Assessing the Link Between Dietary Total Antioxidant Capacity and Pemphigus Vulgaris Severity: A Cross-Sectional Analysis

Introduction: Pemphigus vulgaris (PV) refers to a group of rare autoimmune blistering diseases affecting the skin and mucous membranes. Increased levels of reactive oxygen species (ROS) have been previously reported in PV, suggesting that dietary antioxidants may play a role in reducing oxidative stress and alleviating symptoms. Methods: This study was designed to evaluate the dietary antioxidant status of patients with PV and assess its relationship with disease severity. In this cross-sectional study, PV patients who met the eligibility criteria were enrolled. Disease severity was assessed using the Pemphigus Disease Area Index (PDAI). Patients’ food consumption was measured using a food frequency questionnaire, and the dietary total antioxidant capacity (d-TAC) index was calculated using values from the USDA database. Results: A total of 138 patients with a mean age of 48.3 years (SD: 12.8) were included. The mean d-TAC was 10.8 (SD: 4.3). Participants were divided into two groups based on disease severity. Greater disease severity was associated with shorter disease duration, higher levels of anti-Desmoglein 1, higher corticosteroid consumption, and a lower accumulated dose of Rituximab. It was also associated with higher cholesterol intake and lower daily consumption of fiber and vitamin C. After adjusting for covariates, no significant association was found between d-TAC and PV disease severity. Discussion: Patients with PV appear to have lower antioxidant consumption compared to previous reports. Conclusion: The d-TAC index was not associated with disease severity. Further studies with larger sample sizes and objective measurement methods are recommended to minimize potential biases.