The Diversity of Serum Anti-DSG3 IgG Subclasses Has a Major Impact on Pemphigus Activity and Is Predictive of Relapses After Treatment With Rituximab - Archive ouverte HAL Accéder directement au contenu
Article Dans Une Revue Frontiers in Immunology Année : 2022

The Diversity of Serum Anti-DSG3 IgG Subclasses Has a Major Impact on Pemphigus Activity and Is Predictive of Relapses After Treatment With Rituximab

Marie-Laure Golinski
  • Fonction : Auteur
Alexandre Lemieux
  • Fonction : Auteur
Maud Maho-Vaillant
  • Fonction : Auteur
Marion Barray
  • Fonction : Auteur
Laurent Drouot
  • Fonction : Auteur
Marie Petit
  • Fonction : Auteur
Michael Hertl
  • Fonction : Auteur
Olivier Boyer
  • Fonction : Auteur
Sébastien Calbo
  • Fonction : Auteur
Pascal Joly
  • Fonction : Auteur
Vivien Hébert
  • Fonction : Auteur

Résumé

Introduction We studied the distribution and in vitro pathogenicity of anti-DSG3 IgG subclasses during the course of pemphigus vulgaris (PV). Methods We longitudinally studied the distribution of anti-DSG3 IgG subclasses (before versus after treatment) in sera from PV patients, using an addressable-laser bead immunoassay (ALBIA). The in vitro pathogenicity of corresponding sera was tested using keratinocyte dissociation and immunofluorescence assays. Results Sixty-five sera were assessed at baseline (33 from patients treated with rituximab and 32 with corticosteroids). Sixty-three percent of these baseline sera contained 2 or more anti-DSG3 IgG subclasses versus 35.7% of sera from patients in complete remission (CR) and 75.0% of sera from patients with persistent disease activity after treatment. IgG4 was the most frequently detected anti-DSG3 IgG subclass, both in patients with disease activity and in those in CR. The presence of three or more anti-DSG3 IgG subclasses was predictive of relapse, in particular when it included IgG3, with a positive predictive value of 62.5% and a negative predictive value of 92%. While anti-DSG3 IgG4 Abs from sera collected before treatment were most often pathogenic, anti-DSG3 IgG4 from sera collected after treatment were pathogenic only after adjusting their titer to the one measured before treatment. The IgG3 fraction containing anti-DSG3 Abs also had an in vitro pathogenic effect. The disappearance of the pathogenic effect of some sera after removal of anti-DSG3 IgG3 suggested an additional effect of this IgG subclass. Conclusion The serum levels and number of anti-DSG3 IgG subclasses drive the pathogenic effect of pemphigus sera and may predict the occurrence of relapses.

Dates et versions

hal-03936087 , version 1 (12-01-2023)

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Marie-Laure Golinski, Alexandre Lemieux, Maud Maho-Vaillant, Marion Barray, Laurent Drouot, et al.. The Diversity of Serum Anti-DSG3 IgG Subclasses Has a Major Impact on Pemphigus Activity and Is Predictive of Relapses After Treatment With Rituximab. Frontiers in Immunology, 2022, 13, ⟨10.3389/fimmu.2022.849790⟩. ⟨hal-03936087⟩
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