scholarly journals Utility of oral mucosa as a substrate for the serodiagnosis of pemphigus: A descriptive analysis

2021 ◽  
Vol 0 ◽  
pp. 1-6
Author(s):  
Anuradha Jindal ◽  
Chythra Rao ◽  
Satish B. Pai ◽  
Raghavendra Rao
Keyword(s):  
Human Skin ◽  
Oral Mucosa ◽  
Immunosorbent Assay ◽  
Indirect Immunofluorescence ◽  
Pemphigus Vulgaris ◽  
Enzyme Linked Immunosorbent Assay ◽  
Pemphigus Foliaceus ◽  
Normal Human Skin ◽  
Normal Human ◽  
Monkey Esophagus

Background: The indirect immunofluorescence test is useful in the serodiagnosis of pemphigus. As indirect immunofluorescence titers correlate with disease activity in pemphigus, it is often used as a monitoring tool. The sensitivity of indirect immunofluorescence depends on the substrate used, and the preferred substrates are monkey esophagus for pemphigus vulgaris and normal human skin for pemphigus foliaceus. Aims: We evaluated oral mucosa as a substrate for indirect immunofluorescence in pemphigus. Methods: Fifty patients with pemphigus (40 with pemphigus vulgaris and ten with pemphigus foliaceus) and 50 controls were enrolled for study. Demographic and clinical details were recorded and indirect immunofluorescence using two substrates (oral mucosa and normal human skin) was carried out in serial dilution. Desmoglein (Dsg) 1 and 3 enzyme-linked immunosorbent assay was also evaluated simultaneously. Results: Indirect immunofluorescence was positive in 40 patients (80%) with oral mucosa substrate and 34 patients (68%) with normal human skin substrate. Circulating antibodies were detected with oral mucosa in 33 (82.5%) of the 40 pemphigus vulgaris patients and in 26 (65%) patients using normal human skin. Antibodies were detected in eight of the ten pemphigus foliaceus patients (80%) with normal human skin and in seven (70%) patients with oral mucosa. Dsg enzyme-linked immunosorbent assay was positive in 45 (90%) patients, and 37 of these were also indirect immunofluorescence positive with oral mucosa. In the five Dsg enzyme-linked immunosorbent assay-negative patients, indirect immunofluorescence with oral mucosa was positive in three. Limitations: A comparison of oral mucosa with monkey esophagus could not be performed. Conclusion: Oral mucosa is a suitable and sensitive substrate for indirect immunofluorescence in pemphigus. Further studies comparing the sensitivity of indirect immunofluorescence using oral mucosa with monkey esophagus are recommended.

Clinical and Immunologic Characterization in 26 Indian Pemphigus Patients

2013 ◽  
Vol 17 (5) ◽  
pp. 321-331 ◽  
Author(s):  
Daisuke Tsuruta ◽  
Amrinder J. Kanwar ◽  
Keshavamurthy Vinay ◽  
Shunpei Fukuda ◽  
Hiroshi Koga ◽  
...  
Keyword(s):  
Clinical Features ◽  
Immunosorbent Assay ◽  
Indirect Immunofluorescence ◽  
Pemphigus Vulgaris ◽  
Enzyme Linked Immunosorbent Assay ◽  
Pemphigus Foliaceus ◽  
Lower Sensitivity ◽  
Before And After ◽  
Desmoglein 3

Background: Pemphigus shows geographically variable characteristics. Objective: To study the clinical and immunologic characteristics of Indian pemphigus patients before and after treatment. Methods: Twenty-six Indian pemphigus patients were analyzed with regard to age, gender, clinical features, treatments and response, the results of histopathology, direct and indirect immunofluorescence (IF), enzyme-linked immunosorbent assay (ELISA), and immunoblot analyses. Results: There were 22 pemphigus vulgaris (PV) and 4 pemphigus foliaceus (PF) patients. Direct and indirect IF was positive in 95.8% and 56% of patients, respectively. Indices of ELISA were lower in our study. Immunoblot assays detected the 130 kDa desmoglein-3 in 10 PV patients and the 160 kDa desmoglein-1 in 1 PV patient; 190 kDa periplakin was unexpectedly detected in 8 patients. Conclusion: Indian pemphigus patients showed several unique characteristics, including younger population, predominance of PV, low ELISA indices, lower sensitivity of indirect IF and immunoblotting, and the presence of the 190 kDa periplakin in nearly one-third of patients.

Pemphigus foliaceus. Identification of pemphigus foliaceus antigen extracted from normal human skin.

1990 ◽  
Vol 52 (1) ◽  
pp. 8-11
Author(s):  
Mariko ONO ◽  
Shonosuke NAGAE ◽  
Mitsuse INOUE ◽  
Juichiro NAKAYAMA ◽  
Yoshiaki HORI
Keyword(s):  
Human Skin ◽  
Pemphigus Foliaceus ◽  
Normal Human Skin ◽  
Normal Human

scholarly journals Paraneoplastic Pemphigus Presenting as Mild Cutaneous Features of Pemphigus Foliaceus and Lichenoid Stomatitis with Antidesmoglein 1 Antibodies

2010 ◽  
Vol 2010 ◽  
pp. 1-5 ◽  
Author(s):  
Yayoi Niimi ◽  
Bungo Ohyama ◽  
Giovanni Di Zenzo ◽  
Valentina Calabresi ◽  
Takashi Hashimoto ◽  
...  
Keyword(s):  
B Cell Lymphoma ◽  
Oral Lesion ◽  
Immunoblot Analysis ◽  
Transitional Epithelium ◽  
Enzyme Linked Immunosorbent Assay ◽  
Direct Immunofluorescence ◽  
Pemphigus Foliaceus ◽  
Normal Human Skin ◽  
Paraneoplastic Pemphigus ◽  
Normal Human

Herein, we report a case of paraneoplastic pemphigus with mild skin features of pemphigus foliaceus and lichenoid stomatitis associated with B-cell lymphoma. A 49-year-old man presented with scattered blisters and erosions on the trunk along with mucosal blisters and erosions. Skin biopsy showed subcorneal acantholytic bulla and oral mucosal biopsy demonstrated lichenoid dermatitis. Direct immunofluorescence showed cell surface deposits of IgG and C3. Indirect immunofluorescence identified circulating IgG autoantibodies to the cell surfaces of normal human skin and also on the transitional epithelium of rat bladder. Enzyme-linked immunosorbent assay using recombinant baculoproteins showed positive antidesmoglein 1 autoantibodies (index 46) but negative antidesmoglein 3 autoantibodies (index 8). Immunoblot analysis using normal human epidermal extract detected BP230 and the 190 kDa periplakin, while immunoprecipitation using radiolabeled cultured keratinocyte immunoprecipitated BP230 and the 210 kDa envoplakin. We consider that the skin lesion was produced by humoral immunity whereas the oral lesion was produced by cellular immunity.

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