Indirect immunofluorescence on rat bladder epithelium in patients with pemphigus vulgaris with an extended follow-up.
Journal
Skin health and disease
ISSN: 2690-442X
Titre abrégé: Skin Health Dis
Pays: England
ID NLM: 9918227353706676
Informations de publication
Date de publication:
Sep 2022
Sep 2022
Historique:
received:
04
05
2022
revised:
02
06
2022
accepted:
11
06
2022
entrez:
12
9
2022
pubmed:
13
9
2022
medline:
13
9
2022
Statut:
epublish
Résumé
Indirect immunofluorescence (IIF) on rat bladder epithelium (RBE) has been widely used to detect anti-plakin antibodies present in paraneoplastic pemphigus (PNP). However, anti-plakin antibodies have also been found in a group of patients with pemphigus vulgaris (PV). To assess the reactivity rate of PV sera in IIF using RBE as substrate and the diagnostic usefulness of the aforementioned test. Patients diagnosed with PV presenting to Razi Hospital, Tehran, Iran, were recruited. The patients' demographics, disease severity, and response to the initial treatment were recorded. Sera were collected and tested by IIF on RBE and by desmoglein 3/1 (Dsg 3/1) enzyme-linked immunosorbent assay. Patients were followed up closely for a mean of 53.9 months for any evidence of malignancy. Forty-six patients were enroled (mean age of 42.9 years old, 31 females). Nine sera (19.6%) showed reactivity in IIF on RBE. Mean serum anti-Dsg levels did not differ significantly among the two groups with positive and negative IIF results. Negative anti-Dsg3 was related to a higher positive rate in IIF on RBE. There was no significant correlation between the reactivity of IIF on RBE and patients' demographic, clinical, or serological characteristics. IIF on RBE is a sensitive test for detecting antibodies against plakins. However, it has a relatively high false-positive rate in PV, probably due to the epitope spreading phenomenon. This test should be suggested when there is a clinical or immunohistopathological suspicion of PNP and should be interpreted with caution.
Sections du résumé
Background
UNASSIGNED
Indirect immunofluorescence (IIF) on rat bladder epithelium (RBE) has been widely used to detect anti-plakin antibodies present in paraneoplastic pemphigus (PNP). However, anti-plakin antibodies have also been found in a group of patients with pemphigus vulgaris (PV).
Objectives
UNASSIGNED
To assess the reactivity rate of PV sera in IIF using RBE as substrate and the diagnostic usefulness of the aforementioned test.
Methods
UNASSIGNED
Patients diagnosed with PV presenting to Razi Hospital, Tehran, Iran, were recruited. The patients' demographics, disease severity, and response to the initial treatment were recorded. Sera were collected and tested by IIF on RBE and by desmoglein 3/1 (Dsg 3/1) enzyme-linked immunosorbent assay. Patients were followed up closely for a mean of 53.9 months for any evidence of malignancy.
Results
UNASSIGNED
Forty-six patients were enroled (mean age of 42.9 years old, 31 females). Nine sera (19.6%) showed reactivity in IIF on RBE. Mean serum anti-Dsg levels did not differ significantly among the two groups with positive and negative IIF results. Negative anti-Dsg3 was related to a higher positive rate in IIF on RBE. There was no significant correlation between the reactivity of IIF on RBE and patients' demographic, clinical, or serological characteristics.
Conclusions
UNASSIGNED
IIF on RBE is a sensitive test for detecting antibodies against plakins. However, it has a relatively high false-positive rate in PV, probably due to the epitope spreading phenomenon. This test should be suggested when there is a clinical or immunohistopathological suspicion of PNP and should be interpreted with caution.
Identifiants
pubmed: 36092265
doi: 10.1002/ski2.142
pii: SKI2142
pmc: PMC9435460
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e142Informations de copyright
© 2022 The Authors. Skin Health and Disease published by John Wiley & Sons Ltd on behalf of British Association of Dermatologists.
Déclaration de conflit d'intérêts
The authors have no conflicts of interest to disclose.
Références
J Am Acad Dermatol. 1993 May;28(5 Pt 1):696-9
pubmed: 7684408
Int J Mol Sci. 2020 Mar 21;21(6):
pubmed: 32245283
J Am Acad Dermatol. 2008 Jun;58(6):1043-6
pubmed: 18339444
N Engl J Med. 1990 Dec 20;323(25):1729-35
pubmed: 2247105
Arch Dermatol. 2000 May;136(5):652-6
pubmed: 10815859
Clin Dermatol. 2001 Sep-Oct;19(5):614-21
pubmed: 11604309
Differentiation. 1981;20(3):217-41
pubmed: 7040149
Front Immunol. 2019 Jun 04;10:1259
pubmed: 31214197
Br J Dermatol. 2006 Apr;154(4):624-8
pubmed: 16536803
Australas J Dermatol. 2013 Nov;54(4):241-50
pubmed: 22759072
Br J Dermatol. 2013 Nov;169(5):1016-24
pubmed: 23796242
Nat Rev Dis Primers. 2017 May 11;3:17026
pubmed: 28492232
J Clin Invest. 1992 Jun;89(6):1775-82
pubmed: 1601988
J Invest Dermatol. 1998 Dec;111(6):1236-8
pubmed: 9856851
J Am Acad Dermatol. 2000 Oct;43(4):619-26
pubmed: 11004616
Clinics (Sao Paulo). 2011;66(12):2019-23
pubmed: 22189724
Am J Clin Dermatol. 2017 Feb;18(1):105-126
pubmed: 27878477
J Cutan Pathol. 2021 Sep;48(9):1133-1138
pubmed: 33719070
J Mol Biol. 2013 Nov 1;425(21):4006-22
pubmed: 23911551
J Invest Dermatol. 1998 Sep;111(3):503-10
pubmed: 9740248
J Am Acad Dermatol. 2000 Oct;43(4):714-7
pubmed: 11004638
J Dtsch Dermatol Ges. 2010 Aug;8(8):598-606
pubmed: 20180886
J Am Acad Dermatol. 1995 Mar;32(3):441-7
pubmed: 7868713
Expert Rev Clin Immunol. 2021 Aug;17(8):819-834
pubmed: 34162306