Tunis Med. 2021;99(10):992-999.
Desmoglein (Dsg) 1 and 3 are the 2 major autoantigens in pemphigus foliaceus (PF) and pemphigus vulgaris (PV).
We aimed to determine anti-Dsg1 and 3 Abs'usefulness in the diagnosis of pemphigus and to assess the correlation of these antibodies (Abs) with clinical phenotype and disease activity in south Tunisian patients.
We retrospectively analyzed 131 samples from 82 patients (52 with PF and 30 with PV) during follow-up. Anti-Dsg1 and 3 Abs were measured by ELISA. Consecutive anti-Dsg1 and 3 Abs were correlated with disease activity. Receiver operating characteristics (ROC) curve were calculated to determine anti-Dsg1 and 3 Abs'cut-offs with optimal sensitivity and specificity for disease activity.
Anti-Dsg1 and 3 levels were associated to in PF and PV patients respectively (p<0,001). Anti-Dsg1 and 3 Ab were associated with skin (95%) and mucosal (60%) lesions, respectively. A significant decrease of anti-Dsg1 Abs was observed in patients with PF in clinical remission (36 ± 62 U/mL; (p=0,04). No correlation was found between anti-Dsg3 Abs and the course of mucosal lesions in PV (p=0,3). During follow-up, anti-Dsg1 Abs correlated with relapses (177 ±60 U/mL ; p=0,04). The 161,5 U/mL cut-off for anti-Dsg1 Abs provided 100% specificity and 86,4% sensitivity in PF disease activity. The 30,7U/mL cut-off for anti-Dsg3 provided 89,5% sensitivity and 100% specificity in PV.
High anti-Dsg3 Abs values are not always associated with PV disease activity. Anti-Dsg1 Abs showed a closer relationship with skin activity in PS and should be therefore taken into account in management of pemphigus patients.
桥粒芯糖蛋白 1（Dsg）1 和 3 是落叶型天疱疮（PF）和寻常型天疱疮（PV）的 2 种主要自身抗原。
我们旨在确定抗 Dsg1 和 3 抗体在天疱疮诊断中的有用性，并评估这些抗体与南突尼斯患者临床表型和疾病活动度的相关性。
我们回顾性分析了 82 例患者（52 例 PF 和 30 例 PV）随访期间的 131 份样本。通过 ELISA 测定抗 Dsg1 和 3 抗体。连续的抗 Dsg1 和 3 抗体与疾病活动度相关。计算受试者工作特征（ROC）曲线以确定抗 Dsg1 和 3 抗体的最佳灵敏度和特异性的截止值用于疾病活动度。
抗 Dsg1 和 3 水平与 PF 和 PV 患者分别相关（p<0.001）。抗 Dsg1 和 3 抗体与皮肤（95%）和黏膜（60%）病变相关。PF 患者临床缓解时，抗 Dsg1 抗体水平显著下降（36±62 U/mL；p=0.04）。在 PV 中，抗 Dsg3 抗体与黏膜病变的病程之间未发现相关性（p=0.3）。在随访期间，抗 Dsg1 抗体与复发相关（177±60 U/mL；p=0.04）。抗 Dsg1 抗体的 161.5 U/mL 截止值在 PF 疾病活动中提供了 100%的特异性和 86.4%的敏感性。抗 Dsg3 抗体的 30.7 U/mL 截止值在 PV 中提供了 89.5%的敏感性和 100%的特异性。
高抗 Dsg3 抗体值并不总是与 PV 疾病活动度相关。抗 Dsg1 抗体与 PS 皮肤活性的关系更为密切，因此在天疱疮患者的管理中应考虑到这一点。
