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Correlation of antimuscarinic acetylcholine receptor antibody titers and antidesmoglein antibody titers with the severity of disease in patients with pemphigus - 18/04/17

Doi : 10.1016/j.jaad.2016.11.039 
Manimegalai Jeyasekaran Dhanabhakya Lakshmi, MBBS a, Telanseri Jaykar Jaisankar, MD a, Medha Rajappa, MD, DNB b, Devinder Mohan Thappa, MD a, Laxmisha Chandrashekar, MD, DNB a, , Dakshinamurthy Divyapriya, BTech b, Malathi Munisamy, MD, DNB a, Gunaseelan Revathy, MBBS b
a Department of Dermatology, Jawaharalal Institute of Postgraduate Medical Education and Research, Puducherry, India 
b Department of Biochemistry, Jawaharalal Institute of Postgraduate Medical Education and Research, Puducherry, India 

Reprint requests: Laxmisha Chandrashekar, MD, DNB, Department of Dermatology, Jawaharalal Institute of Postgraduate Medical Education and Research, Dhanvantri Nagar, Gorimedu, Puducherry-605006, India.Department of DermatologyJawaharalal Institute of Postgraduate Medical Education and ResearchDhanvantri Nagar, GorimeduPuducherry605006India

Abstract

Background

Acetylcholine receptor (AchR) antibody levels significantly correlate with disease severity at initial pemphigus diagnosis and during follow-up. However, it is not clear if they are just an epiphenomenon or a potential trigger of the known pathogenic process in pemphigus vulgaris.

Objective

We sought to assess the changes in anti-muscarinic (M3) AchR and anti-desmoglein (Dsg) antibody titers with therapy.

Methods

This was a hospital-based cohort study involving 45 patients with active pemphigus. Disease was graded clinically using Pemphigus Disease Area Index. Antibody titers were estimated using enzyme-linked immunosorbent assay at baseline, 3 months, and 15 months.

Results

All patients with pemphigus had significantly higher anti-M3 AchR titers when compared with a control group. Only 95.5% of patients had anti-Dsg1 antibodies and 84.4% of patients had anti-Dsg3 antibodies. A statistically significant reduction in all 3 antibody titers from baseline to follow-up with treatment was observed. There was a good correlation between all 3 antibody titer and Pemphigus Disease Area Index score at baseline and after therapy and between anti-M3 AchR and anti-Dsg1 antibody titers.

Limitations

Sample size was small and follow-up period was short.

Conclusions

Anti-M3 AchR antibodies are strongly associated with pemphigus. They significantly correlate with disease activity and their titers decline with therapy along with anti-Dsg antibodies.

Le texte complet de cet article est disponible en PDF.

Key words : acantholysis, antibody titers, desmoglein, enzyme-linked immunosorbent assay, muscarinic acetylcholine receptors, pemphigus

Abbreviations used : AchR, Dsg, ELISA, M3, PDAI


Plan


 Supported by an Intramural Research Grant (JIP/Res/Intra-D.M/M.Ch/01/2014) from Jawaharalal Institute of Postgraduate Medical Education and Research, Puducherry, India.
 Conflicts of interest: None declared.


© 2016  American Academy of Dermatology, Inc.. Publié par Elsevier Masson SAS. Tous droits réservés.
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Vol 76 - N° 5

P. 895-902 - mai 2017 Retour au numéro
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