologieUniversität zu LübeckLübeckDeutschland
  2. 2.Lübecker Institut für Experimentelle Dermatologie (LIED)Universität zu LübeckLübeckDeutschland

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