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Epidermolysis Bullosa Acquisita: The 2019 Update

Koga, H., Prost-Squarcioni, C., Iwata, H., Jonkman, M. F., Ludwig, R. J. & Bieber, K., 10-Jan-2019, In : Frontiers in Medicine. 5, 28 p., 362.

Research output: Contribution to journalReview articleAcademicpeer-review

  • Hiroshi Koga
  • Catherine Prost-Squarcioni
  • Hiroaki Iwata
  • Marcel F. Jonkman
  • Ralf J. Ludwig
  • Katja Bieber

Epidermolysis bullosa acquisita (EBA) is an orphan autoimmune disease. Patients with EBA suffer from chronic inflammation as well as blistering and scarring of the skin and mucous membranes. Current treatment options rely on non-specific immunosuppression, which in many cases, does not lead to a remission of treatment. Hence, novel treatment options are urgently needed for the care of EBA patients. During the past decade, decisive clinical observations, and frequent use of pre-clinical model systems have tremendously increased our understanding of EBA pathogenesis. Herein, we review all of the aspects of EBA, starting with a detailed description of epidemiology, clinical presentation, diagnosis, and current treatment options. Of note, pattern analysis via direct immunofluorescence microscopy of a perilesional skin lesion and novel serological test systems have significantly facilitated diagnosis of the disease. Next, a state-of the art review of the current understanding of EBA pathogenesis, emerging treatments and future perspectives is provided. Based on pre-clinical model systems, cytokines and kinases are among the most promising therapeutic targets, whereas high doses of IgG (IVIG) and the anti-CD20 antibody rituximab are among the most promising "established" EBA therapeutics. We also aim to raise awareness of EBA, as well as initiate basic and clinical research in this field, to further improve the already improved but still unsatisfactory conditions for those diagnosed with this condition.

Original languageEnglish
Article number362
Number of pages28
JournalFrontiers in Medicine
Volume5
Publication statusPublished - 10-Jan-2019

    Keywords

  • epidermolysis bullosa acquisita, animal models, diagnosis, treatment, pathogenesis, INDUCED TISSUE-DAMAGE, DERMAL-EPIDERMAL SEPARATION, SERRATION PATTERN-ANALYSIS, PROTEIN-A IMMUNOADSORPTION, LINKED-IMMUNOSORBENT-ASSAY, SEVERE OCULAR INVOLVEMENT, VII COLLAGEN ANTIBODIES, NEONATAL FC-RECEPTOR, INTRAVENOUS IMMUNOGLOBULIN, ESOPHAGEAL INVOLVEMENT

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