A higher correlation of the antibody activities against the calcium-dependent epitopes of desmoglein 3 quantified by ethylenediaminetetraacetic acid-treated enzyme-linked immunosorbent assay with clinical disease activities of pemphigus vulgaris

Koji Kamiya, Yumi Aoyama, Yoshinori Shirafuji, Toshihisa Hamada, Shin Morizane, Kazuyasu Fujii, Keiji Iwatsuki

Research output: Contribution to journalArticle

26 Citations (Scopus)


Background: Nonpathogenic anti-desmoglein (Dsg) 3 antibodies can be found in pemphigus vulgaris (PV) patients' sera. Previously, ethylenediaminetetraacetic acid (EDTA)-treated enzyme-linked immunosorbent assay (ELISA) was found to detect only nonpathogenic anti-Dsg3 antibodies against the non-calcium (Ca2+)-dependent epitopes. Objective: We examined whether the calculated anti-Dsg3 antibody titer for Ca2+-dependent epitopes, using the conventional and EDTA-treated ELISAs, correlated better with the disease activity of PV. Methods: We analyzed 123 serum samples from 19 PV patients. Of these samples, there were 52 samples from 15 PV patients obtained in asymptomatic phases. The difference between conventional Dsg3 ELISA index and EDTA-treated Dsg3 ELISA index was calculated as the anti-Dsg3 antibody activity for Ca2+-dependent conformational epitopes (conformational Dsg3 ELISA index). We analyzed the correlation between Dsg3 ELISA index values and the pemphigus disease area index (PDAI). Moreover, we examined whether the conformational Dsg3 ELISA index fluctuated in parallel with the disease activity during clinical courses of 6 PV patients. We evaluated the pathogenicity of anti-Dsg3 antibodies detected in remission phases using a dissociation assay. Results: The conventional Dsg3 ELISA index showed a high positive rate in the asymptomatic phase of PV. By contrast, the conformational Dsg3 ELISA index showed a much closer correlation to the disease activity when monitored in individual cases. Nonpathogenic anti-Dsg3 antibodies were detected in these cases. Conclusion: The conformational Dsg3 ELISA index reflected the pathogenicity of anti-Dsg3 antibodies more accurately than the conventional Dsg3 ELISA index. Using both conventional and EDTA-treated ELISAs would be useful in monitoring the disease activity of PV.

Original languageEnglish
Pages (from-to)190-195
Number of pages6
JournalJournal of dermatological science
Issue number3
Publication statusPublished - Jun 1 2013



  • Desmoglein 3
  • EDTA-treated ELISA
  • Epitope
  • Pemphigus disease area index
  • Pemphigus vulgaris

ASJC Scopus subject areas

  • Biochemistry
  • Molecular Biology
  • Dermatology

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