Department of Dermatology, Rambam Health Care Campus, POB 9602, 31096, Haifa, Israel.
Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Immunol Res. 2019 Feb;67(1):116-122. doi: 10.1007/s12026-019-9065-4.
The coexistence of pemphigus and systemic lupus erythematosus (SLE) had been reported anecdotally. Anti-desmoglein (Dsg)1 and anti-Dsg3 antibodies were detected concomitantly with antinuclear autoantibodies among blood donors. The aim of the current study was to study the association between pemphigus and SLE in Israeli patients and to synthesize existing data on this association in the current literature. The current study included two sections. Initially, a cross-sectional study was performed to compare pemphigus patients with age-, sex-, and ethnicity-matched control subjects regarding the prevalence of SLE using a real-life large-scale computerized database. Next, a systematic review and meta-analysis of similar observational studies in Medline, Embase, and Web of Science (1823-2017) was conducted. As for the cross-sectional study, a total of 1985 patients with pemphigus and 9874 controls were included in the study. The prevalence of SLE was slightly higher among patients with pemphigus as compared to controls (OR, 1.85; 95% CI, 0.89-3.82). In a sensitivity analysis that included patients who received pemphigus-related treatments, the association between pemphigus and SLE had been substantiated and was statistically significant (OR, 2.10; 95% CI, 1.00-4.48). In the meta-analysis section, three eligible studies, comprising 10,389 pemphigus patients met the eligibility criteria. The overall pooled multivariate OR was 2.50 (95% CI 1.54-4.07, I = 44.19%, P = 0.167) across all studies. In conclusion, the meta-analysis provides epidemiologic evidence that these B cell-driven diseases are significantly associated. Further research is required to elucidate the molecular mechanism underlying this association.
天疱疮和系统性红斑狼疮（SLE）共存的情况已有报道。在献血者中，抗桥粒芯糖蛋白 1（Dsg）1 和抗 Dsg3 抗体与抗核自身抗体同时存在。本研究的目的是研究以色列患者中天疱疮和 SLE 之间的关联，并综合当前文献中关于这种关联的现有数据。本研究包括两个部分。首先，通过使用真实的大规模计算机化数据库，进行了一项横断面研究，比较了天疱疮患者与年龄、性别和种族匹配的对照者之间 SLE 的患病率。接下来，对 Medline、Embase 和 Web of Science（1823-2017）中的类似观察性研究进行了系统回顾和荟萃分析。对于横断面研究，共纳入了 1985 例天疱疮患者和 9874 例对照者。与对照者相比，天疱疮患者 SLE 的患病率略高（OR，1.85；95%CI，0.89-3.82）。在纳入接受天疱疮相关治疗的患者的敏感性分析中，天疱疮和 SLE 之间的关联得到了证实且具有统计学意义（OR，2.10；95%CI，1.00-4.48）。在荟萃分析部分，有三项符合纳入标准的研究，共纳入了 10389 例天疱疮患者。所有研究的总体多变量 OR 为 2.50（95%CI 1.54-4.07，I=44.19%，P=0.167）。总之，荟萃分析提供了流行病学证据，表明这些 B 细胞驱动的疾病存在显著关联。需要进一步研究阐明这种关联的分子机制。
