title: Serum and salivary IgG and IgA antibodies to desmoglein 3 in mucosal pemphigus vulgaris.
abstract: BACKGROUND
  The use of saliva for the diagnosis of pemphigus vulgaris (PV) by enzyme-linked immunosorbent assay (ELISA) using desmoglein (Dsg)3 antigen has not been extensively documented, nor has the detection of serum IgA antibodies to Dsg3.
  
  
  OBJECTIVE
  (i) To establish whether whole saliva might provide a suitable alternative to serum for diagnosing and monitoring PV; (ii) to investigate whether anti-Dsg3 IgA antibodies can be detected in serum and saliva and (iii) to establish whether there is an association between serum or saliva anti-Dsg3 antibodies and disease severity.
  
  
  METHODS
  Precoated Dsg3 ELISA plates were used to test serum and/or saliva for IgG and IgA antibodies. Matched serum and whole saliva samples were collected from 23 patients with PV, 17 healthy subjects and 19 disease controls. All patients with PV, disease controls and six healthy controls provided matched parotid saliva.
  
  
  RESULTS
  Whole saliva IgG antibodies to Dsg3 were detected in 14 of 23 patients (61%) and serum IgG antibodies were detected in 17 of 23 (74%) with a strong positive correlation. Serum IgA antibodies were detected in 14 of 23 patients with PV (61%) with a combined positivity (IgG and/or IgA antibodies to Dsg3) of 78% (18 of 23). We were unable to show IgA anti-Dsg3 antibodies in either whole or parotid saliva of patients with PV. Sequential samples showed that changes in IgG antibody titres in whole saliva were associated with a change in disease severity scores.
  
  
  CONCLUSIONS
  Assay of salivary IgG antibodies to Dsg3 offers a diagnostic alternative to serum in the diagnosis and monitoring of PV. The role of anti-Dsg3 IgA antibodies requires further elucidation in the pathogenesis of PV.
authors.affiliation: Mucosal and Salivary Biology Division, Dental Institute, King's College London, London, U.K.|Oral and Maxillofacial Pathology, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: S
authors.identifier: http://orcid.org/0000-0003-0117-6596
authors.initials: S
authors.lastname: Ali
authors.affiliation: Mucosal and Salivary Biology Division, Dental Institute, King's College London, London, U.K.
authors.forename: C
authors.initials: C
authors.lastname: Kelly
authors.affiliation: Mucosal and Salivary Biology Division, Dental Institute, King's College London, London, U.K.
authors.forename: S J
authors.initials: SJ
authors.lastname: Challacombe
authors.affiliation: Biostatistics and Research Methods Centre, Dental Institute, King's College London, London, U.K.
authors.forename: A N A
authors.initials: AN
authors.lastname: Donaldson
authors.affiliation: St John's Institute of Dermatology, Guy's and St Thomas's NHS Foundation Trust, London, U.K.
authors.forename: B S
authors.initials: BS
authors.lastname: Bhogal
authors.affiliation: Mucosal and Salivary Biology Division, Dental Institute, King's College London, London, U.K.|St John's Institute of Dermatology, Guy's and St Thomas's NHS Foundation Trust, London, U.K.
authors.forename: J F
authors.initials: JF
authors.lastname: Setterfield
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001323:Autoantibodies / Q000378:metabolism*; D051184:Desmoglein 3 / Q000276:immunology*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007070:Immunoglobulin A / Q000378:metabolism*; D007074:Immunoglobulin G / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009059:Mouth Diseases / Q000097:blood / Q000276:immunology*; D009061:Mouth Mucosa / Q000276:immunology / Q000378:metabolism; D009092:Mucous Membrane / Q000378:metabolism; D010392:Pemphigus / Q000097:blood / Q000276:immunology*; D012463:Saliva / Q000737:chemistry / Q000276:immunology; D055815:Young Adult
chemical_list: D001323:Autoantibodies; D051184:Desmoglein 3; D007070:Immunoglobulin A; D007074:Immunoglobulin G