Nondesmoglein autoantibodies in oral pemphigus vulgaris: implications for diagnosis and disease monitoring

Background Pemphigus vulgaris (PV) is an autoimmune blistering disease affecting the skin and mucous membranes. Oral mucosa usually is the first affected site, it may precede the cutaneous lesions by several years. Serological tests for detecting circulating antibodies could help in the diagnosis of oral pemphigus. Objective To evaluate the diagnostic and prognostic performance of nondesmoglein antibodies (non-Dsg Abs) in oral PV patients. Patients and methods This prospective case–control, followed by a single-arm cohort study included 16 patients diagnosed with oral PV and 16 healthy volunteers as a control group. Disease severity was evaluated using the oral disease severity score. Serum levels of antimuscarinic, antinicotinic, antithyroid peroxidase and non-Dsg3 Abswere measured using enzyme-linked immunosorbent assays both before treatment and three months post-treatment. Results All measured parameters showed a statistically significant decline in the patient group between baseline and 3 months post-treatment ( P 1<0.001). Serum antibody titers were significantly higher in the patient group before treatment compared with the control group ( P 2<0.001 for all measurements). However, no statistically significant correlation was found between the severity of oral disease and the levels of non-Dsg Abs titers. Conclusion The measured non-Dsg Abs, particularly antinicotinic, and antithyroid peroxidase antibodies, demonstrated high diagnostic performance and may serve as valuable adjuncts in the diagnosis of oral PV. However, their utility in long-term patient follow-up remains challenging to assess.