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Serum and salivary IgG and IgA antibodies to desmoglein 3 in mucosal pemphigus vulgaris
Author(s) -
Ali S.,
Kelly C.,
Challacombe S.J.,
Donaldson A.N.A.,
Bhogal B.S.,
Setterfield J.F.
Publication year - 2016
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1111/bjd.14410
Subject(s) - saliva , pemphigus vulgaris , antibody , desmoglein 3 , medicine , immunology , immunoglobulin a , pemphigus , immunoglobulin g , autoimmune disease
Summary Background The use of saliva for the diagnosis of pemphigus vulgaris ( PV ) by enzyme‐linked immunosorbent assay ( ELISA ) using desmoglein (Dsg)3 antigen has not been extensively documented, nor has the detection of serum IgA antibodies to Dsg3. Objectives (i) To establish whether whole saliva might provide a suitable alternative to serum for diagnosing and monitoring PV ; (ii) to investigate whether anti‐Dsg3 IgA antibodies can be detected in serum and saliva and (iii) to establish whether there is an association between serum or saliva anti‐Dsg3 antibodies and disease severity. Methods Precoated Dsg3 ELISA plates were used to test serum and/or saliva for IgG and IgA antibodies. Matched serum and whole saliva samples were collected from 23 patients with PV , 17 healthy subjects and 19 disease controls. All patients with PV , disease controls and six healthy controls provided matched parotid saliva. Results Whole saliva IgG antibodies to Dsg3 were detected in 14 of 23 patients (61%) and serum IgG antibodies were detected in 17 of 23 (74%) with a strong positive correlation. Serum IgA antibodies were detected in 14 of 23 patients with PV (61%) with a combined positivity (IgG and/or IgA antibodies to Dsg3) of 78% (18 of 23). We were unable to show IgA anti‐Dsg3 antibodies in either whole or parotid saliva of patients with PV . Sequential samples showed that changes in IgG antibody titres in whole saliva were associated with a change in disease severity scores. Conclusions Assay of salivary IgG antibodies to Dsg3 offers a diagnostic alternative to serum in the diagnosis and monitoring of PV . The role of anti‐Dsg3 IgA antibodies requires further elucidation in the pathogenesis of PV .