nach oben

Archives of Dermatological Research

Erschienen in:

01.05.2010 | Mini Review

Immunoadsorption in dermatology

verfasst von: Enno Schmidt, Detlef Zillikens

Erschienen in: Archives of Dermatological Research | Ausgabe 4/2010

Einloggen, um Zugang zu erhalten

Abstract

Immunoadsorption (IA), also termed immunoapheresis, has been established as effective and specific tool advantageous to plasmapheresis to remove immunoglobulin and immune complexes and in cytapheresis, immune cells from the circulation. IA was successfully used in various autoantibody-mediated diseases, e.g. acquired hemophilia, myasthenia gravis, dilated cardiomyopathy, and Guillain–Barré syndrome. In dermatology, IA has been applied as an effective adjuvant treatment for autoimmune bullous diseases. Autoimmune blistering disorders are a heterogeneous group of diseases that are associated with autoantibodies to desmosomal (pemphigus group) and basal membrane zone proteins (pemphigoid group, epidermolysis bullosa acquisita). Because the pathogenic relevance of autoantibodies was clearly demonstrated in the majority of these disorders, removal of autoantibodies, therefore, appears to be a rational therapeutic approach for these patients. IA has been shown to effectively lower the autoantibody levels and leads to rapid clinical responses in patients with immunobullous disorders. Here, clinical effects and adverse events of IA in more than 50 reported patients with autoimmune blistering disorders are reviewed. In addition, an overview of the available IA systems and treatment protocols is provided and guidelines of a recent consensus of German, Austrian, and Swiss experts for the use of IA in autoimmune bullous diseases are summarized.

Amagai M, Hashimoto T, Shimizu N, Nishikawa T (1994) Absorption of pathogenic autoantibodies by the extracellular domain of pemphigus vulgaris antigen (Dsg3) produced by baculovirus. J Clin Invest 94(1):59–67CrossRefPubMed

Amagai M, Hashimoto T, Green KJ, Shimizu N, Nishikawa T (1995) Antigen-specific immunoadsorption of pathogenic autoantibodies in pemphigus foliaceus. J Invest Dermatol 104(6):895–901CrossRefPubMed

Amagai M, Ikeda S, Shimizu H, Iizuka H, Hanada K, Aiba S, Kaneko F, Izaki S, Tamaki K, Ikezawa Z, Takigawa M, Seishima M, Tanaka T, Miyachi Y, Katayama I, Horiguchi Y, Miyagawa S, Furukawa F, Iwatsuki K, Hide M, Tokura Y, Furue M, Hashimoto T, Ihn H, Fujiwara S, Nishikawa T, Ogawa H, Kitajima Y, Hashimoto K (2009) A randomized double-blind trial of intravenous immunoglobulin for pemphigus. J Am Acad Dermatol 60(4):595–603CrossRefPubMed

Anhalt GJ, Labib RS, Voorhees JJ, Beals TF, Diaz LA (1982) Induction of pemphigus in neonatal mice by passive transfer of IgG from patients with the disease. N Engl J Med 306(20):1189–1196PubMed

Anhalt GJ (2004) Paraneoplastic pemphigus. J Investig Dermatol Symp Proc 9(1):29–33CrossRefPubMed

Bertram F, Brocker EB, Zillikens D, Schmidt E (2009) Prospective analysis of the incidence of autoimmune bullous disorders in Lower Franconia, Germany. J Dtsch Dermatol Ges 7(5):434–440PubMed

Braun N, Bosch T (2000) Immunoadsorption, current status and future developments. Expert Opin Investig Drugs 9(9):2017–2038CrossRefPubMed

Bystryn JC, Steinman NM (1996) The adjuvant therapy of pemphigus: an update. Arch Dermatol 132(2):203–212CrossRefPubMed

Chams-Davatchi C, Valikhani M, Daneshpazhooh M, Esmaili N, Balighi K, Hallaji Z, Barzegari M, Akhiani M, Ghodsi Z, Mortazavi H, Naraghi Z (2005) Pemphigus: analysis of 1209 cases. Int J Dermatol 44(6):470–476CrossRefPubMed

10.

Cotterill JA, Barker DJ, Millard LG (1978) Plasma exchange in the treatment of pemphigus vulgaris. Br J Dermatol 98(2):243CrossRefPubMed

11.

Eming R, Rech J, Barth S, Kalden JR, Schuler G, Harrer T, Hertl M (2006) Prolonged clinical remission of patients with severe pemphigus upon rapid removal of desmoglein-reactive autoantibodies by immunoadsorption. Dermatology 212(2):177–187CrossRefPubMed

12.

Felix SB, Staudt A (2008) Immunoadsorption as treatment option in dilated cardiomyopathy. Autoimmunity 41(6):484–489CrossRefPubMed

13.

Freedman J, Garvey MB (2004) Immunoadsorption of factor VIII inhibitors. Curr Opin Hematol 11(5):327–333CrossRefPubMed

14.

Frost N, Messer G, Fierlbeck G, Risler T, Lytton SD (2005) Treatment of pemphigus vulgaris with protein A immunoadsorption: case report of long-term history showing favorable outcome. Ann N Y Acad Sci 1051:591–596CrossRefPubMed

15.

Gaubitz M, Schneider KM (2003) Immunoadsorption in systemic lupus erythematosus: different techniques and their current role in medical therapy. Ther Apher Dial 7(2):183–188CrossRefPubMed

16.

Genberg H, Kumlien G, Wennberg L, Tyden G (2007) Long-term results of ABO-incompatible kidney transplantation with antigen-specific immunoadsorption and rituximab. Transplantation 84(12 Suppl):S44–S47CrossRefPubMed

17.

Genberg H, Kumlien G, Wennberg L, Berg U, Tyden G (2008) ABO-incompatible kidney transplantation using antigen-specific immunoadsorption and rituximab: a 3-year follow-up. Transplantation 85(12):1745–1754CrossRefPubMed

18.

Guillaume JC, Roujeau JC, Morel P, Doutre MS, Guillot B, Lambert D, Lauret P, Lorette G, Prigent F, Triller R et al (1988) Controlled study of plasma exchange in pemphigus. Arch Dermatol 124(11):1659–1663CrossRefPubMed

19.

Gunther C, Laske J, Frind A, Julius U, Pfeiffer C (2008) Successful therapy of pemphigus vulgaris with immunoadsorption using the TheraSorbtrade mark adsorber. J Dtsch Dermatol Ges

20.

Herrero-Gonzalez JE, Sitaru C, Klinker E, Brocker EB, Zillikens D (2005) Successful adjuvant treatment of severe bullous pemphigoid by tryptophan immunoadsorption. Clin Exp Dermatol 30(5):519–522CrossRefPubMed

21.

Hiepe F, Pfuller B, Wolbart K, Bruns A, Leinenbach HP, Hepper M, Schossler W, Otto V (1999) C1q: a multifunctional ligand for a new immunoadsorption treatment. Ther Apher 3(3):246–251PubMed

22.

Ino N, Kamata N, Matsuura C, Shinkai H, Odaka M (1997) Immunoadsorption for the treatment of bullous pemphigoid. Ther Apher 1(4):372–376CrossRefPubMed

23.

Iwata H, Kamio N, Aoyama Y, Yamamoto Y, Hirako Y, Owaribe K, Kitajima Y (2009) IgG from patients with bullous pemphigoid depletes cultured keratinocytes of the 180-kDa bullous pemphigoid antigen (type XVII collagen) and weakens cell attachment. J Invest Dermatol 129(4):919–926CrossRefPubMed

24.

Kaczmarek I, Deutsch MA, Sadoni S, Brenner P, Schmauss D, Daebritz SH, Weiss M, Meiser BM, Reichart B (2007) Successful management of antibody-mediated cardiac allograft rejection with combined immunoadsorption and anti-CD20 monoclonal antibody treatment: case report and literature review. J Heart Lung Transplant 26(5):511–515CrossRefPubMed

25.

Kadar JG, Borberg H (1990) Biocompatibility of extracorporeal immunoadsorption systems. Transfus Sci 11(2):223–239CrossRefPubMed

26.

Kasperkiewicz M, Hoppe U, Zillikens D, Schmidt E (2009) Relapse-associated autoantibodies to BP180 in a patient with anti-p200 pemphigoid. Clin Exp Dermatol (in press)

27.

Kasperkiewicz M, Schmidt E, Rose C, Frambach, Anemüller W, Grabbe J, Ludwig R, Zillikens D (2009) Immunadsorption bei Patienten mit schwerster atopischer Dermatitis und exzessiv erhöhten peripheren Serum-IgE-Spiegeln. 82. Jahrestagung der Norddeutschen Dermatologischen Gesellschaft. 02.04.09.2009, Halle (Saale) (abstract)

28.

Knobl P, Derfler K (1999) Extracorporeal immunoadsorption for the treatment of haemophilic patients with inhibitors to factor VIII or IX. Vox Sang 77(Suppl 1):57–64PubMed

29.

Kumlien G, Ullstrom L, Losvall A, Persson LG, Tyden G (2006) Clinical experience with a new apheresis filter that specifically depletes ABO blood group antibodies. Transfusion 46(9):1568–1575CrossRefPubMed

30.

Langan SM, Smeeth L, Hubbard R, Fleming KM, Smith CJ, West J (2008) Bullous pemphigoid and pemphigus vulgaris–incidence and mortality in the UK: population based cohort study. BMJ 337:a180

31.

Lazarova Z, Yee C, Darling T, Briggaman RA, Yancey KB (1996) Passive transfer of anti-laminin 5 antibodies induces subepidermal blisters in neonatal mice. J Clin Invest 98(7):1509–1518CrossRefPubMed

32.

Liu Z, Diaz LA, Troy JL, Taylor AF, Emery DJ, Fairley JA, Giudice GJ (1993) A passive transfer model of the organ-specific autoimmune disease, bullous pemphigoid, using antibodies generated against the hemidesmosomal antigen, BP180. J Clin Invest 92(5):2480–2488CrossRefPubMed

33.

Liu Z, Diaz LA, Swartz SJ, Troy JL, Fairley JA, Giudice GJ (1995) Molecular mapping of a pathogenically relevant BP180 epitope associated with experimentally induced murine bullous pemphigoid. J Immunol 155(11):5449–5454PubMed

34.

Liumbruno GM, Centoni PE, Molfettini P, Ceretelli S, Ceccarini M, Bachini L, Pomponi A, Bagnoni G, Vitolo M, Eberle O, Biondi A, Sodini ML (2006) Lymphocytapheresis in the treatment of psoriasis vulgaris. J Clin Apher 21(3):158–164CrossRefPubMed

35.

Luftl M, Stauber A, Mainka A, Klingel R, Schuler G, Hertl M (2003) Successful removal of pathogenic autoantibodies in pemphigus by immunoadsorption with a tryptophan-linked polyvinylalcohol adsorber. Br J Dermatol 149(3):598–605CrossRefPubMed

36.

Marazza G, Pham HC, Scharer L, Pedrazzetti PP, Hunziker T, Trueb RM, Hohl D, Itin P, Lautenschlager S, Naldi L, Borradori L (2009) Incidence of bullous pemphigoid and pemphigus in Switzerland: a 2-year prospective study. Br J Dermatol 161(4):861–868CrossRefPubMed

37.

Marn Pernat A, Buturovic-Ponikvar J, Svigelj V, Ponikvar R (2009) Guillain–Barre syndrome treated by membrane plasma exchange and/or immunoadsorption. Ther Apher Dial 13(4):310–313CrossRefPubMed

38.

Matic G, Hofmann D, Winkler R, Tiess M, Michelsen A, Schneidewind JM, Hebestreit G, Keysser M, Muller W, Kinze EM, Ramlow W (2000) Removal of immunoglobulins by a protein A versus an antihuman immunoglobulin G-based system: evaluation of 602 sessions of extracorporeal immunoadsorption. Artif Organs 24(2):103–107CrossRefPubMed

39.

Mitsuyama K, Sata M (2009) Therapeutic leukocytapheresis in inflammatory bowel disease: clinical efficacy and mechanisms of action. Cytotherapy 11(2):229–237CrossRefPubMed

40.

Mulyowa GK, Jaeger G, Kabakyenga J, Brocker EB, Zillikens D, Schmidt E (2006) Autoimmune subepidermal blistering diseases in Uganda: correlation of autoantibody class with age of patients. Int J Dermatol 45(9):1047–1052CrossRefPubMed

41.

Nagel A, Hertl M, Eming R (2009) B-cell-directed therapy for inflammatory skin diseases. J Invest Dermatol 129(2):289–301CrossRefPubMed

42.

Naito K, Morioka S, Ogawa H (1982) The pathogenic mechanisms of blister formation in bullous pemphigoid. J Invest Dermatol 79(5):303–306CrossRefPubMed

43.

Niedermeier A, Eming R, Pfutze M, Neumann CR, Happel C, Reich K, Hertl M (2007) Clinical response of severe mechanobullous epidermolysis bullosa acquisita to combined treatment with immunoadsorption and rituximab (anti-CD20 monoclonal antibodies). Arch Dermatol 143(2):192–198CrossRefPubMed

44.

Norda R, Stegmayr BG (2003) Therapeutic apheresis in Sweden: update of epidemiology and adverse events. Transfus Apher Sci 29(2):159–166CrossRefPubMed

45.

Ogata K, Yasuda K, Matsushita M, Kodama H (1999) Successful treatment of adolescent pemphigus vulgaris by immunoadsorption method. J Dermatol 26(4):236–239PubMed

46.

Ohji S, Nomura K (2008) The indication of steroid pulse therapy and apheresis therapy for multiple sclerosis. Nippon Rinsho 66(6):1127–1132PubMed

47.

Pfutze M, Eming R, Kneisel A, Kuhlmann U, Hoyer J, Hertl M (2009) Clinical and immunological follow-up of pemphigus patients on adjuvant treatment with immunoadsorption or rituximab. Dermatology 218(3):237–245CrossRefPubMed

48.

Pisanti S, Sharav Y, Kaufman E, Posner LN (1974) Pemphigus vulgaris: incidence in Jews of different ethnic groups, according to age, sex, and initial lesion. Oral Surg Oral Med Oral Pathol 38(3):382–387CrossRefPubMed

49.

Poullin P, Announ N, Mugnier B, Guis S, Roudier J, Lefevre P (2005) Protein A-immunoadsorption (Prosorba column) in the treatment of rheumatoid arthritis. Joint Bone Spine 72(2):101–103CrossRefPubMed

50.

Rech J, Hueber AJ, Kallert S, Leipe J, Kalden JR, Beck M, Schett G, Schulze-Koops H (2008) Remission of demyelinating polyneuropathy with immunoadsorption, low dose corticosteroids and anti-CD20 monoclonal antibody. Ther Apher Dial 12(3):205–208CrossRefPubMed

51.

Ronspeck W, Brinckmann R, Egner R, Gebauer F, Winkler D, Jekow P, Wallukat G, Muller J, Kunze R (2003) Peptide based adsorbers for therapeutic immunoadsorption. Ther Apher Dial 7(1):91–97CrossRefPubMed

52.

Roujeau JC, Revuz J, Touraine R, Joneau-Fabre M, Mannoni P (1979) Cortico-resistant bullous pemphigoid: favorable results with plasmapheresis. Nouv Presse Med 8(41):3362PubMed

53.

Roujeau JC, Andre C, Joneau Fabre M, Lauret P, Flechet ML, Kalis B, Revuz J, Touraine R (1983) Plasma exchange in pemphigus: uncontrolled study of ten patients. Arch Dermatol 119(3):215–221CrossRefPubMed

54.

Sakai Y, Sakai S, Otsuka T, Ohno D, Murasawa T, Munakata K, Mizuno K (2009) Efficacy of high-throughput leukocytapheresis for rheumatoid arthritis with a reduced response to infliximab. Ther Apher Dial 13(3):179–185CrossRefPubMed

55.

Sawada K, Muto T, Shimoyama T, Satomi M, Sawada T, Nagawa H, Hiwatashi N, Asakura H, Hibi T (2003) Multicenter randomized controlled trial for the treatment of ulcerative colitis with a leukocytapheresis column. Curr Pharm Des 9(4):307–321CrossRefPubMed

56.

Schiltz JR, Michel B (1976) Production of epidermal acantholysis in normal human skin in vitro by the IgG fraction from pemphigus serum. J Invest Dermatol 67(2):254–260CrossRefPubMed

57.

Schmidt E, Obe K, Brocker EB, Zillikens D (2000) Serum levels of autoantibodies to BP180 correlate with disease activity in patients with bullous pemphigoid. Arch Dermatol 136(2):174–178CrossRefPubMed

58.

Schmidt E, Klinker E, Opitz A, Herzog S, Sitaru C, Goebeler M, Mansouri Taleghoni B, Brocker EB, Zillikens D (2003) Protein A immunoadsorption: a novel and effective adjuvant treatment of severe pemphigus. Br J Dermatol 148(6):1222–1229CrossRefPubMed

59.

Schmidt E, Brocker EB, Goebeler M (2008) Rituximab in treatment-resistant autoimmune blistering skin disorders. Clin Rev Allergy Immunol 34(1):56–64CrossRefPubMed

60.

Schmidt E, Goebeler M, Zillikens D (2009) Rituximab in severe pemphigus. Ann N Y Acad Sci 1173(9):683–691CrossRefPubMed

61.

Schmidt E, Zillikens D (2009) Research in practice: diagnosis of subepidermal autoimmune bullous disorders. J Dtsch Dermatol Ges 7(4):296–300PubMed

62.

Schoen H, Foedinger D, Derfler K, Amann G, Rappersberger K, Stingl G, Volc-Platzer B (1998) Immunoapheresis in paraneoplastic pemphigus. Arch Dermatol 134(6):706–710CrossRefPubMed

63.

Shimanovich I, Herzog S, Schmidt E, Opitz A, Klinker E, Brocker EB, Goebeler M, Zillikens D (2006) Improved protocol for treatment of pemphigus vulgaris with protein A immunoadsorption. Clin Exp Dermatol 31(6):768–774CrossRefPubMed

64.

Shimanovich I, Nitschke M, Rose C, Grabbe J, Zillikens D (2008) Treatment of severe pemphigus with protein A immunoadsorption, rituximab and intravenous immunoglobulins. Br J Dermatol 158(2):382–388PubMedCrossRef

65.

Shimanovich I, Bohmke AK, Westermann L, Kramer J, Zillikens D, Schmidt E (2009) Successful treatment of severe pemphigus with the combination of immunoadsorption and rituximab. J Invest Dermatol 129:S97

66.

Sitaru C, Kromminga A, Hashimoto T, Brocker EB, Zillikens D (2002) Autoantibodies to type VII collagen mediate Fcgamma-dependent neutrophil activation and induce dermal-epidermal separation in cryosections of human skin. Am J Pathol 161(1):301–311PubMed

67.

Sitaru C, Schmidt E, Petermann S, Munteanu LS, Brocker EB, Zillikens D (2002) Autoantibodies to bullous pemphigoid antigen 180 induce dermal–epidermal separation in cryosections of human skin. J Invest Dermatol 118(4):664–671CrossRefPubMed

68.

Sitaru C, Mihai S, Otto C, Chiriac MT, Hausser I, Dotterweich B, Saito H, Rose C, Ishiko A, Zillikens D (2005) Induction of dermal-epidermal separation in mice by passive transfer of antibodies specific to type VII collagen. J Clin Invest 115(4):870–878PubMed

69.

Sitaru C, Chiriac MT, Mihai S, Buning J, Gebert A, Ishiko A, Zillikens D (2006) Induction of complement-fixing autoantibodies against type VII collagen results in subepidermal blistering in mice. J Immunol 177(5):3461–3468PubMed

70.

Soerensen H, Schneidewind-Mueller JM, Lange D, Kashiwagi N, Franz M, Yokoyama T, Ramlow W (2006) Pilot clinical study of Adacolumn cytapheresis in patients with systemic lupus erythematosus. Rheumatol Int 26(5):409–415CrossRefPubMed

71.

Sondergaard K, Carstens J, Jorgensen J, Zachariae H (1995) The steroid-sparing effect of long-term plasmapheresis in pemphigus. Acta Derm Venereol 75(2):150–152PubMed

72.

Tan-Lim R, Bystryn JC (1990) Effect of plasmapheresis therapy on circulating levels of pemphigus antibodies. J Am Acad Dermatol 22(1):35–40CrossRefPubMed

73.

Turner MS, Sutton D, Sauder DN (2000) The use of plasmapheresis and immunosuppression in the treatment of pemphigus vulgaris. J Am Acad Dermatol 43(6):1058–1064CrossRefPubMed

74.

Wallukat G, Muller J, Hetzer R (2002) Specific removal of beta1-adrenergic autoantibodies from patients with idiopathic dilated cardiomyopathy. N Engl J Med 347(22):1806CrossRefPubMed

75.

Waschke J (2008) The desmosome and pemphigus. Histochem Cell Biol 130(1):21–54CrossRefPubMed

76.

Wohrl S, Geusau A, Karlhofer F, Derfler K, Stingl G, Zillikens D (2003) Pemphigoid gestationis: treatment with immunoapheresis. J Dtsch Dermatol Ges 1(2):126–130PubMed

77.

Woodley DT, Ram R, Doostan A, Bandyopadhyay P, Huang Y, Remington J, Hou Y, Keene DR, Liu Z, Chen M (2006) Induction of epidermolysis bullosa acquisita in mice by passive transfer of autoantibodies from patients. J Invest Dermatol 126(6):1323–1330CrossRefPubMed

78.

Zillikens D, Derfler K, Eming R, Fierlbeck G, Goebeler M, Hertl M, Hofmann SC, Karlhofer F, Kautz O, Nitschke M, Opitz A, Quist S, Rose C, Schanz S, Schmidt E, Shimanovich I, Michael M, Ziller F (2007) Recommendations for the use of immunoapheresis in the treatment of autoimmune bullous diseases. J Dtsch Dermatol Ges 5(10):881–887CrossRefPubMed

79.

Abreu-Velez AM, Howard MS, Hashimoto K, Hashimoto T (2009) Autoantibodies to sweat glands detected by different methods in serum and in tissue from patients affected by a new variant of endemic pemphigus foliaceus. Arch Dermatol Res 301:711–718CrossRefPubMed

80.

Gaines E, Werth VP (2008) Development of outcome measures for autoimmune dermatoses. Arch Dermatol Res 300:3–9CrossRefPubMed

81.

Leighty L, Li N, Diaz LA, Liu Z (2007) Experimental models for the autoimmune and inflammatory blistering disease: bullous pemphigoid. Arch Dermatol Res 299:417–422CrossRefPubMed

82.

Nancy AL, Yehuda S (2009) Prediction and prevention of autoimmune skin disorders. Arch Dermatol Res 301:57–64CrossRefPubMed

Titel: Immunoadsorption in dermatology
verfasst von: Enno Schmidt
Detlef Zillikens
Publikationsdatum: 01.05.2010
Verlag: Springer-Verlag
Erschienen in: Archives of Dermatological Research / Ausgabe 4/2010
Print ISSN: 0340-3696
Elektronische ISSN: 1432-069X
DOI: https://doi.org/10.1007/s00403-009-1024-9

Leitlinien kompakt für die Dermatologie

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Dermatologie

Hirsutismus bei PCOS: Laser- und Lichttherapien helfen

26.04.2024 Hirsutismus Nachrichten

Laser- und Lichtbehandlungen können bei Frauen mit polyzystischem Ovarialsyndrom (PCOS) den übermäßigen Haarwuchs verringern und das Wohlbefinden verbessern – bei alleiniger Anwendung oder in Kombination mit Medikamenten.

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

25.04.2024 Allergien und Intoleranzreaktionen Nachrichten

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Auf diese Krankheiten bei Geflüchteten sollten Sie vorbereitet sein

22.04.2024 DGIM 2024 Nachrichten

Um Menschen nach der Flucht aus einem Krisengebiet bestmöglich medizinisch betreuen zu können, ist es gut zu wissen, welche Erkrankungen im jeweiligen Herkunftsland häufig sind. Dabei hilft eine Internetseite der CDC (Centers for Disease Control and Prevention).

Kein Abstrich bei chronischen Wunden ohne Entzündungszeichen!

16.04.2024 DGIM 2024 Nachrichten

Den Reflex, eine oberflächliche chronische Hautwunde ohne Entzündungszeichen in jedem Fall abzustreichen, sollte man nach einer neuen „Klug-entscheiden“-Empfehlung unterdrücken.

Update Dermatologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 4/2010

Effect of lipopolysaccharide, skin sensitizers and irritants on thioredoxin-1 expression in dendritic cells: relevance of different signalling pathways

A compound heterozygous mutation in the EDAR gene in a Spanish family with autosomal recessive hypohidrotic ectodermal dysplasia

Identification a novel missense mutation p.R761L in Chinese patients with Darier’s disease

Decrease in Mycobacterium tuberculosis specific immune responses in patients with untreated psoriasis living in a tuberculosis endemic area

Expression and function of glycogen synthase kinase-3 in human hair follicles