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The first\u2010line treatment of <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content> is topical and systemic glucocorticoids (<jats:styled-content style=\"fixed-case\">GC<\/jats:styled-content>). Regulation of the immune system and inflammatory cells is the main target of <jats:styled-content style=\"fixed-case\">GC<\/jats:styled-content> actions. <jats:styled-content style=\"fixed-case\">GC<\/jats:styled-content>s act through genomic and non\u2010genomic mechanisms. The human glucocorticoid receptor (<jats:styled-content style=\"fixed-case\">GR<\/jats:styled-content>) mediates most of the biologic effects of GC: cytosolic <jats:styled-content style=\"fixed-case\">GR<\/jats:styled-content> binds <jats:styled-content style=\"fixed-case\">GC<\/jats:styled-content>s and is capable to bind to glucocorticoid response elements in <jats:styled-content style=\"fixed-case\">DNA<\/jats:styled-content> and either transactivate or transrepress genes depending on the tissue and cell type. In addition, <jats:styled-content style=\"fixed-case\">GR<\/jats:styled-content> exerts rapid, non\u2010genomic effects possibly mediated by membrane\u2010localized receptors or by translocation to mitochondria. <jats:styled-content style=\"fixed-case\">GC<\/jats:styled-content>s can also interact directly with several enzymes and cytokines. As a target treatment for <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content>, the production of autoantibodies should be discontinued. <jats:styled-content style=\"fixed-case\">GC<\/jats:styled-content>s, in spite of their wide immunosuppressive actions, are weak to stop immunoglobulin G (IgG) autoantibody formation. However, both systemic and topical <jats:styled-content style=\"fixed-case\">GC<\/jats:styled-content>s are able to reduce the clinical symptoms of <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content>. <jats:styled-content style=\"fixed-case\">GC<\/jats:styled-content>s are used to inhibit the secondary inflammation and symptoms, such as blistering and pruritus, and it is shown that <jats:styled-content style=\"fixed-case\">GC<\/jats:styled-content> treatment will gradually decrease also the autoantibody formation. Our review article analyses the mode of action of <jats:styled-content style=\"fixed-case\">GC<\/jats:styled-content> treatment in <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content>, as far it is possible due to paucity of modern immunological studies.<\/jats:p>","DOI":"10.1111\/exd.13408","type":"journal-article","created":{"date-parts":[[2017,8,3]],"date-time":"2017-08-03T19:34:18Z","timestamp":1501788858000},"page":"1253-1260","source":"Crossref","is-referenced-by-count":12,"title":["Glucocorticoids: The mode of action in bullous pemphigoid"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9304-2140","authenticated-orcid":false,"given":"Minna E.","family":"Kubin","sequence":"first","affiliation":[{"name":"PEDEGO Research Unit Oulu Center for Cell\u2010Matrix Research Department of Dermatology and Medical Research Center Oulu Oulu University Hospital and University of Oulu Oulu Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"Hellberg","sequence":"additional","affiliation":[{"name":"Institute for Medical Microbiology and Hygiene University of L\u00fcbeck L\u00fcbeck Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riitta","family":"Palatsi","sequence":"additional","affiliation":[{"name":"PEDEGO Research Unit Oulu Center for Cell\u2010Matrix Research Department of Dermatology and Medical Research Center Oulu Oulu University Hospital and University of Oulu Oulu Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,11,2]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61140-4"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.13717"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2017.03.010"},{"key":"e_1_2_10_5_1","first-page":"1181","volume-title":"Textbook of Dermatology","author":"Sneddon I. 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