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Autoimmune Disorders

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Autoimmune diseases are a group of disorders in which the body's immune system mistakenly attacks its own cells, tissues, and organs. This results from an overactive immune response against substances and tissues normally present in the body. Let's delve into the concept and mechanism of autoimmune diseases from an immune system point of view, explore different causes and examples of such diseases, and discuss potential solutions.
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Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab...
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Skin is the first line of defense and encounters a variety of microbes. Some pathogenic strains are often the cause of a broad range of infections of the skin and other body systems. These conditions can affect people of all ages and may have different causes, including genetic factors, infections, autoimmune reactions, environmental factors, and lifestyle choices.
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Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
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When T cells with CD4 markers are activated, they give rise to two types of effector cells: helper T cells and regulatory T cells. Meanwhile, T cells with CD8 markers differentiate into effector cytotoxic T cells. The differentiation of CD4 T cells into helper T cell subsets, such as Th1, Th2, and Th17 cells, is dependent on the antigen type, antigen-presenting cell, and regulatory cytokines.
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Autoimmune Bullous Diseases Associated With Immune Checkpoint Inhibitors: An Analysis Based on a Systematic Review.

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Immune checkpoint inhibitor-induced autoimmune bullous diseases (ICI-AIBDs) are rare but serious. This study identified bullous pemphigoid as the most common ICI-AIBD and found female sex and pemphigus group increase mortality risk, while topical glucocorticoids may offer protection.

Keywords:
autoimmune bullous diseaseimmune checkpoint inhibitorpemphigoidpemphigus

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Area of Science:

  • Dermatology
  • Oncology
  • Immunology

Background:

  • Autoimmune bullous diseases (AIBDs) are rare, severe immune-related adverse events (irAEs) associated with immune checkpoint inhibitors (ICIs).
  • The clinical spectrum and survival factors of ICI-induced AIBDs (ICI-AIBDs) require further characterization.
  • Understanding ICI-AIBDs is crucial for managing patients receiving ICIs.

Purpose of the Study:

  • To synthesize existing data on ICI-AIBD patient characteristics.
  • To explore factors influencing survival outcomes in patients with ICI-AIBDs.
  • To provide insights for clinical practice and individualized patient management.

Main Methods:

  • Systematic literature search across five databases.
  • Meta-analysis of 188 studies involving 319 participants.
  • Cox regression analysis to identify prognostic factors for survival.

Main Results:

  • Bullous pemphigoid was the most frequent diagnosis (79.6%), followed by lichen planus pemphigoides (10.7%).
  • Female sex (HR 2.35) and pemphigus group (HR 7.09) were associated with increased mortality.
  • Topical glucocorticoid therapy showed a protective effect (HR 0.44).

Conclusions:

  • This study delineates the clinical spectrum of ICI-AIBDs.
  • Identified potential risk factors (female sex, pemphigus) and protective factors (topical glucocorticoids) for ICI-AIBD patient survival.
  • Findings offer valuable insights for optimizing patient care and therapeutic strategies in ICI-AIBD management.