Correlation of desmoglein autoantibodies, C-reactive protein, and haematological parameters with disease severity in pemphigus vulgaris

Abstract

Objective: Pemphigus vulgaris (PV) is an autoimmune blistering disease mediated by autoantibodies against desmoglein-3 (Dsg3) and desmoglein-1 (Dsg1). This study investigated associations between anti-Dsg1, anti-Dsg3, C-reactive protein (CRP), haematological parameters, and clinical disease severity in patients with PV.

Methods: This case‑control study enrolled 26 patients with PV (diagnosed by dermatologists) and 52 age‑ and sex‑matched healthy controls. Disease severity was quantified using the Pemphigus Disease Area Index (PDAI). Serum levels of anti-Dsg1, anti-Dsg3, and high‑sensitivity CRP were measured by enzyme‑linked immunosorbent assay. Complete blood counts were obtained using an automated haematology analyser. Statistical comparisons employed independent t‑tests, ANOVA with post‑hoc testing, and Pearson correlation.

Results: Nineteen patients (73.1%) were female. Mean age was 51.42±10.93 years. According to PDAI scores, 13 patients (50%) had mild disease, four (15.4%) moderate, and nine (34.6%) severe. Patients showed significantly higher CRP levels than controls (1144.8±393.5 vs. 870.2±267.1 pg/mL, p=0.003). Anti-Dsg3 was markedly elevated in patients (80.33±9.8 vs. 0.83±0.1 arbitrary units, p<0.001). Anti-Dsg1 levels correlated significantly with disease severity (mild vs. severe, p=0.020), whereas anti-Dsg3 did not. Total white blood cell, granulocyte, and platelet counts were significantly higher in patients than in controls (p≤0.01 for all).

Conclusions: Anti-Dsg1 and CRP are associated with clinical severity of PV and may serve as candidate biomarkers for disease activity assessment. The lack of correlation with anti-Dsg3 underscores the complex pathophysiology of PV. Larger longitudinal studies are needed to validate these findings.