اثر سیکلوسپورین روی بیماران پمفیگوس مقاوم به درمان های کلاسیک

Pemphigus is a chronic blistering disease and prednisolone is regarded as the treatment of choice for this disease. The doses of prednisolone required are high, and considerable morbidity maybe associated the treatment. Immunosuppressive drugs, particularly azathioprin are frequently used addition to prednisolone, as steroid – sparing agents, although in our experience, these are not always well tolerated, in addition some of the patients are resistant to the conventional immunosuppressive agents. For these mentioned patients cyclosprin therapy would be successful. The mechanism by which cyclosprin exerts its immunosuppressive effect in pemphigus vulgaris is not fully understood. It has been assumed that cyclosporin inhibits production of antibodies to T-cell dependent antigens through its action against CD4 – positive lymphocytes. In this study 20 patients with pemphigus who have been resistant to/or complicated with conventional therapy, cyclosporin was added to their regimen. Combined therapy was effective in all patients two. Mortality rate was 10%. No relapse was seen in any patient. Thus according to the results of this the rationale of using cyclosporin is to reduce the dosage of predinsolone there by minimizing its complication and to permit treating of difficult cases.