Antidesmoglein autoantibodies in silicosis patients with no bullous diseases

Background: Pemphigus is an autoimmune bullous disease characterized by the presence of antidesmoglein autoantibodies. However, the mechanism of its a utoantibody production remains unknown. In previous reports, we have descri bed rare cases of pemphigus and pemphigoid associated with silicosis. It is well known that during long-term silicosis, some autoimmune diseases, such as systemic sclerosis, systemic lupus erythematosus or rheumatoid arthriti s, can occur. Objective: The aim of this study was to explore the presence of pemphigus or pemphigoid autoantibodies in silicosis patients without cli nical bullous diseases or collagen diseases. Method: The presence of pemphi gus antibodies was examined in 54 silicosis patients with no associated bul lous diseases, using immunofluorescence, the enzyme-linked immunosorbent as say (ELISA) for desmoglein 1 and 3, and immunoblotting methods. In the anti body-positive cases, HLA genotyping of peripheral lymphocytes was performed with PCR-RFLP, Results: Seven out of the 54 patients were found to be posi tive for pemphigus antibodies and 1 for bullous pemphigoid by immunofluores cence, In addition, by ELISA, 6 patients were found to be positive against the desmoglein 1 antigen, 2 against the desmoglein 3 antigen and 2 against both desmoglein 1 and desmoglein 3. Conclusion:The results of the present s tudy strongly suggest the occurrence of pemphigus and pemphigoid autoantibo dies in patients with silicosis. It remains unclear whether such patients w ill develop an autoimmune bullous disease in the future. Accordingly, long- term follow-up of antibody-positive patients is required. Copyright (C) 200 1 S. Karger AG, Basel.