Evaluation of the Relationship between Pemphigus Vulgaris Severity and the Serum Levels of IL33 and anti-Desmoglein-3 Antibody

Background: Pemphigus is a potentially life-threatening autoimmune disorder affecting both skin and mucosa. Clinically, it is characterized by blister formation and erosions, and histologically, by acantholysis. Pemphigus vulgaris (PV) is the most common type within the pemphigus groups. The pathogenesis of pemphigus includes the presence of autoantibodies directed against desmosomal proteins like desmoglein on the cell surface of keratinocytes, which are critical for keratinocyte adhesion and epidermal structural integrity. In addition, PV pathogenesis involves a dysregulated immune response, with multiple involved cytokines, including interleukin-33 (IL-33). Objective: To evaluate the relationship between the severity of PV and IL-33 and anti-Dsg3 antibodies serum levels. Methodology: A case-control study was conducted on fifty patients diagnosed with PV and fifty healthy controls matched in age and sex. Clinical evaluation was performed on each patient, and the Pemphigus Vulgaris Activity Score (PVAS) was used to classify the patients into three distinct categories according to the PV severity. Serum samples were obtained from both patients and control participants and analyzed quantitatively for IL-33 and anti-Dsg3 antibodies using ELISA. Results: Serum levels of IL-33 and anti-Dsg-3 were significantly higher in PV patients compared to healthy controls, with a significant association with PV severity. Conclusion: IL-33 and anti-Dsg-3 are useful markers for the evaluation of PV activity.