Proteinase inhibitors and pemphigus vulgaris. An in vitro and in vivo study.

Abstract

The aim of this study was to determine the inhibitory effect of clinically usable proteinase inhibitors p-aminomethylbenzoic acid (PAMBA), and aprotinin on acantholysis in skin organ culture and in clinical trials with pemphigus patients. PAMBA added to the culture medium at a concentration of 1 mg/ml fully prevented the acantholysis, while Contrykal at 10 ATrE/ml reduced acantholysis. Subsequently, we treated 12 patients (groups 1) with PAMBA 100-200 mg daily for 7 to 26 days in combination with a moderate dose of corticosteroid (mean dose 36.1 mg prednisolone equivalent) or immunosuppressive drugs. A second group of 12 patients (group 2) were treated with a high dose of corticosteroid (mean 94.2 mg prednisolone equivalent) and immunosuppressive drugs. Evaluation was performed before treatment, after 3 weeks and on discharge using a clinical scoring system. The inclusion of PAMBA in the treatment protocol of group 1 resulted in active disease being brought under control with lower corticosteroid doses. As a result, fewer side effects were observed in group 1 than in group 2. In our opinion, protease inhibitors may be useful as adjuvant drugs in the combination therapy of pemphigus.

• Authors: H Dobrev, L Popova, D Vlashev
• Journal: Archives of dermatological research (Arch Dermatol Res) Vol. 288 Issue 11 Pg. 648-55 (Oct 1996) ISSN: 0340-3696 [Print] Germany
• PMID: 8931866 (Publication Type: Clinical Trial, Controlled Clinical Trial, Journal Article)

Chemical References

• Adrenal Cortex Hormones
• Immunosuppressive Agents
• Protease Inhibitors
• para-Aminobenzoates
• 4-aminomethylbenzoic acid
• Aprotinin
• 4-Aminobenzoic Acid

Topics

• 4-Aminobenzoic Acid (administration & dosage, adverse effects, therapeutic use)
• Acantholysis (drug therapy)
• Adrenal Cortex Hormones (administration & dosage)
• Adult
• Aged
• Aged, 80 and over
• Aprotinin (administration & dosage, adverse effects, therapeutic use)
• Drug Therapy, Combination
• Female
• Humans
• Immunosuppressive Agents (administration & dosage)
• Male
• Middle Aged
• Organ Culture Techniques
• Pemphigus (drug therapy, pathology)
• Protease Inhibitors (administration & dosage, adverse effects, therapeutic use)
• Skin (drug effects)
• para-Aminobenzoates