Case Report: Circulating Anti-SARS-CoV-2 Antibodies Do Not Cross-React With Pemphigus or Pemphigoid Autoantigens

Abstract

It is hypothesized that SARS-CoV-2 has the potential to elicit autoimmunity due to molecular mimicry between immunogenic proteins of the virus and human extracellular molecules. While in silico and in vitro evaluation of such immune cross-reactivity of human antibodies to SARS-CoV-2 proteins with several different tissue antigens has been described, there is limited information specifically pertaining to the immunological effects of COVID-19 and vaccines against SARS-CoV-2 on the development of autoimmune bullous diseases (AIBDs). Twelve seropositive post-COVID-19 individuals and 12 seropositive healthy volunteers who received two doses of the mRNA COVID-19 vaccine from Pfizer-BioNTech have been included in this case series investigation. Serum samples of these blood donors were tested for autoantibodies to the main immunobullous autoantigens, i.e., desmoglein 1, desmoglein 3, envoplakin, BP180, BP230, and type VII collagen. Our study revealed that none of the 24 anti-SARS-CoV-2 IgG-positive subjects had concomitant antibody reactivity with any of the tested autoantigens. These results argue against a relationship between SARS-CoV-2 infection/vaccines and AIBDs with respect to disease-triggering antibody cross-reactivity.

Association between vaccination and immunobullous disorders: a brief, updated systematic review with focus on COVID‐19

“…Whether this represents a bona fide causal relationship or is pure coincidence, however, is unknown, taking into account that the information is mainly derived from single case reports/series with a low level of evidence and a cross‐sectional study biased by subjective patient self‐reports. 4 In addition, the lack of cross‐reactivity between circulating anti‐SARS‐CoV‐2 antibodies and pemphigus or pemphigoid autoantigens argues against immunization‐driven autoimmunity from a mechanistic perspective, 5 although alternative immunocellular modalities potentially promoting autoimmune processes by COVID‐19 vaccines cannot be excluded.…”

Autoimmune Bullous Dermatosis Following COVID-19 Vaccination: A Series of Five Cases

“…Kasperkiewicz et al investigated the link between vaccines against SARS-CoV-2 and the evolution of autoimmunity by testing serum samples for autoantibodies to the main immunobullous autoantigens (desmoglein 1, desmoglein 3, envoplakin, BP180, BP230, and type VII collagen) on 12 seropositive post-COVID-19 individuals and 12 seropositive healthy volunteers who received two doses of the Pfizer-BioNTech mRNA COVID-19 vaccine. Although the results argued against a relationship between SARS-CoV-2 infection/vaccines and AIBDs, the theory of disease-triggering antibody cross-reactivity was highly suggested [ 13 ].…”

Development of severe pemphigus vulgaris following ChAdOx1 nCoV‐19 vaccination and review of literature

“…This response is achieved via the stimulation of both humoral and cellular immune responses which leads to an alteration in the cytokines and chemokines levels in the body and activation of wide variety of immune cells, which, in turn, can cause induction or precipitation of a wide range of immune mediated diseases 18 . However, a recent case series by Kasperkiewicz et al 19 has shown that there was no cross‐reactivity among anti‐SARS COV‐2 antibodies and pemphigus or pemphigoid autoantigens.…”