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Hypothetical scheme of the signaling mechanisms leading to acantholysis through predominantly oncotic and apoptotic pathways in PV-1 and PV-2 patients, respectively. The signaling cascades originating from the plasma membrane antigens targeted by PVIgG-1 and PVIgG-2 include distinct stimulatory (↓) and inhibitory (⊥) steps and involve cross-talk between the effectors of oncotic and apoptotic pathway, thus leading to acantholysis through an overlapping, synergistic mechanism.
