AUTHOR=Li Ning , Aoki Valeria , Liu Zhi , Prisayanh Phillip , Valenzuela Jesus G. , Diaz Luis A. 

TITLE=From Insect Bites to a Skin Autoimmune Disease: A Conceivable Pathway to Endemic Pemphigus Foliaceus

JOURNAL=Frontiers in Immunology

VOLUME=13

YEAR=2022

URL=https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2022.907424

DOI=10.3389/fimmu.2022.907424

ISSN=1664-3224

ABSTRACT=<p>In the endemic variants of pemphigus foliaceus (PF), in Brazil and Tunisia, patients generate pathogenic IgG4 anti-desmoglein 1 autoantibodies. Additionally, these patients possess antibodies against salivary proteins from sand flies that react with Dsg1, which may lead to skin disease in susceptible individuals living in endemic areas. This minireview focuses on recent studies highlighting the possible role of salivary proteins from <italic>Lutzomyia longipalpis</italic> (<italic>L. longipalpis</italic>) in EPF from Brazil and <italic>Phlebotomus papatasi</italic> (<italic>P. papatasi</italic>) in EPF from Tunisia. We will briefly discuss the potential mechanisms of molecular mimicry and epitope spreading in the initiation and development of endemic PF (EPF) in Brazil and Tunisia.</p>