ORIGINAL RESEARCH article
Front. Immunol.
Sec. Autoimmune and Autoinflammatory Disorders : Autoimmune Disorders
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1557556
This article is part of the Research TopicLymphocytes and Autoimmune Disease: from molecular mechanism to clinical implicationsView all 8 articles
Factors associated with persistent anti-desmoglein positivity after remission in pemphigus vulgaris: a prospective registry-based cohort study
Provisionally accepted
- West China Hospital, Sichuan University, Chengdu, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Introduction: Anti-desmoglein (Dsg) antibodies are well-established markers correlated with clinical phenotype and disease severity in pemphigus vulgaris (PV). However, elevated anti-Dsg antibody levels have been observed in some patients during clinical remission (CR). This study aimed to identify clinical characteristics and risk factors in PV patients with elevated anti-Dsg antibodies after achieving CR. Methods: We conducted a cohort study based on the prospective registry database of autoimmune bullous diseases patients at West China Hospital between April 2016 and March 2022. PV patients with at least 12 months of follow-up were enrolled. The pemphigus disease area index (PDAI) and anti-Dsg antibody titers were measured at baseline and 1, 3, 6, 9, 12 months during follow-up. Univariate, multivariate analyses and receiver operating characteristics (ROC) curves were performed to identify associated factors with persistent antibody positivity and optimal cut-off values respectively. The primary outcome was the persistent positivity of antibodies against Dsg after achieving CR. Results: Among 239 PV patients enrolled in this study, 118 (49%) achieved CR. Cataracts were identified as an independent risk factor for persistent anti-Dsg1 positivity after CR. Higher baseline anti-Dsg3 antibody titers and PDAI scores were significant predictors of increased anti-Dsg3 levels post-CR, with gender also being a contributing factor. ROC analysis determined a cut-off value of 157.4 U/mL for anti-Dsg3 with 56.3% sensitivity and 82.6% specificity.The presence of Cataracts may indicate persistent anti-Dsg1 positivity after CR, while elevated anti-Dsg3 titers and PDAI scores at baseline may predict sustained elevated anti-Dsg3 post-CR.
Keywords: Pemphigus Vulgaris, desmoglein, Antibody titers, clinical phenotype, disease activity, Risk factors
Received: 08 Jan 2025; Accepted: 23 Apr 2025.
Copyright: © 2025 Zhou, Wang, Wang, Zhou, Luo, Yan and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Wei Li, West China Hospital, Sichuan University, Chengdu, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.