The Correlation between Anti-desmoglein Autoantibody Titers, IgG Antibody Levels, and the Pemphigus Disease Area Index by Location in Patients with Pemphigus Vulgaris
Keywords:
Desmoglein 1, desmoglein 3, indirect immunofluorescence, Pemphigus Disease Area Index, pemphigus vulgaris.Abstract
Background: Quantifying anti-desmoglein (anti-Dsg) antibodies and indirect immunofluorescence (IIF) are valuable methods for diagnosing and assessing the severity of pemphigus vulgaris (PV). Location-specific Pemphigus Disease Area Index (PDAI) scoring may better reflect disease activity than total PDAI scores. Objectives: To explore correlations between anti-Dsg1, anti-Dsg3 antibody levels, IIF titers, and location-specific PDAI scores in Vietnamese patients with PV. Methods: A cross-sectional study was conducted on 48 PV patients, including newly diagnosed or those off immunosuppressive therapy for at least one month. Anti-Dsg1 and anti-Dsg3 levels were measured by ELISA, and IgG antibodies were assessed by IIF. Results: Among 48 patients (mean age 56.15 years; 64.58% female), anti-Dsg1 positivity was 91.67%, and anti-Dsg3 positivity was 66.67%. Anti-Dsg1 positivity was significantly higher in patients with cutaneous lesions (97.73% vs. 25.00%; P=0.0009), while anti-Dsg3 positivity was higher in those with mucosal lesions (92.86% vs. 30.00%; P<0.0001). Anti-Dsg1 levels correlated with cutaneous PDAI (r=0.378; P=0.0081), and anti-Dsg3 levels strongly correlated with mucosal PDAI (r=0.795; P<0.0001). IIF titers correlated with total PDAI (r=0.377; P=0.0082) and mucosal PDAI (r=0.389; P=0.0062), and were associated with anti-Dsg3 levels (r=0.444; P=0.0015). Higher anti-Dsg1 levels were observed in IIF-negative patients compared to IIF-positive ones. Serum levels of anti-Dsg3 were higher in the IIF-positive group compared to the IIF-negative group (median 114.63 RU/ml vs. 13.9 RU/ml, P=0.0369). Conclusion: Severity of PV, assessed by location-specific PDAI scores, correlates significantly with anti-Dsg ELISA levels and IIF titers. Integrating clinical scoring with serological and immunofluorescence assays enhances disease monitoring in PV.References
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