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Antimuscarinic acetylcholine receptor antibody strongly related to pemphigus

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A strong association exists between antimuscarinic (anti-M3) acetylcholine receptor (AchR) antibodies and pemphigus, according to a study. In addition, anti-M3 AchR antibodies significantly correlate with disease activity, and their titers decline with therapy along with antidesmoglein (anti-Dsg) antibodies.

Researchers performed a hospital-based cohort study involving 45 patients with active pemphigus to evaluate the changes in anti-M3 AchR and anti-Dsg antibody titers with therapy. The Pemphigus Disease Area Index was used to clinically grade the disease. Antibody titers were estimated using enzyme-linked immunosorbent assay at baseline, 3 and 15 months.

Compared with a control group, all patients with pemphigus had significantly greater anti-M3 AchR titers. Only 95.5 and 84.4 percent of patients had anti-Dsg1 and anti-Dsg3 antibodies, respectively.

The findings showed a statistically significant decrease in all three antibody titers from baseline to follow-up with treatment. All three antibody titers had a good association with Pemphigus Disease Area Index score at baseline and after therapy. Also, there was a good correlation between anti-M3 AchR and anti-Dsg1 antibody titers.

The small sample size and short follow-up period were the limitations of the study, according to researchers.

A group of bullous diseases that affect the oral mucosa and the skin, pemphigus is caused by antibody-mediated autoimmune reaction to Dsg, desmosomal transmembrane glycoproteins, leading to acantholysis. It is categorized into pemphigus vulgaris (PV), with suprabasal acantholysis, and pemphigus foliaceus (PF), with acantholysis in the more superficial epidermis. [Minerva Stomatol 2007;56:215-23]

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