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Human cervix: an alternative substrate for detecting circulating pemphigus antibodies

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Abstract

Monkey esophagus (ME) is a well-accepted substrate for diagnosing pemphigus vulgaris (PV) by indirect immunofluorescence (IIF). However, its availability is sometimes limited due to ethical concerns. This study aimed to investigate the usefulness of human cervix (HC) as a substrate in the diagnosis of PV by IIF. Initially, serum from 1 PV patient was incubated with tissues from 48 HCs. Median IIF titers on HCs that had different demographic and clinical characteristics were compared. Sera from 5 PV patients were then incubated with ME and 21 HCs. For each serum, the titer of IIF on HC that was not different from ME by more than two-fold dilutions was acceptable. Last, sera from 42 PV, 14 pemphigus foliaceous, and 62 non-pemphigus patients were used to evaluate sensitivity and specificity. The results demonstrate that differences in demographic data among HCs did not affect IIF titers. Titers obtained from ME and HC were comparable (81–100 % acceptable values). Sensitivity of HC for diagnosis of PV was better than for diagnosis of pemphigus foliaceus (90.5 and 71.4 %, respectively). Specificity for PV and PF was 96.2 %. We proposed that HC substrate can be used as an alternative substrate for diagnosis of PV by IIF.

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Abbreviations

DIF:

Direct immunofluorescence test

ELISA:

Enzyme-linked immunosorbent assay

HC:

Human cervix

IIF:

Indirect immunofluorescence test

ME:

Monkey esophagus

NPV:

Negative predictive value

PBS:

Phosphate-buffered saline

PF:

Pemphigus foliaceus

PPV:

Positive predictive value

PV:

Pemphigus vulgaris

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Acknowledgments

The authors gratefully acknowledge Mr. Suthipol Udompanthurak for the statistical advice and analysis.

Author information

Authors and Affiliations

  1. Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Siriraj, Bangkok Noi, Bangkok, Thailand

    Leena Chularojanamontri, Papapit Tuchinda, Sumruay Pinkaew, Pattriya Chanyachailert & Kanokvalai Kulthanan

  2. College of Medicine and Public Health, Ubon Ratchathani University, 85 Warin Chamrap, Ubon Ratchathani, Thailand

    Puan Suthipinittharm

  3. Department of Obstetrics and Gynaecology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Siriraj, Bangkok Noi, Bangkok, Thailand

    Somsin Petyim & Suthi Sangkarat

Authors
  1. Leena Chularojanamontri
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Correspondence to Papapit Tuchinda.

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This was an unfunded study.

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The authors hereby declare no personal or professional conflicts of interest regarding any aspect of this study.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Ethical approval

All procedures performed in the studies involving human participants were in accordance with the Siriraj Institutional Review Board, Siriraj Hospital, Mahidol University, Bangkok, Thailand and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Chularojanamontri, L., Tuchinda, P., Pinkaew, S. et al. Human cervix: an alternative substrate for detecting circulating pemphigus antibodies. Arch Dermatol Res 308, 437–442 (2016). https://doi.org/10.1007/s00403-016-1658-3

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  • DOI: https://doi.org/10.1007/s00403-016-1658-3

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