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Open Access 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*

Author Affiliations

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, 2nd 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

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Journal of Translational Medicine 2006, 4:43  doi: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 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.

Conclusion

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.