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By Martin Röcken, Tilo Biedermann (auth.), Michael Hertl MD (eds.)
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Extra resources for Autoimmune Diseases of the Skin: Pathogenesis, Diagnosis, Management
A well analyzed example is pemphigus vulgaris, where patients have frequently lgG4 antibodies against desmoglein 3 and predominant Th2 responses against this same autoantigen. Therapeutic Induction of Functional Tolerance Current therapeutic strategies reflect a combination of corticosteroids and immunosuppressive agents, most of them acting on both T and B cells. Corticosteroids are used with the primary goal to reduce the acute inflammation and to limit tissue damage. They are also efficient in suppressing T and B cell responses, but long-term side effects are very important.
Such an approach may be of special interest as Th2 responses have a tendency to perpetuate and to establish an antiinflammatory Th2 memory, once they are initiated (Biedermann et al. 2001). The third reflects the opposite, the redirection of harmful Th2 responses into a Th1 phenotype, an approach that may be of interest in lgE-mediated diseases. These antigen-specific T cell based approaches are still at a very early clinical experimental stage and not appropriate for acute interventions. For future development, these vaccination approaches are of special interest as they circumvent a series of major problems associated with all other thera- 16 Martin Rocken and Tilo Biedermann pies.
1992), dermatomyositis/polymyositis (Haga et al. 1992) and MCTD (Van Numen et al. 1982). These cases from many different countries demonstrated world-wide concern and several epidemiological studies were initiated. Some studies focused on scleroderma alone (Weisman et al. 1988; Burns 1994; Englert and Brooks 1994; Hochberg et al. 1996), others on CTD, comprising a variety of diagnoses (Schusterman et al. 1993; Gabriel et al. 1994; Giltay et al. 1994; Goldman et al. 1995; Perkins et al. 1995; Sanchez-Guerrero et al.
Autoimmune Diseases of the Skin: Pathogenesis, Diagnosis, Management by Martin Röcken, Tilo Biedermann (auth.), Michael Hertl MD (eds.)