title: Longitudinal Tracking of Autoantibody Levels in a Pemphigus Vulgaris Patient: Support for a Role of Anti-Desmoglein 1 Autoantibodies as Predictors of Disease Progression.
abstract: Anti-desmoglein (Dsg) 1 and -Dsg3 antibody titers have an established role in the diagnosis of the autoimmune blistering skin disease pemphigus vulgaris (PV). However, their usefulness for disease monitoring has been controversial. A recent large-scale immunoprofiling study by our group indicated that anti-Dsg1 levels may be a better predictor of disease activity than anti-Dsg3 levels, with declining levels predicting progression from active phase of disease to early remission, irrespective of lesional subtypes. Here, we report an illustrative case of a PV patient with mucocutaneous disease that was followed longitudinally for >2.5 years clinically and by serum serology. Autoantibody levels directed against both Dsg1 and -3 showed a moderate correlation with PDAI scores, supporting a correlation of Dsg1 and 3 levels with disease severity. However, while both anti-Dsg3 and -Dsg1 antibody levels demonstrated a steady parallel decline after initiation of rituximab therapy, only anti-Dsg1 antibodies fell to levels below detectability with the progression to remission, while anti-Dsg3 levels remained elevated. This case illustrates the potential key role and clinical benefit of tracking anti-Dsg1 levels to monitor and conceivably predict disease activity in patients with PV. <em>J Drugs Dermatol. 2017;16(2):135-139.</em>.
authors.forename: Nadia Y
authors.initials: NY
authors.lastname: Abidi
authors.forename: Irene
authors.initials: I
authors.lastname: Lainiotis
authors.forename: Gretchen
authors.initials: G
authors.lastname: Malikowski
authors.forename: Kristina
authors.initials: K
authors.lastname: Seiffert-Sinha
authors.forename: Animesh A
authors.initials: AA
authors.lastname: Sinha
mesh_terms: D000328:Adult; D001323:Autoantibodies / Q000097:blood*; D051183:Desmoglein 1 / Q000276:immunology*; D051184:Desmoglein 3 / Q000276:immunology*; D003937:Diagnosis, Differential; D018450:Disease Progression; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D010392:Pemphigus / Q000097:blood / Q000175:diagnosis* / Q000276:immunology; D012720:Severity of Illness Index
chemical_list: D001323:Autoantibodies; D051183:Desmoglein 1; D051184:Desmoglein 3