自身免疫性大疱性疾病(AIBDs)的特征是囊泡的形成,大疱性病变,粘膜糜烂.自身抗体靶向表皮角质形成细胞表面的细胞锚定结构,称为桥粒,导致细胞内聚力丧失,称为棘皮松解。AIBDs根据临床特征分为表皮内或表皮下类型,组织学特征,和免疫荧光模式。天疱疮(PF)是一种获得性,罕见,与特异性靶向桥粒蛋白-1的自身抗体相关的自身免疫性皮肤病,导致临床表现以皮肤小泡为特征,通常保留粘膜。几个因素,包括遗传倾向,环境触发因素,恶性肿瘤,药物使用,和疫苗接种(流感,乙型肝炎,狂犬病,破伤风,最近,严重急性呼吸道综合征冠状病毒2被称为SARS-CoV-2),可能引发天疱疮的发作。随着疫苗的出现,在对抗2019年冠状病毒病(COVID-19)方面发挥着关键作用,在全球范围内进行了广泛的研究,以确定其疗效和潜在的皮肤不良反应。虽然医学文献中存在COVID-19疫苗接种后AIBDs的报道,疫苗接种后PF的病例在全球范围内报道较少。该疾病的病理生理学可能归因于这些疫苗中存在的核糖核酸(RNA)抗原与细胞核物质之间的相似性。BNT-162b2信使核糖核酸(mRNA)疫苗产生的蛋白质包括免疫原性表位,这些表位可能通过几种机制在易感个体中引发自身免疫现象。包括分子模仿,模式识别受体的激活,B细胞的多克隆刺激,I型干扰素的生产,和自体炎症。在这次审查中,我们对现有的关于COVID-19和PF之间关系的文献进行了全面的研究,深入他们复杂的互动。这一探索提高了对天疱疮和mRNA疫苗机制的理解,强调密切监测PF免疫后的重要性。
Autoimmune bullous diseases (AIBDs) are characterized by the formation of vesicles, bullous lesions, and mucosal erosions. The autoantibodies target the cellular anchoring structures from the surface of epidermal keratinocyte named desmosomes, leading to a loss of cellular cohesion named acantholysis. AIBDs are classified into intraepidermal or subepidermal types based on clinical features, histological characteristics, and immunofluorescence patterns. Pemphigus foliaceus (PF) is an acquired, rare, autoimmune skin condition associated with autoantibodies that specifically target desmoglein-1, leading to a clinical presentation characterized by delicate cutaneous blisters, typically sparing the mucous membranes. Several factors, including genetic predisposition, environmental triggers, malignancies, medication use, and vaccination (for influenza, hepatitis B, rabies, tetanus, and more recently, severe acute respiratory syndrome Coronavirus 2 known as SARS-CoV-2), can potentially trigger the onset of pemphigus. With the advent of vaccines playing a pivotal role in combatting the 2019 coronavirus disease (COVID-19), extensive research has been conducted globally to ascertain their efficacy and potential cutaneous adverse effects. While reports of AIBDs post-COVID-19 vaccination exist in the medical literature, instances of PF following vaccination have been less commonly reported worldwide. The disease\'s pathophysiology is likely attributed to the resemblance between the ribonucleic acid (RNA) antigen present in these vaccines and cellular nuclear matter. The protein produced by the BNT-162b2 messenger ribonucleic acid (mRNA) vaccine includes immunogenic epitopes that could potentially trigger autoimmune phenomena in predisposed individuals through several mechanisms, including molecular mimicry, the activation of pattern recognition receptors, the polyclonal stimulation of B cells, type I interferon production, and autoinflammation. In this
review, we present a comprehensive examination of the existing literature regarding the relationship between COVID-19 and PF, delving into their intricate interactions. This exploration improves the understanding of both pemphigus and mRNA vaccine mechanisms, highlighting the importance of close monitoring for PF post-immunization.