title: Autoantibody Levels and Clinical Disease Severity in Patients with Pemphigus: Comparison of Aggregated Anti-desmoglein ELISA Values and Indirect Immunofluorescence Titres.
abstract: Detecting serum-autoantibodies by anti-Desmoglein-1 (anti-Dsg1) and anti-Dsg3 ELISAs as well as indirect immunofluorescence (IIF) are established complementary methods to diagnose pemphigus. Whether autoantibody levels also reflect clinical disease activity is still a matter of debate, as head-to-head comparisons of ELISA values and IIF titres with clinical activity over a longer treatment period are scarce. In our retrospective study, we compared aggregated repetitive intra-patient ELISA values and IIF titres with grades of clinical disease (1 = remission, 2 = moderate activity, 3 = exacerbation) in 47 patients suffering from pemphigus vulgaris (PV, n = 36) and pemphigus foliaceus (PF, n=11). We found that anti-Dsg1 ELISA values in PF and mucocutaneous PV as well as anti-Dsg3 ELISA values in PV best reflect disease activity. IIF titres, by contrast, did not show a significant association with disease severity. From these data we conclude that ELISA index values can be a valuable tool to monitor disease in patients with pemphigus, whereas IIF titres reflect clinical activity only insufficiently.
authors.affiliation: Department of Dermatology, Division of Immunology, Allergy and Infectious Diseases, Medical University of Vienna, Vienna, Austria.
authors.forename: Doris
authors.initials: D
authors.lastname: Weiss
authors.forename: Robin
authors.initials: R
authors.lastname: Ristl
authors.forename: Johannes
authors.initials: J
authors.lastname: Griss
authors.forename: Christine
authors.initials: C
authors.lastname: Bangert
authors.forename: Dagmar
authors.initials: D
authors.lastname: Foedinger
authors.forename: Georg
authors.initials: G
authors.lastname: Stingl
authors.forename: Patrick M
authors.initials: PM
authors.lastname: Brunner
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001317:Austria; D001323:Autoantibodies / Q000276:immunology / Q000378:metabolism; D015415:Biomarkers / Q000378:metabolism; D002648:Child; D015331:Cohort Studies; D051182:Desmogleins / Q000276:immunology* / Q000378:metabolism; D018450:Disease Progression; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect / Q000379:methods*; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D010392:Pemphigus / Q000175:diagnosis* / Q000276:immunology*; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D001323:Autoantibodies; D015415:Biomarkers; D051182:Desmogleins