Ocular manifestations of systemic disease part IMucous membrane pemphigoid: an updateEschle-Meniconi, Margherita Ea; Ahmad, Sumera Rb; Foster, C StephenaAuthor Information aMassachusetts Eye Research and Surgery Institute, Boston, Massachusetts, USA, and bMedical School of Aga Khan University, Karachi, Pakistan This work was supported by a grant from the Swiss National Science Foundation to M Eschle-Meniconi. Correspondence to C Stephen Foster, MD, Massachusetts Eye Research and Surgery Institute, 5 Cambridge Center, 8th Floor, Cambridge, MA 02142, USA Tel: 617 742 6377; fax: 617 227 1185; e-mail: email@example.com Current Opinion in Ophthalmology: October 2005 - Volume 16 - Issue 5 - p 303-307 doi: 10.1097/01.icu.0000179802.04101.79 Buy Metrics Abstract Purpose of review To review articles on mucous membrane pemphigoid, published between June 2004-May 2005. Recent findings Decreased glycosylation of mucin was found in patients with ocular cicatricial pemphigoid. A unique antigen in oral mucous membrane pemphigoid has not yet been identified. Increased vascular cell adhesion molecule and intercellular adhesion molecule 1 expression was found in skin of patients affected by mucous membrane pemphigoid. Autoreactive T cells to an epitope of bullous pemphigoid antigen 180 kilodaltons were identified in the blood of some patients with mucous membrane pemphigoid. Circulating IgA against an antigen in mucous membrane pemphigoid was found in about 20% of patients, without prognostic significance. Enhanced sensitivity for direct immunofluorescence was reported if skin biopsy specimens were stored for 24 hours in saline. An enzyme-linked immunosorbent assay for detection of circulating autoantibodies against laminin-5 was developed. Sensitivity was higher than indirect immunofluorescence on salt-split skin and immunoblotting. Patients with younger onset (<60 years) of ocular cicatricial pemphigoid were found to have disease evolution similar to that of an older group (>70 years) but were visually impaired earlier in life. Intravenous immunoglobulin as treatment of ocular cicatricial pemphigoid was found to be superior to conventional immunosuppressants, with fewer side effects and better long-term outcome for halting disease activity. Intraoperative adjunction of mitomycin C during fornix reconstruction with amniotic membrane resulted in achieving a deeper fornix in 83% of patients with various cicatrizing conjunctivitis. Transplantation of cultured epithelial cells of oral mucosa in corneal limbal stem cell deficiency was successful in improving visual acuity and reestablishing corneal transparency in mid- to advanced ocular cicatricial pemphigoid. Summary Further advances have been achieved in the field of mucous membrane pemphigoid. © 2005 Lippincott Williams & Wilkins, Inc.