title: IgG/IgA pemphigus with IgG and IgA antidesmoglein 1 antibodies detected by enzyme-linked immunosorbent assay.
abstract: Pemphigus is an autoimmune mucocutaneous bullous disease characterized by autoantibodies against the cell surfaces of epidermal keratinocytes. Six cases with deposition of both IgG and IgA on keratinocyte cell surfaces have been reported in the recent literature. We provisionally termed these cases IgG/IgA pemphigus. We describe a 42-year-old Japanese woman with clinical and histopathological features resembling herpetiform pemphigus who demonstrated in vivo bound and circulating anticell surface autoantibodies of both IgG and IgA classes on immunofluorescence examination. Enzyme-linked immunosorbent assay using baculovirus-expressed recombinant desmoglein (Dsg) 1 and Dsg 3 showed that both IgG and IgA antibodies reacted with Dsg1. The reactivity was completely adsorbed with preincubation of serum with Dsg1 baculoprotein, further confirming the exclusive reactivity of both IgG and IgA antibodies with Dsg1. This is the second case of IgG/IgA pemphigus in which the human target antigens for both IgG and IgA antibodies have been unequivocally identified. This study provides further evidence that IgG/IgA pemphigus is a distinct disease entity.
authors.affiliation: Department of Dermatology, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno, Osaka 545-8585, Japan. Naoki.Oiso@UCHSC.edu
authors.forename: N
authors.initials: N
authors.lastname: Oiso
authors.forename: C
authors.initials: C
authors.lastname: Yamashita
authors.forename: K
authors.initials: K
authors.lastname: Yoshioka
authors.forename: M
authors.initials: M
authors.lastname: Amagai
authors.forename: A
authors.initials: A
authors.lastname: Komai
authors.forename: Y
authors.initials: Y
authors.lastname: Nagata
authors.forename: T
authors.initials: T
authors.lastname: Hashimoto
authors.forename: M
authors.initials: M
authors.lastname: Ishii
mesh_terms: D000328:Adult; D001323:Autoantibodies / Q000032:analysis*; D001324:Autoantigens / Q000276:immunology; D001327:Autoimmune Diseases / Q000276:immunology*; D015820:Cadherins / Q000276:immunology*; D051183:Desmoglein 1; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007070:Immunoglobulin A / Q000276:immunology*; D007074:Immunoglobulin G / Q000276:immunology*; D010392:Pemphigus / Q000276:immunology*
chemical_list: D001323:Autoantibodies; D001324:Autoantigens; D015820:Cadherins; D051183:Desmoglein 1; D007070:Immunoglobulin A; D007074:Immunoglobulin G