Correlation of antibodies in skin and serum with disease severity in pemphigus

Abstract

Direct and indirect immunofluorescence (IF) testing was performed on 63 patients with active or inactive pemphigus in order to determine the reliability of these tests for diagnosis and for monitoring disease severity. Direct IF was positive in 58 of 63 patients with pemphigus. The five patients with negative direct IF had been free of lesions for more than a year. Thus, the direct IF test is a reliable diagnostic procedure that shows positive findings early in the disease. Indirect IF is inferior to direct IF as a diagnostic test because it may be negative in early cases, as observed in four patients. Furthermore, indirect IF, contrary to claims, is not reliable for evaluating the status of the disease. Thus, in patients with lesions and receiving treatment, 41% of the determinations showed a negative titer; whereas in patients free of lesions, 45% of the determinations showed a positive titer. In particular, seven patients without lesions and without treatment for more than a year had a positive titer.

Pemphigus Antibodies Identify a Cell Surface Glycoprotein Synthesized by Human and Mouse Keratinocytes

“…Thus, the interaction of pemphigus antibody with a cell surface antigen or antigens is probably a mediator of disease. Furthermore, most authors (13)(14)(15)(16), but not all (17), have (18), was used at passages 10-12. Normal human epidermal cells (HEC)' derived from neonatal foreskins were cultured on collagen substrates as previously reported (19), and used at passage 3. Fibroblasts were derived from the dermis of BALB/c mice (20) and used in the first passage, or from the dermis of human foreskins (19), and used at passage 11.…”

Novel Mechanisms of Target Cell Death and Survival and of Therapeutic Action of IVIg in Pemphigus

“…4 PV patients represent a heterogeneous population with regard to the natural course of their disease, clinical features, and response to therapy, perhaps due to dramatic patient-to-patient variations in the immunopathological mechanisms. [5][6][7][8] Apoptosis is believed to play a role in the mechanism of keratinocyte death in PV. The occurrence of apoptosis markers has been observed in early lesions of PV patients before acantholysis.…”

Pemphigus vulgaris localized to the tongue

“…Similar observations have been reported. 6,7 Another interesting observation made in this case was the presence of high titers of anti-Dsg-3 antibodies in the patient's sera throughout the disease course and while in remission. The titers of anti-Dsg-1 and -3 antibodies have been reported to correlate with disease activity in several studies.…”