Endemic pemphigus foliaceus (fogo selvagem) and pemphigus vulgaris: immunoglobulin G heterogeneity detected by indirect immunofluorescence

Abstract

Pemphigus are autoimmune intraepidermal blistering diseases in which immunoglobulin G (IgG) autoantibodies are directed against desmosomal glycoproteins. The aim of this study was to determine the IgG subclass profile of endemic pemphigus foliaceus (fogo selvagem) and pemphigus vulgaris utilizing indirect immunofluorescence. PATIENTS AND METHODS:Twenty-five patients with pemphigus vulgaris, 25 with endemic pemphigus foliaceus (fogo selvagem), and 25 healthy controls were analyzed by indirect immunofluorescence for circulating autoantibodies (total IgG and its subclasses).RESULTS: Our data revealed a significant correlation (P <.05) of disease activity and autoantibody levels in both forms of pemphigus, i.e., negative titers related to clinical remission, whereas positive results related to active disease. Immunoglobulin G subclass analysis in fogo selvagem demonstrated that in patients in remission, 56% showed positive immunoglobulin G4; in active disease, immunoglobulin G4 was the predominant subclass (100% positive in all cases). The IgG subclass profile in pemphigus vulgaris showed that in patients in remission, only 10% were positive for immunoglobulin G4; in active disease, positivity for immunoglobulin G4 was present in 78% to 88% of the cases.CONCLUSION: Subclass characterization of immunoglobulin G autoantibodies is a useful tool for pemphigus followup, since immunoglobulin G4 (IgG4) is the subclass that is closely related to recognition of pathogenic epitopes, and consequently with disease activity. Careful monitoring should be performed for fogo selvagem in clinical remission with a homogeneous IgG4 response, since this may indicate more frequent relapses.

Processos de resiliência no contexto de hospitalização: um estudo de caso

“…Apresenta-se na forma de lesões cutâneas bolhosas, que podem se romper rapidamente, formando ulcerações dolorosas por toda a pele. Se não tratada pode evoluir para desnudamento intenso, levando a desequilíbrio hidroeletrolítico, sepsis e óbito (Aoki, 2004).…”

Antígenos de histocompatibilidade humanos e dermatologia: da pesquisa para a prática clínica

“…It can present as three different types: pemphigus vulgaris (PV), pemphigus foliaceus (PF) and the endemic form, the endemic pemphigus foliaceus (EPF), also known as fogo selvagem [wild fire] (FS). 25,26 HLA alleles seem to be the most important predisposing genetic factors. 26,27 As to the association with class I HLA system, Glorio et al did not find an association of PV with HLA-A, -B or -C antigens in Caucasian Argentinians.…”

Comparative study of direct and indirect immunofluorescence for diagnosis of canine pemphigus foliaceus

“…In human medicine, the immunofluorescence techniques have emerged as useful methods for diagnosing autoimmune blistering conditions since the early 1960s and present excellent results (Beutner and Gordon, 1964;Brandsen et al, 1997). Currently, immunofluorescence tests are a useful tool for the laboratory diagnosis of autoimmune dermatosis in humans, since their clinical and histopathological findings may be inconclusive (Mutasim and Adams, 2001;Aoki et al, 2004;Aoki et al, 2010).…”