Research

Preliminary data on Pemphigus vulgaris treatment by a proteomics-defined peptide: a case report

Giovanni Angelini¹ , Domenico Bonamonte¹ , Alberta Lucchese² , Gianfranco Favia² , Rosario Serpico³ , Abraham Mittelman⁴ , Simone Simone⁵ , Animesh A Sinha⁶ and Darja Kanduc⁵

¹  Department of Internal Medicine, Immunology and Infectious Diseases, Dermatology Section, University of Bari, Italy

²  Department of Odontostomatology and Surgery, University of Bari, Italy

³  Institute of Clinical Odontostomatology, 2^nd University of Naples, Italy

⁴  Department of Medicine, New York Medical College, Valhalla, NY, USA

⁵  Department of Biochemistry and Molecular Biology, University of Bari, Italy

⁶  Division of Dermatology and Cutaneous Sciences, Michigan State University, East Lansing, USA

author email corresponding author email

Journal of Translational Medicine 2006, 4:43doi:10.1186/1479-5876-4-43

Published:	24 October 2006

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 Dsg3_49–60REWVKFAKPCRE 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.

Conclusion

With the limits inherent to any preliminary study, this case report indicates that topical treatment with Dsg3_49–60REWVKFAKPCRE peptide may represent a feasible first step in the search for a simple, effective and safe treatment of PV.