Antibodies against desmoglein 3 (pemphigus vulgaris antigen) are present in sera from patients with paraneoplastic pemphigus and cause acantholysis in vivo in neonatal mice

Paraneoplastic pemphigus (PNP) is an autoimmune blistering disease that occurs in association with underlying neoplasms. Patients with PNP develop characteristic IgG autoantibodies directed against multiple antigens, most of which have been identified as cytoplasmic proteins of the plakin family (de...

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Published inThe Journal of clinical investigation Vol. 102; no. 4; pp. 775 - 782
Main Authors Amagai, M, Nishikawa, T, Nousari, H C, Anhalt, G J, Hashimoto, T
Format Journal Article
LanguageEnglish
Published United States 15.08.1998
Subjects
Acantholysis - chemically induced
Acantholysis - immunology
Animals
Animals, Newborn
Autoantibodies - blood
Autoantibodies - toxicity
Autoantigens - immunology
Blister - chemically induced
Cadherins - immunology
Desmoglein 1
Desmoglein 3
Humans
Mice
Paraneoplastic Syndromes - etiology
Paraneoplastic Syndromes - immunology
Pemphigus - etiology
Pemphigus - immunology
Skin - pathology
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Summary:Paraneoplastic pemphigus (PNP) is an autoimmune blistering disease that occurs in association with underlying neoplasms. Patients with PNP develop characteristic IgG autoantibodies directed against multiple antigens, most of which have been identified as cytoplasmic proteins of the plakin family (desmoplakin I, II, BPAG1, envoplakin, and periplakin). This study identified cell surface target antigens of PNP. We focused on desmoglein (Dsg) 3 and Dsg1, the autoantigens of pemphigus vulgaris and pemphigus foliaceus. ELISA using baculovirus-expressed recombinant Dsgs (rDsg3, rDsg1) has revealed that 25 out of 25 PNP sera tested were positive against Dsg3 and 16 of 25 were positive against Dsg1. All of 12 PNP sera tested immunoprecipitated Dsg3. Removal of anti-Dsg3 autoantibodies by immunoadsorption was sufficient to eliminate the ability of PNP sera to induce cutaneous blisters in neonatal mice in vivo. Furthermore, anti-Dsg3-specific antibodies that were affinity purified from PNP sera were proven to be pathogenic and caused blisters in neonatal mice. These findings indicate that Dsg3 and Dsg1 are the cell surface target antigens in PNP and that IgG autoantibodies against Dsg3 in PNP sera play a pathogenic role in inducing loss of cell adhesion of keratinocytes and causing blister formation.
ISSN:0021-9738
DOI:10.1172/JCI3647