Autoimmunity to desmocollin 3 in pemphigus vulgaris.
Pemphigus vulgaris is a blistering disease associated with autoantibodies to the desmosomal adhesion protein, desmoglein 3. Genetic deficiency of desmoglein 3 in mice mimics autoimmunity to desmoglein 3 in pemphigus vulgaris, with mucosal-dominant blistering in the suprabasal layer of the epidermis. Mice with an epidermal-specific deletion of desmocollin 3, the other major desmosomal cadherin isoform expressed in the basal epidermis, develop suprabasal blisters in skin that are histologically identical to those observed in pemphigus vulgaris, suggesting that desmocollin 3 might be a target of autoantibodies in some pemphigus vulgaris patients. We now demonstrate that desmocollin 3 is an autoantigen in pemphigus vulgaris, illustrated in a patient with mucosal-dominant blistering. Six of 38 pemphigus vulgaris and one of 85 normal serum samples immunoprecipitate desmocollin 3 (P = 0.003). Incubation of patient IgG with human keratinocytes causes loss of intercellular adhesion, and adsorption with recombinant desmocollin 3 specifically prevents this pathogenic effect. Additionally, anti-desmocollin 3 sera cause loss of keratinocyte cell surface desmocollin 3, but not desmoglein 3 by immunofluorescence, indicating distinct cellular pathogenic effects in anti-desmocollin and anti-desmoglein pemphigus, despite their identical clinical presentations. These data demonstrate that desmocollin 3 is a pathogenic autoantigen in pemphigus vulgaris and suggest that pemphigus vulgaris is a histological reaction pattern that may result from autoimmunity to desmoglein 3, desmocollin 3, or both desmosomal cadherins.
Department of Dermatology, University of Pennsylvania, Philadelphia, Pennsylvania, PA, USA.
Xuming
X
Mao
Arielle R
AR
Nagler
Sara A
SA
Farber
Eun Jung
EJ
Choi
Lauren H
LH
Jackson
Kristin M
KM
Leiferman
Norito
N
Ishii
Takashi
T
Hashimoto
Masayuki
M
Amagai
John J
JJ
Zone
Aimee S
AS
Payne
D000818:Animals; D001323:Autoantibodies / Q000097:blood / Q000494:pharmacology; D015551:Autoimmunity / Q000502:physiology; D016022:Case-Control Studies; D002462:Cell Membrane / Q000187:drug effects / Q000378:metabolism; D002478:Cells, Cultured; D051187:Desmocollins / Q000276:immunology* / Q000378:metabolism; D051184:Desmoglein 3 / Q000378:metabolism; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D015603:Keratinocytes / Q000187:drug effects / Q000378:metabolism / Q000502:physiology; D008875:Middle Aged; D010392:Pemphigus / Q000097:blood* / Q000453:epidemiology / Q000276:immunology*; D011499:Protein Processing, Post-Translational / Q000187:drug effects; D016036:Seroepidemiologic Studies; D018411:Spodoptera
D001323:Autoantibodies; C490356:DSC3 protein, human; C071894:DSG3 protein, human; D051187:Desmocollins; D051184:Desmoglein 3