Altered pattern of connectivity in serum immunoglobulins from pemphigus vulgaris patients

Pemphigus vulgaris is a cutaneous autoimmune disease in which the occurrenc e of autoantibodies directed against desmoglein-3 and other self-antigens h as been well established in patient sera. However, V-region interactions (c onnectivity) of serum IgG and IgM have not been analysed to date. In this r eport, it has been demonstrated that IgG and IgM in the sera of pemphigus v ulgaris patients bind a preparation of F(ab')(2) fragments fractionated acc ording to their isoelectric points, and that a pattern of connectivity dist inguishable from that of healthy donor sera arises when the sera are tested against 20 individual isoelectric-focusing separated F(ab')(2)-containing fractions. This suggests that there are alterations in regulatory networks. In spite of the fact that prednisolone-based treatment of pemphigus patien ts has proved to be effective in controlling the disease, some undesirable effects associated with this form of treatment have prompted investigation into other therapeutic approaches. One possible approach to the treatment o f this autoimmune disease is the use of high doses of normal polyclonal imm unoglobulins. In fact then are a few reports of the empirical intravenous a dministration of immunoglobulins to pemphigus vulgaris patients. The result s presented here provide the rational basis for using such a treatment, sin ce it is demonstrated that a deviation from healthy V-region interactions c an be attributed to pemphigus patients and that such a condition is conside red to be modified by this type of immunotherapy.