The Value of Anti-Desmoglein Enzyme-Linked Immunosorbent Assay in the Immunological Follow-Up of Pemphigus

Abstract

Background: The value of anti-desmoglein 1 and 3 (Dsg1, Dsg3) enzyme-linked immunosorbent assay (ELISA) is controversial in the follow-up of pemphigus. Objective: To evaluate anti-desmoglein ELISA (Dsg ELISA) in the follow-up of pemphigus and compare ELISA with direct and indirect immunofluorescence in complete remission (CR). Methods: We performed a retrospective monocenter study of patients with pemphigus and consecutive sera samples collected at baseline (M0), 12 months (M12) and 24 or 36 months after M0 (M24/36). Tests were compared in CR and in active disease. Direct immunofluorescence and circulating autoantibodies were compared for patients with stable CR. Results: We included 36 patients. At M12, ELISA values did not differ between CR and active disease. At M24/36, Dsg3 but not Dsg1 ELISA values were lower in CR (p = 0.07). For 5/8 patients with stable CR, direct immunofluorescence and ELISA findings remained positive. Conclusion: In routine practice, Dsg ELISA seems to be of little interest for immunological follow-up of pemphigus.

Factors associated with the healing time of pemphigus vulgaris oral lesions: A prospective study

“…According to several studies, there are some discrepancies between the titer of anti‐Dsg 3 and diseases remission (Ahmed et al, 2016; Bellon et al, 2014; Li et al, 2015; Nakahara et al, 2014; Russo et al, 2017). There is also less correlation between the anti‐Dsg3 titer (an indicator of mucosal involvement) and the severity of the disease.…”

New biochip immunofluorescence test for the serological diagnosis of pemphigus vulgaris and foliaceus: A review of the literature

“…Nonetheless, contradictory studies have been published with regard to serum levels that reflect the clinical activity during the disease course. Some authors promote its use to monitor patient prognosis and treatment ( Zhou et al, 2016 ), but others have observed no significant relationship between disease extent and levels of Dsg1 and Dsg3 autoantibodies ( Bellon et al, 2014 , Bracke et al, 2013 ). Although the biochip approach does not provide quantitative autoantibody serum levels like the ELISA methods, which have been shown to correlate with disease activity, the biochip can produce a semi-quantitative analysis by preparing various serial dilutions (1:10, 1:32, 1:100, 1:320, 1:1000, and 1:3200) and checking the highest dilution that still produces immunofluorescence ( Russo et al, 2014 , van Beek et al, 2012 ).…”

Successful monotherapy of pemphigus vegetans with minocycline and nicotinamide

“…For the assessment of immunological remission in patients with pemphigus and sustained clinical remission, a negative DIF result has long been considered mandatory before drug withdrawal . Although in the literature, controversially discussed, the majority of studies and actual European guidelines recommend serial serological DSG ELISA as an appropriate non‐invasive test in the follow‐up of patients with pemphigus vulgaris in clinical remission …”