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Fania L, Moro F, De Paolis E, Provini A, Salemme A, Mariotti F, Sinagra JLM, Mazzanti C, Ruzzi L, Capoluongo E, Di Zenzo G. Pemphigus vulgaris in two pairs of siblings from two unrelated Italian families: Human leukocyte antigen genotypes, ST18 mutation and immunological profile. J Dermatol 2020; 48:211-214. [PMID: 33258504 DOI: 10.1111/1346-8138.15656] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 09/18/2020] [Indexed: 11/30/2022]
Abstract
Pemphigus vulgaris (PV) is an autoimmune intraepithelial bullous disease. Associations with the class II human leukocyte antigen (HLA) alleles and pemphigus vulgaris have been described. Furthermore, an association between the single nucleotide polymorphism of the ST18 gene and pemphigus vulgaris has been reported. We report two pairs of siblings from two unrelated Italian families affected by pemphigus vulgaris, characterizing their genetic and immunological profile. In order to assess the genetic background, HLA-DQA1, HLA-DQB1, HLA-DRB1 and a relevant ST18 polymorphism were investigated. As for the immunological profiles, anti-desmoglein antibodies were analyzed. In family A, the two pemphigus vulgaris patients had the same HLA genetic profile: HLA-DQA1 *01:04/*03:01, HLA-DQB1 *03:02/*05:03 and HLA-DRB1 *04:02/*14:01. The male patient was heterozygous for the ST18 mutation while the female patient had a wild genotype. In family B, the two pemphigus vulgaris patients were both wild type for the ST18 mutation and showed the same HLA genotype: HLA-DQA1 *03:01/*05:08, HLA-DQB1 *03:01/*03:03 and HLA-DRB1 *04:02/*11:01. Our data show a relevant relationship between the HLA profile and pemphigus vulgaris in our Italian families. In family A, all six alleles are frequently associated with pemphigus vulgaris and were expressed only in the two pemphigus patients; and in family B, two of the six alleles are frequently associated with pemphigus vulgaris. No relevant relationship was found between ST18 polymorphism and pemphigus disease.
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Affiliation(s)
- Luca Fania
- First Dermatology Division, IDI-IRCCS, Rome, Italy
| | | | - Elisa De Paolis
- Molecular Diagnostics and Genomics Laboratory, Fondazione Policlinico Universitario A. Gemelli IRCCS, Italy
| | | | | | | | | | | | - Laura Ruzzi
- Clinical Analysis Laboratory, IDI-IRCCS, Rome, Italy
| | - Ettore Capoluongo
- Advanced Biotechnology, Department of Molecular Medicine and Medical Biotechnology, Federico II University - CEINGE, Naples, Italy
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Ogawa M, Goto K, Kanameishi S, Dainichi T, Kabashima K, Tanabe H. Pemphigus vulgaris in a recipient and pemphigus foliaceus in a donor after allogeneic peripheral blood stem cell transplantation between two siblings. J Eur Acad Dermatol Venereol 2020; 34:e383-e386. [PMID: 32043651 DOI: 10.1111/jdv.16289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- M Ogawa
- Department of Dermatology, Tenri Hospital, Tenri City, Japan
| | - K Goto
- Department of Dermatology, Tenri Hospital, Tenri City, Japan
| | - S Kanameishi
- Department of Dermatology, Tenri Hospital, Tenri City, Japan
| | - T Dainichi
- Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - K Kabashima
- Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - H Tanabe
- Department of Dermatology, Tenri Hospital, Tenri City, Japan
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Rabinovich OF, Rabinovich IM, Abramova ES. [Epidemiology, etiology and pathogenesis of oral mucosa bullous lesions]. STOMATOLOGII︠A︡ 2019; 98:71-75. [PMID: 31089125 DOI: 10.17116/stomat20199802171] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Based on the data available in modern literature, to conduct a study on the epidemiology, etiology and pathogenesis of bullous lesions of the oral mucosa (pemphigus vulgaris, pemphigoid bullosa, lichen ruber planus). MATERIAL AND METHODS The article is based on the study of materials of foreign and domestic research databases Pubmed and Elibrary. Used literature data over the past 15 years. RESULTS According to domestic and foreign studies, among dermatological diseases, the most frequently detected diseases are: lichen ruber planus, pemphigoid bullosa and pemphigus vulgaris. The initial signs of these diseases are often neglected, both in patients and doctors, which leads to irreversible changes and severe course of the pathological process. In this connection, the number of patients with these lesions of the oral mucosa increases every year in all countries of the world. Bullous lesions of the oral mucosa are inflammatory and destructive diseases characterized mainly by recurrent course, variety of clinical manifestations, resistance to various therapeutic drugs. The specific features of the course of these diseases are explained both by the anatomical and physiological features of the oral mucosa, and by the etiologic and pathogenetic mechanisms of development. Currently, autoimmune processes play a leading role in the genesis of diseases, developing in response to changes in the antigenic structure of epidermal and epithelial cells under the influence of various damaging agents. CONCLUSION Thanks to the study, it was found that currently there are no data confirming the presence of microbial contamination of the tissues of the oral mucosa in the pathology under study. Not enough information on the factors of the immune response, in particular, on proinflammatory cytokines in the tissues of the oral mucosa.
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Affiliation(s)
- O F Rabinovich
- Central Research Institute of Dentistry and Maxillofacial surgery, Moscow, Russia
| | - I M Rabinovich
- Central Research Institute of Dentistry and Maxillofacial surgery, Moscow, Russia
| | - E S Abramova
- Central Research Institute of Dentistry and Maxillofacial surgery, Moscow, Russia
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Gil JM, Weber R, Rosales CB, Rodrigues H, Sennes LU, Kalil J, Chagury A, Miziara ID. Study of the association between human leukocyte antigens (HLA) and pemphigus vulgaris in Brazilian patients. Int J Dermatol 2017; 56:557-562. [PMID: 28197992 DOI: 10.1111/ijd.13577] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2016] [Revised: 12/15/2016] [Accepted: 01/09/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND Pemphigus vulgaris is a mucocutaneous blistering autoimmune disease that manifests as painful blisters or erosions on the skin and/or mucosal surfaces. IgG autoantibodies target desmoglein, playing a major role in disease pathogenesis. Genetic predisposal to pemphigus vulgaris, especially the HLA DR and DQ alleles, has been known since the 1980s. The unique constitution of the Brazilian population favors exploratory genetic studies. METHODS The study group included 51 patients with a confirmed diagnosis of pemphigus vulgaris from a tertiary hospital in Sao Paulo city, Sao Paulo, southeast Brazil. DNA was extracted from peripheral blood, and HLA A, B, C, DR, and DQ typing was performed. The control group was composed of a database of 297 deceased donors from the city of São Paulo typed with the same method. The statistical significance level was adjusted using the Bonferroni correction depending on the phenotypic frequencies evaluated for HLA A, HLA B, HLA C, HLA DRB1, DQA1, and HLA DQB1. RESULTS The alleles HLA-B*57, HLA-C*15, HLA-DRB1*04:02, HLA-DRB1*08:04, HLA-DRB1*14:01, DQA1*03:01, DQB1*03:02, and DQB1*05:03 were associated with susceptibility. Alleles HLA DRB1*04:02 and HLA-DRB1*14:01 and their respective haplotypes DRB1*04-DQA1*03:01-DQB1*03:02, and DRB1*14-DQA1*01:01-DQB1*05:03 conferred a risk of the disease. CONCLUSIONS The DRB1*04:02 and DQB1*05:03 alleles are associated with pemphigus vulgaris in our study as well as in various populations. The association with HLA-DRB1*08:04 in our study was confirmed to be specific to this allele and not to linkage disequilibrium to any adjacent gene. The association between HLA-B*57 and pemphigus vulgaris is reported for the first time in the present study.
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Affiliation(s)
- Julio M Gil
- ENT Department of School of Medicine, Sao Paulo University, Sao Paulo, Brazil
| | - Raimar Weber
- ENT Department of School of Medicine, Sao Paulo University, Sao Paulo, Brazil
| | - Claudia B Rosales
- Transplant Immunology and Immunogenetics Laboratory, Heart Institute (INCOR), School of Medicine, Sao Paulo University, Sao Paulo, Brazil
| | - Helcio Rodrigues
- Transplant Immunology and Immunogenetics Laboratory, Heart Institute (INCOR), School of Medicine, Sao Paulo University, Sao Paulo, Brazil
| | - Luiz U Sennes
- ENT Department of School of Medicine, Sao Paulo University, Sao Paulo, Brazil
| | - Jorge Kalil
- Transplant Immunology and Immunogenetics Laboratory, Heart Institute (INCOR), School of Medicine, Sao Paulo University, Sao Paulo, Brazil
| | - Azis Chagury
- ENT Department of School of Medicine, Sao Paulo University, Sao Paulo, Brazil
| | - Ivan D Miziara
- ENT Department of School of Medicine, Sao Paulo University, Sao Paulo, Brazil
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Mitsui S, Kamiya K, Tokura Y, Iwatsuki K, Aoyama Y. Analysis of human leukocyte antigen genotypes in pemphigus with antidesmoglein antibody profile shift. DERMATOL SIN 2016. [DOI: 10.1016/j.dsi.2016.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Salathiel AM, Brochado MJF, Kim O, Deghaide NHS, Donadi EA, Roselino AM. Family study of monozygotic twins affected by pemphigus vulgaris. Hum Immunol 2016; 77:600-4. [PMID: 27177496 DOI: 10.1016/j.humimm.2016.05.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Revised: 12/21/2015] [Accepted: 05/10/2016] [Indexed: 10/21/2022]
Abstract
Rare are the family studies that include siblings affected by pemphigus vulgaris (PV) and in whom HLA class II alleles are related. HLA-DR and -DQ genotyping and profiling of antibodies against desmogleins (Dsg) 1 and Dsg3 were performed in ten members of a family including monozygotic twins affected by PV. The twin sisters were heterozygotes; they presented the haplotypes most commonly associated with increased susceptibility to PV (DRB1∗04:02-DQA1∗03:01-DQB1∗03:02 and DRB1∗14:04-DQA1∗01:01-DQB1∗05:03). Their parents and five siblings had only one or none of these two haplotypes in combination with the alleles or haplotypes associated with resistance to PV (DRB1∗07:01-DQA1∗02:01-DQB1∗02:02 and DRB1∗13:01-DQA1∗01:03-DQB1∗06:03). Only the monozygotic twins presented IgG antibodies against both Dsg1 and Dsg3. According to our knowledge based on a review of published literature on the topic, this is the first report of PV affecting monozygotic twins.
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Affiliation(s)
- Adriana Martinelli Salathiel
- Laboratory of Dermatology, University Hospital, Division of Dermatology, Department of Medical Clinics, Ribeirao Preto Medical School - University of Sao Paulo, Brazil
| | - Maria José Franco Brochado
- Laboratory of Dermatology, University Hospital, Division of Dermatology, Department of Medical Clinics, Ribeirao Preto Medical School - University of Sao Paulo, Brazil
| | - Olivia Kim
- Laboratory of Dermatology, University Hospital, Division of Dermatology, Department of Medical Clinics, Ribeirao Preto Medical School - University of Sao Paulo, Brazil
| | - Neifi Hassan Saloum Deghaide
- Laboratory of Immunogenetics of Blood Donor Center, Division of Immunology, Department of Medical Clinics, Ribeirao Preto Medical School - University of Sao Paulo, Brazil
| | - Eduardo Antonio Donadi
- Laboratory of Immunogenetics of Blood Donor Center, Division of Immunology, Department of Medical Clinics, Ribeirao Preto Medical School - University of Sao Paulo, Brazil
| | - Ana Maria Roselino
- Laboratory of Dermatology, University Hospital, Division of Dermatology, Department of Medical Clinics, Ribeirao Preto Medical School - University of Sao Paulo, Brazil.
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Familial Pemphigus Vulgaris Occured in a Father and Son as the First Confirmed Cases. Case Rep Dermatol Med 2016; 2016:1653507. [PMID: 27403352 PMCID: PMC4925942 DOI: 10.1155/2016/1653507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2015] [Revised: 04/09/2016] [Accepted: 05/15/2016] [Indexed: 11/30/2022] Open
Abstract
Pemphigus vulgaris (PV) is a chronic autoimmune bullous disease of the skin and mucous membranes. Although there is some evidence pointing towards a genetic predisposition by some human leukocyte antigen (HLA) genes, familial occurrence of PV is very rare. Most of the familial PV cases so far reported have been in mother and daughter and in siblings. PV in father and son, as presented here, has not been reported in the literature before, except an unconfirmed report. The diagnosis of PV was established by histologic, cytologic studies and enzyme linked immunosorbent assay (ELISA) in Case 1 and by ELISA and BIOCHIP indirect immunofluorescence test in Case 2. The son was responsive to moderate doses of methylprednisolone, with the treatment continuing with tapered doses. The father was in a subclinic condition; consequently, only close follow-up was recommended. HLA typing studies revealed identical HLA alleles of HLA-DR4 (DRB1⁎04) and HLA-DQB1⁎03 in both of our cases; this had been found to be associated with PV in prior studies. Familial occurrences of PV and related HLA genes indicate the importance of genetic predisposition. The first occurrence of confirmed familial PV in father and son is reported here.
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Suliman NM, Åstrøm AN, Ali RW, Salman H, Johannessen AC. Clinical and histological characterization of oral pemphigus lesions in patients with skin diseases: a cross sectional study from Sudan. BMC Oral Health 2013; 13:66. [PMID: 24261459 PMCID: PMC3871015 DOI: 10.1186/1472-6831-13-66] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Accepted: 11/11/2013] [Indexed: 12/20/2022] Open
Abstract
Background Pemphigus is a rare group of life-threatening mucocutaneous autoimmune blistering diseases. Frequently, oral lesions precede the cutaneous ones. This study aimed to describe clinical and histological features of oral pemphigus lesions in patients with skin disease has been canceled aged 18 years and above, attending outpatient’s facility of Khartoum Teaching Hospital - Dermatology Clinic, Sudan. In addition, the study aimed to assess the diagnostic significance of routine histolopathology along with immunohistochemical (IHC) examination of formalin-fixed, paraffin-embedded biopsy specimens in patients with oral pemphigus. Methods A cross-sectional hospital-based study was conducted from October 2008 to January 2009. A total of 588 patients with confirmed skin has been canceled disease diagnosis completed an oral examination and a personal interview. Clinical evaluations supported with histopathology were the methods of diagnosis. IHC was used to confirm the diagnosis. Location, size, and pain of oral lesions were used to measure the oral disease activity. Results Twenty-one patients were diagnosed with pemphigus vulgaris (PV), 19 of them (mean age: 43.0; range: 20–72 yrs) presented with oral manifestations. Pemphigus foliaceus was diagnosed in one patient. In PV, female: male ratio was 1.1:1.0. Buccal mucosa was the most commonly affected site. Exclusive oral lesions were detected in 14.2% (3/21). In patients who experienced both skin and oral lesion during their life time, 50.0% (9/18) had oral mucosa as the initial site of involvement, 33.3% (6/18) had skin as the primary site, and simultaneous involvement of both skin and oral mucosa was reported by 5.5% (1/18). Two patients did not provide information regarding the initial site of involvement. Oral lesion activity score was higher in those who reported to live outside Khartoum state, were outdoor workers, had lower education and belonged to Central and Western tribes compared with their counterparts. Histologically, all tissues except one had suprabasal cleft and acantholytic cells. IHC revealed IgG and C3 intercellularly in the epithelium. Conclusions PV was the predominating subtype of pemphigus in this study. The majority of patients with PV presented with oral lesions. Clinical and histological pictures of oral PV are in good agreement with the literature. IHC confirmed all diagnoses of PV.
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MICHENKO AV, ZNAMENSKAYA LF, LVOV AN, VOLKOV IA, FRIGO NV, VOLNUKHIN VA. Pemphigus pathogenesis: problems and prospects. VESTNIK DERMATOLOGII I VENEROLOGII 2012. [DOI: 10.25208/vdv682] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Provides the survey of most prospective trends of research of the pathogenesis of the true acantholytic pemphigus. Cites key results of studies of factors of genetic predisposition to the development of this bullous dermatosis. Highlights problems of studies of the role of antiself antibodies and self-antigens in pemphigus pathogenesis. Represents the apoptolyse theory, explaining mechanisms of the loss of link between keratinocytes. Discusses issues of the cellular regulation of autoimmune reactions at acantholytic pemphigus.
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