Petruzzi Massimo, Lucchese Alberta, Contaldo Maria, Tampoia Marilina, Frassanito Maria Antonia, Lauritano Dorina, Della Vella Fedora
Interdisciplinary Department of Medicine, University of Bari "Aldo Moro", Bari, Italy.
Multidisciplinary Department of Medical, Surgical and Odontostomatological Specialties, University of Campania "Luigi Vanvitelli," Naples, Italy.
Oral Dis. 2022 May;28(4):1149-1156. doi: 10.1111/odi.13849. Epub 2021 Mar 22.
The aim of this study was to test the efficacy of autoantibodies to desmoglein 1 and desmoglein 3 detected by ELISA and indirect immunofluorescence in the diagnosis of oral pemphigus and to correlate the antibody titres with the severity of the disease.
We report a retrospective cohort study of 22 patients with oral pemphigus and 64 controls from a single tertiary centre. Data about histopathological examination, direct immunofluorescence, indirect immunofluorescence and ELISA were analysed. Global validation of ELISA and IIF both alone and combined was established by calculating sensitivity, specificity, accuracy and both positive predictive value and negative predictive value. The relationship between Oral Disease Severity Score values and ELISA titres was analysed using Pearson's coefficient.
The best diagnostic performance was observed for anti-desmoglein 3 ELISA. The sensitivity was 75% and specificity 100% and positive predictive value and negative predictive value were 92.5% and accuracy 93.9%. The level of agreement with histopathology + direct immunofluorescence was substantial (k = .758). Anti-desmoglein 3 titres showed a significant correlation with Oral Disease Severity Score (p < .05).
Serological tests are commonly employed during clinical practice as adjunctive tools. Anti-desmoglein 3 ELISA should be considered as a first-instance diagnostic test for oral pemphigus early detection.
