Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran AND Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Iran J Allergy Asthma Immunol. 2023 Jun 20;22(3):312-318. doi: 10.18502/ijaai.v22i3.13059.
Evaluation and monitoring of pemphigus vulgaris (PV) typically involve autoantibody detection by enzyme-linked immunosorbent assay (ELISA) and indirect immunofluorescence (IIF). We aimed to determine the levels of antipemphigus immunoglobulin (Ig) G autoantibodies using ELISA and IIF (as standard biomarkers), and compare it to prolactin, macrophage migration inhibitory factor (MIF), and C-reactive protein (CRP) (as nonstandard biomarkers) to determine which of these non-standard biomarkers is appropriate for PV monitoring. The experiment was performed before and during therapy. Anti-Dsg immunoglobulin G autoantibodies were measured using ELISA and IIF (as standard biomarkers) versus prolactin, MIF, and CRP (nonstandard), before 1 and 3 months after the treatment. Before beginning the treatment, the severity of the disease was determined using the pemphigus disease area Index (PDAI). We enrolled 60 newly diagnosed patients with PV (32 men and 28 women; mean age=43.8±14.2 years). Before treatment, the levels of anti-Dsg1, anti-Dsg3, and IIF were high and had a significant relationship with PDAI. PDAI also had a connection with the levels of CRP and prolactin. The anti-Dsg1, anti-Dsg3, IIF, and CRP titers decreased in patients treated with conventional (prednisolone plus azathioprine) and rituximab therapy during and after treatment. In conclusion, anti-Dsg1, anti-Dsg3, and IIF autoantibody titers remain standard biomarkers for assessing disease activity, severity, and PV monitoring. The trend of CRP was similar to that of anti-Dsg1, anti-Dsg3, and IIF. Thus, CRP may be used for PV monitoring.
寻常型天疱疮（PV）的评估和监测通常涉及酶联免疫吸附试验（ELISA）和间接免疫荧光（IIF）检测自身抗体。我们旨在使用 ELISA 和 IIF（作为标准生物标志物）确定抗天疱疮免疫球蛋白（Ig）G 自身抗体的水平，并将其与催乳素、巨噬细胞移动抑制因子（MIF）和 C 反应蛋白（CRP）（作为非标准生物标志物）进行比较，以确定这些非标准生物标志物中哪一种适合用于 PV 监测。该实验在治疗前后进行。使用 ELISA 和 IIF（作为标准生物标志物）与催乳素、MIF 和 CRP（非标准）在治疗前 1 个月和 3 个月时测量抗 Dsg IgG 自身抗体。在开始治疗之前，使用天疱疮疾病面积指数（PDAI）确定疾病的严重程度。我们招募了 60 名新诊断的 PV 患者（32 名男性和 28 名女性；平均年龄=43.8±14.2 岁）。在治疗前，抗 Dsg1、抗 Dsg3 和 IIF 的水平较高，与 PDAI 有显著关系。PDAI 也与 CRP 和催乳素水平有关。接受常规（泼尼松龙加硫唑嘌呤）和利妥昔单抗治疗的患者在治疗期间和治疗后，抗 Dsg1、抗 Dsg3、IIF 和 CRP 滴度降低。总之，抗 Dsg1、抗 Dsg3 和 IIF 自身抗体滴度仍然是评估疾病活动度、严重程度和 PV 监测的标准生物标志物。CRP 的趋势与抗 Dsg1、抗 Dsg3 和 IIF 的趋势相似。因此，CRP 可用于 PV 监测。
