The recent availability of
cDNA clones for
pemphigus antigens has allowed the production of recombinant
desmoglein 1 and
desmoglein 3 molecules and the development of an ELISA approach in order to determine levels of
antibodies to them. The aim of the study was to determine the relationship between
autoantibodies levels and the extent of both mucosal and skin lesions in 20 patients with
pemphigus vulgaris at the time of diagnosis and during follow-up. For the detection of
autoantibodies by ELISA we used the
recombinant proteins expressing overlapping sequences with the entire extracellular
desmoglein 1 and
desmoglein 3 domains. We showed that in presence of mucosal lesions there was a correlation between extension of mucosal involvement and
autoantibodies titres against both
desmoglein 1 and
desmoglein 3, whereas in presence of skin lesions there was a statistically significant correlation between extension of skin lesions and
autoantibodies titres against
desmoglein 3, but not against
desmoglein 1. A not negligible number of patients showed variations of the
desmoglein 3 autoantibodies titre which did not correlate with the severity of both cutaneous and mucosal involvement. Similar results were obtained analyzing
autoantibodies titres against
desmoglein 1. In conclusion, we believe that the utilization of recombinant
desmoglein 1 and
desmoglein 3 proteins by ELISA should be used with caution to monitor disease severity and response to
therapy, although it remains a high specific test for the initial diagnosis of
pemphigus and the identification of a change in the clinical phenotype of this condition.