Terapija autoimunih buloznih dermatoza

master's thesis

• Title (english): Treatment of autoimmune bullous dermatoses
• Author: Domagoj Vlašić
• Mentor: Branka Marinović (mentor)
• Committee member: Suzana Ljubojević Hadžavdić (predsjednik povjerenstva)
• Committee member: Romana Čeović (član povjerenstva)
• Committee member: Branka Marinović (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Dermatology); Zagreb
• Defense date and country: 2019-07-12, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Dermatovenerology
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Clinical Pharmacology and Toxicology

Abstract

Autoimune bulozne dermatoze (AIBD) čine heterogenu skupinu bolesti kože i sluznica kod kojih je primarna eflorescencija mjehur. Lezije nastaju zbog djelovanja autoprotutijela usmjerenih prema strukturnim glikoproteinskim sastavnicama epidermisa i epidermalno-dermalne granice. Radi se o teškim bolestima koje su u prošlosti, prije otkrića kortikosteroidne terapije, nerijetko bile smrtonosne. Danas se značajno smanjila stopa mortaliteta od ovih bolesti, no smrtni ishod nije isključen, najčešće zbog nuspojava imunosupresivne terapije ili rezistencije na uobičajni terapijski pristup. Dva najčešća patološka entiteta u ovoj skupini su vulgarni pemfigus i bulozni pemfigoid, koji najčešće zahvaćaju populaciju srednje i starije životne dobi. Terapijski pristup ovisi ne samo o vrsti AIBD, nego i o težini bolesti, komorbiditetima te podnošljivosti terapije odnosno o njenim nuspojavama. Središnje mjesto u liječenju zauzima kortikosteroidna terapija koja je kao zlatni standard prepoznata još sredinom prošlog stoljeća. No, napredak u razumijevanju kompleksne imunopatogeneze ovih bolesti omogućio je primjenu novijih terapijskih opcija, poput monoklonskih protutijela, u liječenju bolesnika s težim oblicima bolesti koji nisu zadovoljavajuće odgovorili na konvencionalnu terapiju.

Abstract (english)

Autoimmune bullous dermatoses (AIBD) are a heterogeneous group of chronic mucocutaneous diseases with a blister as the primary lesions. Blisters are a consequence of pathological autoimmune reaction caused by auto-antibodies which react with structural glycoprotein components of the epidermis and the epidermal-dermal barrier. AIBD are severe diseases which have been, prior to the discovery of corticosteroid therapy, considered as lethal diseases. Nowadays, the mortality rate of these diseases is significantly reduced; however, the letal outcome may occur due to the side effects of immunosuppressive therapy or resistance to conventional therapeutic approach. Two most common pathological entities in this group are pemphigus vulgaris and bullous pemphigoid, most commonly affecting the middle-aged and older population. Therapeutic approach depends not only on the type of AIBD, but also on the severity of the disease, comorbidities and tolerability of the therapy or its adverse effects. Corticosteroids are most widely used treatment, which have been recognized as a gold standard since 1950s. However, progress in understanding complexity of immunopathogenesis has enabled the use of new therapeutic options, such as monoclonal antibodies, in the treatment of patients with the severe disease types or of those who have not responded satisfactorily to conventional therapy.

• Keywords: autoimune bulozne dermatoze; pemfigus; bulozni pemfigoid; terapija
• Keywords (english): autoimmune bullous dermatoses; pemphigus; bullous pemphigoid; therapy
• Language: croatian
• URN:NBN: urn:nbn:hr:105:189101
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2019-10-30 09:49:59