The severity of cutaneous and oral pemphigus is related to desmoglein 1 and 3 antibody levels

K E Harman; P T Seed; M J Gratian; B S Bhogal; S J Challacombe; M M Black

doi:10.1046/j.1365-2133.2001.04132.x

The severity of cutaneous and oral pemphigus is related to desmoglein 1 and 3 antibody levels

K E Harman, P T Seed, M J Gratian, B S Bhogal, S J Challacombe, M M Black

Research output: Contribution to journal › Article › peer-review

231 Citations (Scopus)

Abstract

Background Pemphigus vulgaris (PV) and foliaceus (PF) are characterized by antibodies to the desmosomal proteins desmoglein 3 (Dsg3) and desmoglein 1 (Dsg1), respectively. Past studies using indirect immunofluorescence (IIF) as a measure of pemphigus antibody levels have failed to demonstrate consistently a relationship between disease severity and IIF titres. However, IIF is not able to measure separately Dsg1 and 3 antibodies, unlike enzyme-linked immunosorbent assays (ELISA), which utilize recombinant proteins. Objectives To compare independently Dsg1 and 3 antibody levels with the severity of both cutaneous and oral involvement in PV and PE Patients and methods Four hundred and twenty-four serum samples were analysed from 80 subjects with PV and 24 with PE IgG antibodies to Dsg1 and 3 were measured by ELISA, For every sample analysed, the associated severity of skin and oral disease were graded from 0 to 3; quiescent, mild, moderate and severe. Results A relationship between Dsg1 antibodies and skin severity was demonstrated such that a 10-unit increase in Dsg1 ELISA value was associated with a 34% chance of having a higher severity score [95% confidence interval (CI), 25-45%, P <0.0005]. This was observed in both PV and PE Oral severity was associated with Dsg3 antibody levels and a 10-unit increase in the Dsg3 ELISA value was associated with a 25% chance of a higher oral severity score (CT 17-33%, P <0.0005). We were unable to demonstrate a relationship between Dsg1 antibodies and oral severity, even after adjusting for the effect of Dsg3 antibodies, Similarly, there was no relationship between Dsg3 antibodies and skin severity, Conclusions This study suggests that the clinical phenotype of pemphigus, in particular the balance of skin and oral disease, is determined principally by the quantities of Dsg1 and 3 autoantibodies, respectively.

Original language	English
Pages (from-to)	775 - 780
Number of pages	6
Journal	British Journal of Dermatology
Volume	144
Issue number	4
DOIs	https://doi.org/10.1046/j.1365-2133.2001.04132.x
Publication status	Published - 2001

Access to Document

10.1046/j.1365-2133.2001.04132.x

Cite this

@article{8b5e6b002a5642cda44794d8ab91737f,

title = "The severity of cutaneous and oral pemphigus is related to desmoglein 1 and 3 antibody levels",

abstract = "Background Pemphigus vulgaris (PV) and foliaceus (PF) are characterized by antibodies to the desmosomal proteins desmoglein 3 (Dsg3) and desmoglein 1 (Dsg1), respectively. Past studies using indirect immunofluorescence (IIF) as a measure of pemphigus antibody levels have failed to demonstrate consistently a relationship between disease severity and IIF titres. However, IIF is not able to measure separately Dsg1 and 3 antibodies, unlike enzyme-linked immunosorbent assays (ELISA), which utilize recombinant proteins. Objectives To compare independently Dsg1 and 3 antibody levels with the severity of both cutaneous and oral involvement in PV and PE Patients and methods Four hundred and twenty-four serum samples were analysed from 80 subjects with PV and 24 with PE IgG antibodies to Dsg1 and 3 were measured by ELISA, For every sample analysed, the associated severity of skin and oral disease were graded from 0 to 3; quiescent, mild, moderate and severe. Results A relationship between Dsg1 antibodies and skin severity was demonstrated such that a 10-unit increase in Dsg1 ELISA value was associated with a 34% chance of having a higher severity score [95% confidence interval (CI), 25-45%, P <0.0005]. This was observed in both PV and PE Oral severity was associated with Dsg3 antibody levels and a 10-unit increase in the Dsg3 ELISA value was associated with a 25% chance of a higher oral severity score (CT 17-33%, P <0.0005). We were unable to demonstrate a relationship between Dsg1 antibodies and oral severity, even after adjusting for the effect of Dsg3 antibodies, Similarly, there was no relationship between Dsg3 antibodies and skin severity, Conclusions This study suggests that the clinical phenotype of pemphigus, in particular the balance of skin and oral disease, is determined principally by the quantities of Dsg1 and 3 autoantibodies, respectively.",

author = "Harman, {K E} and Seed, {P T} and Gratian, {M J} and Bhogal, {B S} and Challacombe, {S J} and Black, {M M}",

year = "2001",

doi = "10.1046/j.1365-2133.2001.04132.x",

language = "English",

volume = "144",

pages = "775 -- 780",

journal = "British Journal of Dermatology",

issn = "1365-2133",

publisher = "John Wiley & Sons, Ltd (10.1111)",

number = "4",

}

TY - JOUR

T1 - The severity of cutaneous and oral pemphigus is related to desmoglein 1 and 3 antibody levels

AU - Harman, K E

AU - Seed, P T

AU - Gratian, M J

AU - Bhogal, B S

AU - Challacombe, S J

AU - Black, M M

PY - 2001

Y1 - 2001

N2 - Background Pemphigus vulgaris (PV) and foliaceus (PF) are characterized by antibodies to the desmosomal proteins desmoglein 3 (Dsg3) and desmoglein 1 (Dsg1), respectively. Past studies using indirect immunofluorescence (IIF) as a measure of pemphigus antibody levels have failed to demonstrate consistently a relationship between disease severity and IIF titres. However, IIF is not able to measure separately Dsg1 and 3 antibodies, unlike enzyme-linked immunosorbent assays (ELISA), which utilize recombinant proteins. Objectives To compare independently Dsg1 and 3 antibody levels with the severity of both cutaneous and oral involvement in PV and PE Patients and methods Four hundred and twenty-four serum samples were analysed from 80 subjects with PV and 24 with PE IgG antibodies to Dsg1 and 3 were measured by ELISA, For every sample analysed, the associated severity of skin and oral disease were graded from 0 to 3; quiescent, mild, moderate and severe. Results A relationship between Dsg1 antibodies and skin severity was demonstrated such that a 10-unit increase in Dsg1 ELISA value was associated with a 34% chance of having a higher severity score [95% confidence interval (CI), 25-45%, P <0.0005]. This was observed in both PV and PE Oral severity was associated with Dsg3 antibody levels and a 10-unit increase in the Dsg3 ELISA value was associated with a 25% chance of a higher oral severity score (CT 17-33%, P <0.0005). We were unable to demonstrate a relationship between Dsg1 antibodies and oral severity, even after adjusting for the effect of Dsg3 antibodies, Similarly, there was no relationship between Dsg3 antibodies and skin severity, Conclusions This study suggests that the clinical phenotype of pemphigus, in particular the balance of skin and oral disease, is determined principally by the quantities of Dsg1 and 3 autoantibodies, respectively.

AB - Background Pemphigus vulgaris (PV) and foliaceus (PF) are characterized by antibodies to the desmosomal proteins desmoglein 3 (Dsg3) and desmoglein 1 (Dsg1), respectively. Past studies using indirect immunofluorescence (IIF) as a measure of pemphigus antibody levels have failed to demonstrate consistently a relationship between disease severity and IIF titres. However, IIF is not able to measure separately Dsg1 and 3 antibodies, unlike enzyme-linked immunosorbent assays (ELISA), which utilize recombinant proteins. Objectives To compare independently Dsg1 and 3 antibody levels with the severity of both cutaneous and oral involvement in PV and PE Patients and methods Four hundred and twenty-four serum samples were analysed from 80 subjects with PV and 24 with PE IgG antibodies to Dsg1 and 3 were measured by ELISA, For every sample analysed, the associated severity of skin and oral disease were graded from 0 to 3; quiescent, mild, moderate and severe. Results A relationship between Dsg1 antibodies and skin severity was demonstrated such that a 10-unit increase in Dsg1 ELISA value was associated with a 34% chance of having a higher severity score [95% confidence interval (CI), 25-45%, P <0.0005]. This was observed in both PV and PE Oral severity was associated with Dsg3 antibody levels and a 10-unit increase in the Dsg3 ELISA value was associated with a 25% chance of a higher oral severity score (CT 17-33%, P <0.0005). We were unable to demonstrate a relationship between Dsg1 antibodies and oral severity, even after adjusting for the effect of Dsg3 antibodies, Similarly, there was no relationship between Dsg3 antibodies and skin severity, Conclusions This study suggests that the clinical phenotype of pemphigus, in particular the balance of skin and oral disease, is determined principally by the quantities of Dsg1 and 3 autoantibodies, respectively.

UR - http://www.scopus.com/inward/record.url?scp=0035040270&partnerID=8YFLogxK

U2 - 10.1046/j.1365-2133.2001.04132.x

DO - 10.1046/j.1365-2133.2001.04132.x

M3 - Article

SN - 1365-2133

VL - 144

SP - 775

EP - 780

JO - British Journal of Dermatology

JF - British Journal of Dermatology

IS - 4

ER -

The severity of cutaneous and oral pemphigus is related to desmoglein 1 and 3 antibody levels

Abstract

Access to Document

Other files and links

Fingerprint

Cite this