ELISA Testing of Anti–Desmoglein 1 and 3 Antibodies in the Management of Pemphigus

OBJECTIVE To assess the predictive value of anti–desmoglein (Dsg) 1 and anti-Dsg3 antibody (Ab) enzyme-linked immunosorbent assay (ELISA) values for the occurrence of relapses in pemphigus. DESIGN Retrospective study. SETTING Dermatology departments from 13 university hospitals in France. PATIENTS T...

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Veröffentlicht in:Archives of dermatology (1960) 2009-05, Vol.145 (5), p.529-535
Hauptverfasser: Abasq, Claire, Mouquet, Hugo, Gilbert, Danièle, Tron, François, Grassi, Vanessa, Musette, Philippe, Joly, Pascal
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container_end_page 535
container_issue 5
container_start_page 529
container_title Archives of dermatology (1960)
container_volume 145
creator Abasq, Claire
Mouquet, Hugo
Gilbert, Danièle
Tron, François
Grassi, Vanessa
Musette, Philippe
Joly, Pascal
description OBJECTIVE To assess the predictive value of anti–desmoglein (Dsg) 1 and anti-Dsg3 antibody (Ab) enzyme-linked immunosorbent assay (ELISA) values for the occurrence of relapses in pemphigus. DESIGN Retrospective study. SETTING Dermatology departments from 13 university hospitals in France. PATIENTS The study population comprised 26 patients with typical clinical, histologic, and immunofluorescence findings of pemphigus, who were followed up over a 17-month period. MAIN OUTCOME MEASURES Serial anti-Dsg1 and anti-Dsg3 Ab ELISA values were recorded during the patients' follow-up examinations and correlated with the occurrence of skin and/or mucosal relapses. RESULTS A significant reduction of anti-Dsg1 (P 
doi_str_mv 10.1001/archdermatol.2009.9
format Article
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DESIGN Retrospective study. SETTING Dermatology departments from 13 university hospitals in France. PATIENTS The study population comprised 26 patients with typical clinical, histologic, and immunofluorescence findings of pemphigus, who were followed up over a 17-month period. MAIN OUTCOME MEASURES Serial anti-Dsg1 and anti-Dsg3 Ab ELISA values were recorded during the patients' follow-up examinations and correlated with the occurrence of skin and/or mucosal relapses. RESULTS A significant reduction of anti-Dsg1 (P &lt; .001) and anti-Dsg3 (P &lt; .001) Ab ELISA values was observed in serum samples from patients with pemphigus foliaceus or pemphigus vulgaris after the initial treatment. During the long-term follow-up, anti-Dsg1 Ab ELISA values correlated with the course of skin lesions (P = .03); the 20 U/mL cutoff for the anti-Dsg1 Ab ELISA value provided a 79% positive and an 84% negative predictive value for the occurrence of cutaneous relapses. No correlation was observed between anti-Dsg3 Ab ELISA values and the course of mucosal lesions (P = .13). Anti-Dsg3 Ab ELISA values higher than the 14-U/mL cutoff were observed in 5 of the 5 patients with relapse and in 10 of the 13 patients with ongoing mucosal remission, providing a 100% sensitivity but a poor specificity of 23%. A cutoff value of 130 U/mL for anti-Dsg3 Abs was calculated based on the receiver operating characteristics curve and provided an 84% positive and an 81% negative predictive value. CONCLUSIONS Anti-Dsg1 Ab ELISA values are more closely correlated than anti-Dsg3 Ab ELISA values with the course of the disease in patients with pemphigus vulgaris or pemphigus foliaceus. This should be taken into account for the management of patients with pemphigus.Arch Dermatol. 2009;145(5):529-535--&gt;</description><identifier>ISSN: 0003-987X</identifier><identifier>ISSN: 2168-6068</identifier><identifier>EISSN: 1538-3652</identifier><identifier>EISSN: 2168-6084</identifier><identifier>DOI: 10.1001/archdermatol.2009.9</identifier><identifier>PMID: 19451496</identifier><identifier>CODEN: ARDEAC</identifier><language>eng</language><publisher>Chicago, IL: American Medical Association</publisher><subject>Antibodies - blood ; Antibodies - immunology ; Biological and medical sciences ; Bullous diseases of the skin ; Dermatology ; Desmoglein 1 - immunology ; Desmoglein 2 - immunology ; Disease Progression ; Drug Therapy, Combination ; Enzyme-Linked Immunosorbent Assay - methods ; Enzyme-Linked Immunosorbent Assay - utilization ; Female ; Follow-Up Studies ; Glucocorticoids - therapeutic use ; Humans ; Immunoassay ; Immunosuppressive Agents - therapeutic use ; Male ; Medical sciences ; Middle Aged ; Pemphigus - diagnosis ; Pemphigus - drug therapy ; Pemphigus - immunology ; Predictive Value of Tests ; Prednisone - therapeutic use ; Prognosis ; Recurrence ; Retrospective Studies ; Sensitivity and Specificity ; Skin diseases ; Time Factors</subject><ispartof>Archives of dermatology (1960), 2009-05, Vol.145 (5), p.529-535</ispartof><rights>2009 INIST-CNRS</rights><rights>Copyright American Medical Association May 2009</rights><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-a378t-5aa71b661bacebc24a13a33e8bd780b466e7902d530846cb06945429f124eb273</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://jamanetwork.com/journals/jamadermatology/articlepdf/10.1001/archdermatol.2009.9$$EPDF$$P50$$Gama$$H</linktopdf><linktohtml>$$Uhttps://jamanetwork.com/journals/jamadermatology/fullarticle/10.1001/archdermatol.2009.9$$EHTML$$P50$$Gama$$H</linktohtml><link.rule.ids>64,314,776,780,3327,27901,27902,76458,76461</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=21453277$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19451496$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Abasq, Claire</creatorcontrib><creatorcontrib>Mouquet, Hugo</creatorcontrib><creatorcontrib>Gilbert, Danièle</creatorcontrib><creatorcontrib>Tron, François</creatorcontrib><creatorcontrib>Grassi, Vanessa</creatorcontrib><creatorcontrib>Musette, Philippe</creatorcontrib><creatorcontrib>Joly, Pascal</creatorcontrib><title>ELISA Testing of Anti–Desmoglein 1 and 3 Antibodies in the Management of Pemphigus</title><title>Archives of dermatology (1960)</title><addtitle>Arch Dermatol</addtitle><description>OBJECTIVE To assess the predictive value of anti–desmoglein (Dsg) 1 and anti-Dsg3 antibody (Ab) enzyme-linked immunosorbent assay (ELISA) values for the occurrence of relapses in pemphigus. DESIGN Retrospective study. SETTING Dermatology departments from 13 university hospitals in France. PATIENTS The study population comprised 26 patients with typical clinical, histologic, and immunofluorescence findings of pemphigus, who were followed up over a 17-month period. MAIN OUTCOME MEASURES Serial anti-Dsg1 and anti-Dsg3 Ab ELISA values were recorded during the patients' follow-up examinations and correlated with the occurrence of skin and/or mucosal relapses. RESULTS A significant reduction of anti-Dsg1 (P &lt; .001) and anti-Dsg3 (P &lt; .001) Ab ELISA values was observed in serum samples from patients with pemphigus foliaceus or pemphigus vulgaris after the initial treatment. During the long-term follow-up, anti-Dsg1 Ab ELISA values correlated with the course of skin lesions (P = .03); the 20 U/mL cutoff for the anti-Dsg1 Ab ELISA value provided a 79% positive and an 84% negative predictive value for the occurrence of cutaneous relapses. No correlation was observed between anti-Dsg3 Ab ELISA values and the course of mucosal lesions (P = .13). Anti-Dsg3 Ab ELISA values higher than the 14-U/mL cutoff were observed in 5 of the 5 patients with relapse and in 10 of the 13 patients with ongoing mucosal remission, providing a 100% sensitivity but a poor specificity of 23%. A cutoff value of 130 U/mL for anti-Dsg3 Abs was calculated based on the receiver operating characteristics curve and provided an 84% positive and an 81% negative predictive value. CONCLUSIONS Anti-Dsg1 Ab ELISA values are more closely correlated than anti-Dsg3 Ab ELISA values with the course of the disease in patients with pemphigus vulgaris or pemphigus foliaceus. 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Medical Complete (Alumni)</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of dermatology (1960)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Abasq, Claire</au><au>Mouquet, Hugo</au><au>Gilbert, Danièle</au><au>Tron, François</au><au>Grassi, Vanessa</au><au>Musette, Philippe</au><au>Joly, Pascal</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>ELISA Testing of Anti–Desmoglein 1 and 3 Antibodies in the Management of Pemphigus</atitle><jtitle>Archives of dermatology (1960)</jtitle><addtitle>Arch Dermatol</addtitle><date>2009-05-01</date><risdate>2009</risdate><volume>145</volume><issue>5</issue><spage>529</spage><epage>535</epage><pages>529-535</pages><issn>0003-987X</issn><issn>2168-6068</issn><eissn>1538-3652</eissn><eissn>2168-6084</eissn><coden>ARDEAC</coden><abstract>OBJECTIVE To assess the predictive value of anti–desmoglein (Dsg) 1 and anti-Dsg3 antibody (Ab) enzyme-linked immunosorbent assay (ELISA) values for the occurrence of relapses in pemphigus. DESIGN Retrospective study. SETTING Dermatology departments from 13 university hospitals in France. PATIENTS The study population comprised 26 patients with typical clinical, histologic, and immunofluorescence findings of pemphigus, who were followed up over a 17-month period. MAIN OUTCOME MEASURES Serial anti-Dsg1 and anti-Dsg3 Ab ELISA values were recorded during the patients' follow-up examinations and correlated with the occurrence of skin and/or mucosal relapses. RESULTS A significant reduction of anti-Dsg1 (P &lt; .001) and anti-Dsg3 (P &lt; .001) Ab ELISA values was observed in serum samples from patients with pemphigus foliaceus or pemphigus vulgaris after the initial treatment. During the long-term follow-up, anti-Dsg1 Ab ELISA values correlated with the course of skin lesions (P = .03); the 20 U/mL cutoff for the anti-Dsg1 Ab ELISA value provided a 79% positive and an 84% negative predictive value for the occurrence of cutaneous relapses. No correlation was observed between anti-Dsg3 Ab ELISA values and the course of mucosal lesions (P = .13). Anti-Dsg3 Ab ELISA values higher than the 14-U/mL cutoff were observed in 5 of the 5 patients with relapse and in 10 of the 13 patients with ongoing mucosal remission, providing a 100% sensitivity but a poor specificity of 23%. A cutoff value of 130 U/mL for anti-Dsg3 Abs was calculated based on the receiver operating characteristics curve and provided an 84% positive and an 81% negative predictive value. CONCLUSIONS Anti-Dsg1 Ab ELISA values are more closely correlated than anti-Dsg3 Ab ELISA values with the course of the disease in patients with pemphigus vulgaris or pemphigus foliaceus. This should be taken into account for the management of patients with pemphigus.Arch Dermatol. 2009;145(5):529-535--&gt;</abstract><cop>Chicago, IL</cop><pub>American Medical Association</pub><pmid>19451496</pmid><doi>10.1001/archdermatol.2009.9</doi><tpages>7</tpages></addata></record>
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subjects Antibodies - blood
Antibodies - immunology
Biological and medical sciences
Bullous diseases of the skin
Dermatology
Desmoglein 1 - immunology
Desmoglein 2 - immunology
Disease Progression
Drug Therapy, Combination
Enzyme-Linked Immunosorbent Assay - methods
Enzyme-Linked Immunosorbent Assay - utilization
Female
Follow-Up Studies
Glucocorticoids - therapeutic use
Humans
Immunoassay
Immunosuppressive Agents - therapeutic use
Male
Medical sciences
Middle Aged
Pemphigus - diagnosis
Pemphigus - drug therapy
Pemphigus - immunology
Predictive Value of Tests
Prednisone - therapeutic use
Prognosis
Recurrence
Retrospective Studies
Sensitivity and Specificity
Skin diseases
Time Factors
title ELISA Testing of Anti–Desmoglein 1 and 3 Antibodies in the Management of Pemphigus
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