title: Preliminary data on Pemphigus vulgaris treatment by a proteomics-defined peptide: a case report.
abstract: BACKGROUND
  Although described by Hippocrates in 400 B.C., pemphigus disease still needs a safe therapeutical approach, given that the currently used therapies (i.e. corticosteroids and immunosuppressive drugs) often provoke collateral effects. Here we present preliminary data on the possible use of a proteomics derived desmoglein peptide which appears promising in halting disease progression without adverse effects.
  
  
  METHODS
  The low-similarity Dsg349-60REWVKFAKPCRE peptide was topically applied for 1 wk onto a lesion in a patient with a late-stage Pemphigus vulgaris (PV) complicated by diabetes and cataract disease. The peptide was applied as an adjuvant in combination with the standard corticosteroid-based immunosuppressive treatment.
  
  
  RESULTS
  After 1 wk, the treated PV eroded lesion appeared dimensionally reduced and with an increased rate of re-epithelization when compared to adjacent non-treated lesions. Short-term benefits were: decrease of anti-Dsg antibody titer and reduction of the corticosteroid dosage. Long-term benefits: after two years following the unique 1-wk topical treatment, the decrease of anti-Dsg antibody titer persists. The patient is still at the low cortisone dosage. Adverse effects: no adverse effect could be monitored.
  
  
  CONCLUSIONS
  With the limits inherent to any preliminary study, this case report indicates that topical treatment with Dsg349-60REWVKFAKPCRE peptide may represent a feasible first step in the search for a simple, effective and safe treatment of PV.
authors.affiliation: Department of Internal Medicine, Immunology and Infectious Diseases, Dermatology Section, University of Bari, Italy. g.angelini@dermatologia.uniba.it
authors.forename: Giovanni
authors.initials: G
authors.lastname: Angelini
authors.forename: Domenico
authors.initials: D
authors.lastname: Bonamonte
authors.forename: Alberta
authors.initials: A
authors.lastname: Lucchese
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Favia
authors.forename: Rosario
authors.initials: R
authors.lastname: Serpico
authors.forename: Abraham
authors.initials: A
authors.lastname: Mittelman
authors.forename: Simone
authors.initials: S
authors.lastname: Simone
authors.forename: Animesh A
authors.initials: AA
authors.lastname: Sinha
authors.forename: Darja
authors.initials: D
authors.lastname: Kanduc