Abstract |
Pemphigus vulgaris (PV) is an autoimmune, blistering disease that affects the mucosa and skin. The current theory favors the concept that anti- desmoglein (Dsg) 3 autoimmunity is the only pathogenic event needed to induce acantholysis. However, a few cases of active PV in the oral cavity had no detectable anti-Dsg 3 antibody. The aim of this study was to evaluate the differences in clinical and laboratory findings, whether or not the anti-Dsg 3 antibodies were present. This study was based on a retrospective review of 10 PV cases. The evaluation of the circulating autoantibody titers to Dsg 3 was conducted by using enzyme-linked immunosorbent assay (ELISA). An index value of 20 or more was used as the cutoff for a positive reaction. Only five of the 10 PV cases had a positive Dsg 3 ELISA. There were no differences in clinical, cytological, histopathological, and direct immunofluorescence findings, whether or not the anti-Dsg 3 antibodies were present. Of the five patients with a negative reaction at the time of diagnosis, the Dsg 3 ELISA became positive in the follow-up period in three cases. In the remaining two cases, the Dsg 3 ELISA was consistently negative for 18 months. Dsg 3 ELISA was negative early in some PV cases. Therefore, PV acantholysis may precede the elevation of circulating anti-Dsg 3 antibody levels. The diagnosis of PV should be considered based on comprehensive clinical, histopathological, and immunofluorescent criteria.
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Authors | Hiroyasu Endo, Terry D Rees, Hideo Niwa, Kayo Kuyama, Maya Oshima, Tae Serizawa, Shigeo Tanaka, Masamichi Komiya, Takanori Ito |
Journal | Clinical and experimental dental research
(Clin Exp Dent Res)
Vol. 5
Issue 3
Pg. 219-224
(06 2019)
ISSN: 2057-4347 [Electronic] United States |
PMID | 31249702
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Autoantibodies
- DSG3 protein, human
- Desmoglein 3
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Topics |
- Acantholysis
(etiology, immunology)
- Adult
- Aged
- Autoantibodies
(immunology)
- Desmoglein 3
(immunology)
- Enzyme-Linked Immunosorbent Assay
- Female
- Gingivitis
(etiology, immunology)
- Humans
- Male
- Middle Aged
- Pemphigus
(complications, immunology)
- Time Factors
- Young Adult
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