Mucosal and Salivary Biology Division, Dental Institute, King's College London, London, U.K.
Oral and Maxillofacial Pathology, King Abdulaziz University, Jeddah, Saudi Arabia.
Br J Dermatol. 2016 Jul;175(1):113-21. doi: 10.1111/bjd.14410. Epub 2016 Apr 27.
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.
(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.
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.
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.
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.
通过酶联免疫吸附试验（ELISA）使用桥粒芯糖蛋白 3（Dsg）3 抗原检测寻常型天疱疮（PV）患者的唾液，尚未得到广泛证实，也尚未检测血清 IgA 抗体对 Dsg3 的反应。
（i）确定全唾液是否可替代血清用于诊断和监测 PV；（ii）研究血清和唾液中是否可检测到抗 Dsg3 IgA 抗体；（iii）确定血清或唾液中抗 Dsg3 抗体与疾病严重程度之间是否存在关联。
使用预先包被的 Dsg3 ELISA 板检测血清和/或唾液中的 IgG 和 IgA 抗体。收集 23 例 PV 患者、17 例健康对照者和 19 例疾病对照者的配对血清和全唾液样本。所有 PV 患者、疾病对照者和 6 名健康对照者均提供配对的腮腺唾液样本。
23 例患者中有 14 例（61%）检测到全唾液 IgG 抗体对 Dsg3，其中 17 例（74%）血清 IgG 抗体对 Dsg3 呈阳性，两者具有很强的相关性。23 例 PV 患者中有 14 例（61%）检测到血清 IgA 抗体，两者联合阳性（Dsg3 IgG 和/或 IgA 抗体）率为 78%（18/23）。我们未能在 PV 患者的全唾液或腮腺唾液中检测到 IgA 抗 Dsg3 抗体。对连续样本的检测表明，全唾液 IgG 抗体滴度的变化与疾病严重程度评分的变化相关。
检测唾液 IgG 抗体对 Dsg3 为 PV 的诊断和监测提供了血清学替代方法。抗 Dsg3 IgA 抗体的作用需要在 PV 的发病机制中进一步阐明。
