The pathogenic activity of anti-desmoglein autoantibodies parallels disease severity in rituximab-treated patients with pemphigus vulgaris

Anna Sinistro, Valentina Calabresi, Francesca Lupi, Francesco Sera, Alessandra Frezzolini, Marina Ruffelli, Ornella De Pità, Diana Camaioni, Giuseppe Cianchini, Giovanni Di Zenzo

Research output: Contribution to journalArticle

Abstract

Background: Pemphigus vulgaris (PV) is an autoimmune blistering disease mediated by IgG autoantibodies targeting desmogleins (Dsgs). The anti-CD20 monoclonal antibody rituximab is increasingly used in corticosteroid-resistant PV patients. In a subset of rituximab-treated patients in remission, high ELISA index values have been reported; however, their significance remains so far unclear. Objective: To address the discrepancy between anti-Dsg3 serum antibody titers and disease severity. Materials & methods: 6 rituximab-treated PV patients were prospectively followed-up for two years and anti-Dsg3 autoantibodies levels and pathogenic activity were measured. Results: All patients achieved complete remission without any serious side effects. Both anti-Dsg3 autoantibodies (p = 0.031) and their pathogenic activity (p = 0.003) were significantly related to disease severity. However, in selected patients, the dissociation index was a more sensitive indicator for PV clinical activity than the ELISA index. Conclusion: Our findings have demonstrated the existence of non-pathogenic autoantibodies in PV patients in remission, establishing the basis for the design of a system able to precisely monitor the course of disease.

Original languageEnglish
Pages (from-to)578-585
Number of pages8
JournalEuropean Journal of Dermatology
Volume25
Issue number6
DOIs
Publication statusPublished - Nov 1 2015

Keywords

  • Autoantibodies
  • Desmoglein 3
  • Disease severity
  • ELISA
  • Pathogenicity

ASJC Scopus subject areas

  • Dermatology

Fingerprint Dive into the research topics of 'The pathogenic activity of anti-desmoglein autoantibodies parallels disease severity in rituximab-treated patients with pemphigus vulgaris'. Together they form a unique fingerprint.

  • Cite this

    Sinistro, A., Calabresi, V., Lupi, F., Sera, F., Frezzolini, A., Ruffelli, M., De Pità, O., Camaioni, D., Cianchini, G., & Di Zenzo, G. (2015). The pathogenic activity of anti-desmoglein autoantibodies parallels disease severity in rituximab-treated patients with pemphigus vulgaris. European Journal of Dermatology, 25(6), 578-585. https://doi.org/10.1684/ejd.2015.2652