|
1
|
Emtenani S, Ghorbanalipoor S, Mayer-Hain S, Kridin K, Komorowski L, Probst C, Hashimoto T, Pas HH, Męcińska-Jundziłł K, Czajkowski R, Recke A, Sunderkötter C, Schneider SW, Hundt JE, Zillikens D, Schmidt E, Ludwig RJ, Hammers CM. Pathogenic Activation and Therapeutic Blockage of FcαR-Expressing Polymorphonuclear Leukocytes in IgA Pemphigus. J Invest Dermatol 2021; 141:2820-2828. [PMID: 34246620 DOI: 10.1016/j.jid.2021.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 05/06/2021] [Accepted: 06/04/2021] [Indexed: 10/20/2022]
Abstract
Pathomechanisms in IgA pemphigus are assumed to rely on Fc-dependent cellular activation by antigen-specific IgA autoantibodies; however, models for the disease and more detailed pathophysiologic data are lacking. In this study, we aimed to establish in vitro models of disease for IgA pemphigus, allowing us to study the effects of the interaction of anti-keratinocyte IgA with cell surface FcαRs. Employing multiple in vitro assays, such as a skin cryosection assay and a human skin organ culture model, in this study, we present mechanistic data for the pathogenesis of IgA pemphigus, mediated by anti-desmoglein 3 IgA autoantibodies. Our results reveal that this disease is dependent on FcαR-mediated activation of leukocytes in the epidermis. Importantly, this cell-dependent pathology can be dose-dependently abrogated by peptide-mediated inhibition of FcαR:IgA-Fc interaction, as confirmed in an additional model for IgA-dependent disease, that is, IgA vasculitis. These data suggest that IgA pemphigus can be modeled in vitro and that IgA pemphigus and IgA vasculitis are FcαR-dependent disease entities that can be specifically targeted in these experimental systems.
Collapse
Affiliation(s)
- Shirin Emtenani
- Luebeck Institute of Experimental Dermatology (LIED), University of Luebeck, Luebeck, Germany
| | - Saeedeh Ghorbanalipoor
- Luebeck Institute of Experimental Dermatology (LIED), University of Luebeck, Luebeck, Germany
| | - Sarah Mayer-Hain
- Department of Translational Dermatoinfectiology, University Hospital of Muenster, University of Muenster, Muenster, Germany; Institute of Immunology, University Hospital of Muenster, University of Muenster, Muenster, Germany
| | - Khalaf Kridin
- Luebeck Institute of Experimental Dermatology (LIED), University of Luebeck, Luebeck, Germany
| | | | | | - Takashi Hashimoto
- Department of Dermatology, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Hendri H Pas
- Department of Dermatology, University of Groningen, Groningen, The Netherlands
| | - Kaja Męcińska-Jundziłł
- Department of Dermatology and Venerology, Faculty of Medicine, Ludwik Rydygier Medical College in Bydgoszcz, Nicolaus Copernicus University, Torun, Poland
| | - Rafał Czajkowski
- Department of Dermatology and Venerology, Faculty of Medicine, Ludwik Rydygier Medical College in Bydgoszcz, Nicolaus Copernicus University, Torun, Poland
| | - Andreas Recke
- Luebeck Institute of Experimental Dermatology (LIED), University of Luebeck, Luebeck, Germany
| | - Cord Sunderkötter
- Department of Translational Dermatoinfectiology, University Hospital of Muenster, University of Muenster, Muenster, Germany; Department of Dermatology, Martin Luther University of Halle-Wittenberg, Halle (Saale), Germany
| | - Stefan W Schneider
- Department of Dermatology and Venerology, University Medical Center Hamburg-Eppendorf, University of Hamburg, Hamburg, Germany
| | - Jennifer E Hundt
- Luebeck Institute of Experimental Dermatology (LIED), University of Luebeck, Luebeck, Germany
| | - Detlef Zillikens
- Department of Dermatology, Allergology and Venerology, University of Luebeck, Luebeck, Germany
| | - Enno Schmidt
- Luebeck Institute of Experimental Dermatology (LIED), University of Luebeck, Luebeck, Germany; Department of Dermatology, Allergology and Venerology, University of Luebeck, Luebeck, Germany
| | - Ralf J Ludwig
- Luebeck Institute of Experimental Dermatology (LIED), University of Luebeck, Luebeck, Germany; Department of Dermatology, Allergology and Venerology, University of Luebeck, Luebeck, Germany
| | - Christoph M Hammers
- Luebeck Institute of Experimental Dermatology (LIED), University of Luebeck, Luebeck, Germany; Department of Dermatology, Allergology and Venerology, University of Luebeck, Luebeck, Germany.
| |
Collapse
|
|
3
|
Molinelli E, Paolinelli M, Campanati A, Brisigotti V, Offidani A. Metabolic, pharmacokinetic, and toxicological issues surrounding dapsone. Expert Opin Drug Metab Toxicol 2019; 15:367-379. [DOI: 10.1080/17425255.2019.1600670] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Elisa Molinelli
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Matteo Paolinelli
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Anna Campanati
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Valerio Brisigotti
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Annamaria Offidani
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| |
Collapse
|
|
4
|
Lekić B, Gajić-Veljić M, Popadić S, Nikolić M. IgA Pemphigus in a Child – a Case Report. SERBIAN JOURNAL OF DERMATOLOGY AND VENEREOLOGY 2017. [DOI: 10.1515/sjdv-2017-0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
IgA pemphigus (IGAP) is a rare autoimmune bullous disease characterized by IgA deposits on keratinocyte cell surfaces. The IGAP is classified into: 1) subcorneal pustular dermatosis (SPD) type, and 2) intraepidermal neutrophilic (IEN) IgA dermatosis type. So far, only 9 children with IGAP have been described in the literature, of whom only 3 with SPD type. We report a 3-year-old boy with SPD type of IGAP. Clinically, he presented with pruritic vesicles, pustules and erosions on the face, trunk, groin area, and extremities. Histopathology showed subcorneal pustules containing a few acantholytic cells. Direct immunofluorescence (DIF) test of Tzanck smear showed intercellular IgA deposits on the surface of the groups of epidermal cells. Oral dapsone and prednisone induced remission after two weeks; the treatment was discontinued 11 months later, and complete remission was achieved during 19 months without any treatment. Direct immunofluorescence of Tzanck smear is a simple, sensitive, rapid and non-aggressive test, very suitable for the diagnosis of IGAP in children.
Collapse
Affiliation(s)
- Branislav Lekić
- Clinic of Dermatovenereology , Clinical Center of Serbia , Belgrade , Republic of Serbia
| | - Mirjana Gajić-Veljić
- Clinic of Dermatovenereology , Clinical Center of Serbia , Belgrade , Republic of Serbia
- University of Belgrade , School of Medicine , Belgrade , Republic of Serbia
| | - Svetlana Popadić
- Clinic of Dermatovenereology , Clinical Center of Serbia , Belgrade , Republic of Serbia
- University of Belgrade , School of Medicine , Belgrade , Republic of Serbia
| | - Miloš Nikolić
- Clinic of Dermatovenereology , Clinical Center of Serbia , Belgrade , Republic of Serbia
- University of Belgrade , School of Medicine , Belgrade , Republic of Serbia
| |
Collapse
|
|
5
|
Accuracy of molecular diagnostics in pemphigus and bullous pemphigoid: comparison of commercial and modified mosaic indirect immunofluorescence tests as well as enzyme-linked immunosorbent assays. Postepy Dermatol Alergol 2017; 34:21-27. [PMID: 28261028 PMCID: PMC5329104 DOI: 10.5114/ada.2017.65617] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Accepted: 11/29/2015] [Indexed: 12/24/2022] Open
Abstract
Introduction Pemphigus and bullous pemphigoid (BP) are identified by autoantibodies (abs) against desmoglein 1, 3 (DSG1/3) and BP180/BP230, respectively. A novel mosaic to indirect immunofluorescence (IIF) using purified BP180 recombinant proteins spotted on slide and transfected cells expressing BP230, DSG1, DSG3 is available. The commercial (IgG detection) and modified (IgG4 detection) mosaic for indirect immunofluorescence (IIFc – IIF commercial, IIFm – IIF modified) and IgG ELISAs were evaluated in pemphigus and bullous pemphigoid (BP) molecular diagnostics. Aim To compare diagnostic accuracy of commercial (IgG detection) and modified (IgG4 detection) mosaic IIF assay and to examine the diagnostic value of ELISAs in relation to mosaic IIF in routine laboratory diagnostics of pemphigus and BP. Material and methods Sera from 37 BP and 19 pemphigus patients were studied. Associations between tests were assessed using Fisher’s exact test. Results There are associations between the positive/negative samples detected by IIFc with desmoglein1 (DSG1)/desmoglein3 (DSG3)/BP230 transfected cells and ELISAs and no association between anti-BP180 IgG detection by IIFc and ELISA. IIFm with DSG1 and DSG3 showed both 100% sensitivity and 100% and 78% specificity, respectively, and 100% and 83% positive predictive value in relation to IIFc. IIFm with BP230 had 87% specificity, 55% sensitivity, whereas IIFm with BP180 had a 100% sensitivity and 13% specificity in relation to IIFc. Conclusions The IIFc with DSG1/DSG3/BP230 transfected cells, excluding BP180 spots, is an alternative method to ELISA in pemphigus/BP diagnostics. IgG4 antibodies, both pathogenically and diagnostically important, are inconsistently detectable with IIFm.
Collapse
|