What is pemphigus?

Pemphigus is a group of rare autoimmune diseases that cause blistering of the skin and mucous membranes. These conditions are characterized by the development of blisters and erosions on the skin and mucous membranes, which occur due to the body’s immune system mistakenly attacking proteins in the skin and mucous membranes.


There are several types of pemphigus, including:


  • Pemphigus Vulgaris: This is the most common type of pemphigus. It typically affects middle-aged or older adults. Blisters often start in the mouth and can spread to other areas of the body, including the skin and genitals.


  • Pemphigus Foliaceus: This type of pemphigus causes blistering of the skin but usually does not affect the mucous membranes. Blisters often begin on the face and scalp and can spread to the chest, back, and other parts of the body.


  • Paraneoplastic Pemphigus: This rare type of pemphigus is associated with an underlying cancer, such as lymphoma or leukemia. It can cause severe blistering of the skin and mucous membranes and is often difficult to treat.


  • IgA Pemphigus: This type of pemphigus is characterized by the presence of IgA antibodies attacking the skin. It can cause blistering and pustules on the skin and mucous membranes.


The exact cause of pemphigus is not fully understood, but it is believed to be an autoimmune disorder. In pemphigus, the body’s immune system produces antibodies that target proteins called desmosomes, which are responsible for holding skin cells together. When these antibodies attack desmosomes, it weakens the connections between skin cells, leading to the formation of blisters and erosions.


What is the relationship between pemphigus and oxidative stress?

The relationship between pemphigus and oxidative stress is an area of ongoing research, and while the exact mechanisms are not fully understood, there are several ways in which oxidative stress may contribute to the pathogenesis and progression of pemphigus:


  • Inflammation: Oxidative stress is closely linked to inflammation, and both processes can exacerbate each other. In pemphigus, inflammation plays a central role in the development of blisters and erosions on the skin and mucous membranes. Oxidative stress can contribute to the activation of inflammatory pathways and the release of pro-inflammatory cytokines, which can further amplify the inflammatory response in pemphigus lesions.


  • Cell Damage and Apoptosis: Oxidative stress can lead to cellular damage and apoptosis (programmed cell death) in skin cells and mucosal epithelial cells. In pemphigus, the binding of autoantibodies to desmosomal proteins disrupts cell-cell adhesion and weakens the integrity of the skin and mucous membranes, making them more susceptible to damage from oxidative stress-induced apoptosis.


  • Mitochondrial Dysfunction: Oxidative stress can impair mitochondrial function in cells, leading to decreased energy production and increased production of reactive oxygen species (ROS). Mitochondrial dysfunction has been implicated in the pathogenesis of autoimmune diseases, including pemphigus, and may contribute to the dysregulation of cell signaling pathways and the activation of apoptotic pathways.


  • Antioxidant Defenses: Imbalance between oxidants and antioxidants can occur in pemphigus, leading to increased oxidative stress. Antioxidant enzymes such as superoxide dismutase, catalase, and glutathione peroxidase play a crucial role in neutralizing ROS and protecting cells from oxidative damage. Dysfunction of antioxidant defenses may exacerbate oxidative stress and contribute to the progression of pemphigus lesions.


  • Drug-Induced Oxidative Stress: Some medications used to treat pemphigus, such as corticosteroids and immunosuppressants, may induce oxidative stress as a side effect. Prolonged use of these medications can lead to the accumulation of ROS and oxidative damage in cells, potentially exacerbating pemphigus symptoms.


Overall, while the specific mechanisms linking oxidative stress to pemphigus are not fully understood, there is growing evidence to suggest that oxidative stress plays a role in the pathogenesis and progression of pemphigus.