Circulating pemphigus IgG in families of patients with pemphigus: comparison of indirect immunofluorescence, direct immunofluorescence, and immunoblotting.
BACKGROUND
Patients with pemphigus vulgaris (PV) are genetically linked to two alleles of the HLA subgroup, and circulating antibodies were found in first-degree relatives of these patients, thus showing genetic predisposition.


OBJECTIVE
Our purpose was to determine the occurrence of circulating true PV-IgG in patients' relatives.


METHODS
Circulating PV-IgG was determined in 21 first-degree relatives of 12 patients with PV by indirect immunofluorescence on monkey esophagus, carcinoma A431 cultures, and Western immunoblotting. Direct immunofluorescence was performed on skin biopsy specimens of 20 relatives.


RESULTS
Circulating PV-IgG was detected in 15 relatives (71%) by all methods tested. Good correlation was found between immunoblot reactivity and immunofluorescence. Of the 15 "positive" relatives, only five showed fixation of IgG to epidermal cells in vivo.


CONCLUSIONS
The permeability of the epidermis or epidermal cell reactivity in vivo probably controls the expression of disease in patients' relatives.
Brandsen
R
R
Department of Dermatology, Elias Sourasky Medical Center, Tel Aviv, Israel.
Frusic-Zlotkin
M
M
Lyubimov
H
H
Yunes
F
F
Michel
B
B
Tamir
A
A
Milner
Y
Y
Brenner
S
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000483:Alleles; D000818:Animals; D001706:Biopsy; D015153:Blotting, Western; D002277:Carcinoma / Q000276:immunology; D004817:Epidermis / Q000276:immunology / Q000473:pathology; D004947:Esophagus / Q000276:immunology; D005260:Female; D019085:Fluorescent Antibody Technique, Direct / Q000379:methods; D019084:Fluorescent Antibody Technique, Indirect / Q000379:methods; D015870:Gene Expression; D020022:Genetic Predisposition to Disease; D006680:HLA Antigens / Q000235:genetics; D000882:Haplorhini; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood* / Q000235:genetics; D007557:Israel; D007585:Jews / Q000235:genetics; D008297:Male; D008875:Middle Aged; D010392:Pemphigus / Q000235:genetics / Q000276:immunology*; D010539:Permeability; D012867:Skin / Q000276:immunology / Q000473:pathology; D014407:Tumor Cells, Cultured
D006680:HLA Antigens; D007074:Immunoglobulin G