Preliminary data on Pemphigus vulgaris treatment by a proteomics-defined peptide: a case report.
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.
Angelini
Giovanni
G
Department of Internal Medicine, Immunology and Infectious Diseases, Dermatology Section, University of Bari, Italy. g.angelini@dermatologia.uniba.it
Bonamonte
Domenico
D
Lucchese
Alberta
A
Favia
Gianfranco
G
Serpico
Rosario
R
Mittelman
Abraham
A
Simone
Simone
S
Sinha
Animesh A
AA
Kanduc
Darja
D