Clin Exp Dermatol. 2023 Oct 4:llad319. doi: 10.1093/ced/llad319. Online ahead of print.
ABSTRACT
BACKGROUND: Dermatitis herpetiformis (DH) is a rare gluten-induced skin disorder characterized predominantly by IgA autoantibodies against endomysium, tissue transglutaminase (TG2/tTG), epidermal transglutaminase (TG3/eTG), and deamidated gliadin. To date, circulating autoantibody reactivity has not been systematically described.
OBJECTIVE: Characterization of serum reactivities in DH.
METHODS: This multicenter international study analyzed sera from 242 DH patients taken at the time of initial diagnosis. DH-specific IgA and IgG serum autoantibodies were analyzed by indirect immunofluorescence (IF) on monkey esophagus, and by enzyme-linked immune sorbent assay (ELISA) based on recombinant TG2/tTG, TG3/eTG, and deamidated gliadin (GAF3X).
RESULTS: IgA indirect IF microscopy on monkey esophagus revealed the highest reactivity (84.3%; specificity 100%) followed by IgA TG2/tTG ELISA (78.5%, 99.0%), IgA TG3/eTG ELISA (72.7%, 95.0%), and IgA GAF3X ELISA (69.0%, 98.5%).
CONCLUSION: Serum IgA and IgG autoantibodies against endomysium, TG2/tTG, TG3/eTG, and deamidated gliadin are highly prevalent in DH. Indirect IF microscopy on monkey esophagus (IgA) provides the highest diagnostic accuracy that can be further enhanced by 3.5% when combined with IgA TG2/tTG ELISA.
PMID:37793183 | DOI:10.1093/ced/llad319
