Pemphigus vulgaris. Superior sensitivity of monkey esophagus in the determination of pemphigus antibody

Abstract

This study demonstrates that monkey esophagus is a more sensitive substrate than guinea pig esophagus for the demonstration of serum antibodies, in patients with pemphigus vulgaris. In this study, for example, five patients with active pemphigus who had demonstrable pemphigus antibodies on monkey esophagus substrate failed to demonstrate pemphigus antibody activity when guinea pig esophagus was employed as a substrate. Furthermore, pemphigus antibody titers determined on monkey esophagus substrate frequently exceeded, by several dilutions, titers detected with guinea pig esophagus. By contrast, in no instance did we detect pemphigus antibody titer activity on guinea pig esophagus in excess of the pemphigus antibody activity detected on monkey esophagus. The reason for the disparity in the sensitivity of the guinea pig and monkey esophagus substrates is unknown.

Comparison of the reactivity of various epithelial substrates for the titration of pemphigus antibodies by indirect immunofluorescence.

“…A direct relationship between sequential serum antibody titre and the clinical activity of pemphigus has been reported by several authors (Chorzelski & Beutner, 1969;O'Loughlin et al, 1978;Weissman et al, 1978;Fitzpatrick & Newcomer, 1980;Feibelman et al, 1981). All these authors used human skin or monkey oesophagus as substrates for the titration of pemphigus sera.…”

“…The choice of substrate for IF testing may account for their results, since it has been shown by others (Feibelman et al, 1981), and by us, that guinea-pig oesophagus is an inferior substrate for the titration of pemphigus antibody.…”

Diagnosis of pemphigus by ELISA: a critical evaluation of two ELISAs for the detection of antibodies to the major pemphigus antigens, desmoglein 1 and 3

“…The best substrate for IIF in PV and PF has not yet been established beyond doubt and data has been conflicting. 13–17 However, with the benefit of ELISA to accurately classify pemphigus cases according to the presence of Dsg 1 and/or Dsg 3 antibodies, we are currently re‐evaluating IIF on different tissue substrates.…”

The use of two substrates to improve the sensitivity of indirect immunofluorescence in the diagnosis of pemphigus

“… 18 With the benefit of a Dsg ELISA, we have shown that it is the combination of a Dsg1‐rich substrate, such as HS, and a Dsg3‐rich substrate, such as MO, which is the crucial prerequisite to increase the sensitivity of IIF when screening the serum of subjects with pemphigus. Although there have been a number of previous studies in which IIF on different epithelial substrates has been compared in pemphigus, 13,18 , 20–24 most of these studies were done without any knowledge of the Dsg autoantibody content of the sera and the data have been conflicting. Although Jiao and Bystryn used immunoblotting as a means of detecting Dsg1 and Dsg3 antibodies, 65% of PF sera and 17% of PV sera were negative and could not be classified.…”