Diagnosis of pemphigus by ELISA: a critical evaluation of two ELISAs for the detection of antibodies to the major pemphigus antigens, desmoglein 1 and 3

Clin Exp Dermatol. 2000 May;25(3):236-40. doi: 10.1046/j.1365-2230.2000.00624.x.

Abstract

Pemphigus vulgaris (PV) and pemphigus foliaceus (PF) are characterized by autoantibodies to the desmosomal glycoproteins desmoglein 3 (Dsg 3) and Dsg 1 (Dsg 1), respectively. In this study, two enzyme-linked immunosorbent assays (ELISA) which detect IgG autoantibodies to Dsg 1 and Dsg 3 have been evaluated. A total of 317 normal and disease controls, 82 patients with PV and 25 with PF were studied. The Dsg 3 ELISA was positive in all 34 patients with untreated PV and the Dsg 1 ELISA was positive in all 10 with untreated PF. When patients undergoing treatment were included, the sensitivities fell to 95% and 92%, respectively, but still compared favourably to the sensitivity of indirect immunofluorescence which was 79% in PV and 84% in PF. All PF sera were negative in the Dsg 3 ELISA and the specificity of both assays was 98% or greater. Large numbers of samples could be analysed simultaneously over a relatively short time period. The Dsg 1 and Dsg 3 ELISAs also provided objective, quantitative, reproducible data which allowed differentiation of PV from PF and in view of these advantages, they are likely to become a routine technique in diagnostic laboratories.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antibodies / analysis
  • Antigens / immunology
  • Child
  • Cytoskeletal Proteins / immunology*
  • Desmoglein 1
  • Desmoglein 3
  • Desmogleins
  • Desmoplakins
  • Enzyme-Linked Immunosorbent Assay / methods*
  • Female
  • Humans
  • Immunoglobulin A / analysis
  • Male
  • Middle Aged
  • Pemphigus / diagnosis*
  • Pemphigus / immunology
  • Sensitivity and Specificity

Substances

  • Antibodies
  • Antigens
  • Cytoskeletal Proteins
  • DSG1 protein, human
  • Desmoglein 1
  • Desmoglein 3
  • Desmogleins
  • Desmoplakins
  • Immunoglobulin A