Antidesmoglein autoantibodies in silicosis patients with no bullous diseases.
BACKGROUND
Pemphigus is an autoimmune bullous disease characterized by the presence of antidesmoglein autoantibodies. However, the mechanism of its autoantibody production remains unknown. In previous reports, we have described rare cases of pemphigus and pemphigoid associated with silicosis. It is well known that during long-term silicosis, some autoimmune diseases, such as systemic sclerosis, systemic lupus erythematosus or rheumatoid arthritis, can occur.


OBJECTIVE
The aim of this study was to explore the presence of pemphigus or pemphigoid autoantibodies in silicosis patients without clinical bullous diseases or collagen diseases.


METHODS
The presence of pemphigus antibodies was examined in 54 silicosis patients with no associated bullous diseases, using immunofluorescence, the enzyme-linked immunosorbent assay (ELISA) for desmoglein 1 and 3, and immunoblotting methods. In the antibody-positive cases, HLA genotyping of peripheral lymphocytes was performed with PCR-RFLP.


RESULTS
Seven out of the 54 patients were found to be positive for pemphigus antibodies and 1 for bullous pemphigoid by immunofluorescence. In addition, by ELISA, 6 patients were found to be positive against the desmoglein 1 antigen, 2 against the desmoglein 3 antigen and 2 against both desmoglein 1 and desmoglein 3.


CONCLUSIONS
The results of the present study strongly suggest the occurrence of pemphigus and pemphigoid autoantibodies in patients with silicosis. It remains unclear whether such patients will develop an autoimmune bullous disease in the future. Accordingly, long-term follow-up of antibody-positive patients is required.
Department of Dermatology, Kawasaki Medical School, Okayama, Japan. huekih@med.kawasaki-m.ac.jp
H
H
Ueki
M
M
Kohda
T
T
Nobutoh
M
M
Yamaguchi
K
K
Omori
Y
Y
Miyashita
T
T
Hashimoto
A
A
Komai
A
A
Tomokuni
A
A
Ueki
D000368:Aged; D000369:Aged, 80 and over; D001323:Autoantibodies / Q000097:blood*; D003598:Cytoskeletal Proteins / Q000276:immunology*; D051183:Desmoglein 1; D051184:Desmoglein 3; D051182:Desmogleins; D051180:Desmoplakins; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D006650:Histocompatibility Testing; D006801:Humans; D015151:Immunoblotting; D008297:Male; D008875:Middle Aged; D010391:Pemphigoid, Bullous / Q000276:immunology*; D012829:Silicosis / Q000276:immunology / Q000473:pathology*
D001323:Autoantibodies; D003598:Cytoskeletal Proteins; C495297:DSG1 protein, human; D051183:Desmoglein 1; D051184:Desmoglein 3; D051182:Desmogleins; D051180:Desmoplakins