medalphabetМедицинский алфавитMedical alphabet2078-56312949-2807ООО «Альфмед»10.33667/2078-5631-2024-25-30-33medalphabet-4008Research ArticleСтатьиБуллезный пемфигоид. Новые направления терапии, перспективы на будущее (обзор литературы)Bullous pemphigoid. New directions of therapy, prospects for the future (literature review)https://orcid.org/0000-0003-4583-0617МатушевскаяЕ. В.MatushevskayaE. V.

Матушевская Елена Владиславовна - д.м.н., проф., проф. кафедры дерматовенерологии и косметологии. Академии постдипломного образования.

Москва

Elena V. Matushevskaya - DM Sci (habil.), professor at Dept of Dermatovenereology and Cosmetology of the Academy of Postgraduate Education.

Moscow

matushevskaya@mail.ruФГБУ «Федеральный научно-клинический центр специализированных видов медицинской помощи и медицинских технологий Федерального медико-биологического агентства России» (ФНКЦ ФМБА России)РоссияFederal Scientific and Clinical Center for Specialized Types of Medical Care and Medical Technologies of the Federal Medical and Biological Agency of RussiaRussian Federation202405122024025Дерматология (2)3033Copyright © Матушевская Е.В., 20242024Матушевская Е.В.Matushevskaya E.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-alphabet.com/jour/article/view/4008

Буллезный пемфигоид (БП) – аутоиммунный субэпидермальный пузырный дерматоз, значительно влияющий на качество жизни пациентов в связи с выраженной субъективной симптоматикой, поражающий в основном пожилых людей. В патогенезе БП участвуют аутоантитела против гемидесмосомных белков BP180 и BP230, что приводит к отслоению в области соединения дермы и эпидермиса, а также к образованию пузырей. Степень тяжести, распространенность патологического процесса и мучительный зуд требуют назначения высоких доз или постоянного применения системных глюкокортикоидов, что в связи с обширной сопутствующей патологией и большим перечнем побочных эффектов не всегда возможно. В статье представлены современные методы терапии буллезного пемфигоида с использованием моноклональных антител (ритуксимаб, дупилумаб, омализумаб). Механизмы терапевтического воздействия, описанных в статье препаратов, направлены на различные пути иммунопатогенеза буллезного пемфигоида. Представленные новые методы лечения предлагают альтернативные пути помощи пациентам, демонстрирующим отсутствие эффекта от применения базисной терапии, имеющим противопоказания к назначению системных глюкокортикостероидов, при рецидивирующем процессе. Новые терапевтические методики позволят улучшить результаты и снизить высокие кумулятивные дозы системных кортикостероидов и связанные с ними нежелательные явления.

Bullous pemphigoid (BP) is an autoimmune subepidermal bullous dermatosis that significantly affects the quality of life of patients due to pronounced subjective symptoms, affecting mainly the elderly. Autoantibodies against hemidesmosomal proteins BP180 and BP230 are involved in the pathogenesis of BP, which leads to detachment at the junction of the dermis and epidermis, as well as the formation of blisters. The severity, prevalence of the pathological process and painful itching require the appointment of high doses or constant use of systemic glucocorticoids, which is not always possible due to extensive concomitant pathology and a large list of side effects. The article presents modern methods of bullous pemphigoid therapy using monoclonal antibodies (rituximab, dupilumab, omalizumab). The mechanisms of therapeutic effect of the drugs described in the article are aimed at various pathways of immunopathogenesis of bullous pemphigoid. The new treatment methods described in the article offer alternative ways of helping patients who have contraindications to the appointment of systemic glucocorticosteroids, demonstrating the lack of effect from the use of basic therapy, with a recurrent process. New therapeutic techniques will improve results and reduce high cumulative doses of systemic corticosteroids and their associated toxic effects.

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The authors declare that there are no conflicts of interest present.