I believe Prednisone works in pemphigus because of an unknown mechanism to counter the action of antibodies. He is searching for a safer drug which will treat pemphigus without the many side effects of Prednisone. A report in the Archives of Dermatology that pemphigus was improved by cigarette smoking supported his earlier research that nicotine may play a role in the mystery of pemphigus antibodies. Nicotine stimulates the production of adhesion molecules. He does not recommend pemphigus patients take up smoking, quite the contrary.
Cigarettes contain thousands of chemicals many proven harmful.
It is only nicotine he is interested in. Antibodies to the nicotinic receptors of muscle tissue has been shown to be a cause of myasthenia. In general, when pemphigus antibodies are found in the skin, blisters occur. When Prednisone is used the blisters stop. He parts with traditional theories about the mechanism of pemphigus because the they cannot adequately explain why, in pemphigus, the cells detach but the bridges between the cells remain intact.