Background: Pemphigus Vulgaris (PV) is a potentially life-threatening autoimmune disease targeting the skin and mucous membranes, characterized by apoptolysis novel archetype of keratinocyte damage. This links the suprabasal acantholytic and cell death pathways to basal cell shrinkage rendering a 'tombstone' appearance to these lesions. Comprehending the acantholytic pathways leading to the blistering in PV is a key to development of novel treatments.
Objective: The objective of this systematic review is to determine predominant apoptotic pathway involved in the pathogenesis of Pemphigus vulgaris and if it plays a crucial role in yet another pathogenic mechanism-apoptolysis.
Methods: Articles were searched in PUBMED, EMBASE, MEDLINE and a thorough Google search was done. Hand search of Journals were also performed. The Articles were reviewed and analysed.
Results: Out of 25 potentially relevant articles, 5 were excluded on the grounds of exclusion criteria, and 6 were excluded being review articles. However 2 articles among these were included by internet search and hand search. Of the total 14 relevant articles reviewed, the resulting data were collected and tabulated.
Conclusion: The inference drawn from this systematic review is that the predominant apoptotic pathway involved in the pathogenesis of pemphigus vulgaris is the extrinsic pathway (86% of the reviewed studies). Evaluating factors involved in both intrinsic and extrinsic apoptotic pathways in the same study might provide an insight into the Apoptotic mechanism in pemphigus vulgaris giving a breakthrough for better targeted therapeutic modalities for the same.
Renu R*, Ramani P, Natesan A, Premkumar P and Sherlin HJ
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