Serum reactivity in dermatitis herpetiformis: an international multicentre study

Katharina Boch; Florian Heck; Christoph M. Hammers; Emiliano Antiga; Marzia Caproni; David Juhl; Stephanie Goletz; Orsolya N. Horváth; Laura Huilaja; Stanislav Khil'chenko; Christian Sina; Kaisa Tasanen; Snejina Vassileva; Wolfgang Schlumberger; Detlef Zillikens; Martin Shahid; Kossara Drenovska; John J. Zone; Kamilla Koszorú; Kai Fechner; Cornelia Dähnrich; Inke R. König; Enno Schmidt

doi:10.1093/ced/llad319

Serum reactivity in dermatitis herpetiformis: an international multicentre study

Katharina Boch, Florian Heck, Christoph M. Hammers, Emiliano Antiga, Marzia Caproni, David Juhl, Stephanie Goletz, Orsolya N. Horváth, Laura Huilaja, Stanislav Khil'chenko, Christian Sina, Kaisa Tasanen, Snejina Vassileva, Wolfgang Schlumberger, Detlef Zillikens, Martin Shahid, Kossara Drenovska, John J. Zone, Kamilla Koszorú, Kai FechnerCornelia Dähnrich, Inke R. König, Enno Schmidt^*

^*Corresponding author for this work

Abstract

Background: Dermatitis herpetiformis (DH) is a rare gluten-induced skin disorder characterized predominantly by IgA autoantibodies against endomysium, tissue transglutaminase (TG2/tTG), epidermal transglutaminase (TG3/eTG) and deamidated gliadin. To date, circulating autoantibody reactivity has not been systematically described. Objectives: Characterization of serum reactivities in DH. Methods: This multicentre international study analysed sera from 242 patients with DH taken at the time of initial diagnosis. DH-specific IgA and IgG serum autoantibodies were analysed by indirect immunofluorescence (IF) on monkey oesophagus, and by enzyme-linked immunosorbent assay (ELISA) based on recombinant TG2/tTG, TG3/eTG and deamidated gliadin (GAF3X). Results: IgA indirect IF microscopy on monkey oesophagus revealed the highest reactivity (84.3%; specificity 100%) followed by IgA TG2/tTG ELISA (78.5%, specificity 99.0%), IgA TG3/eTG ELISA (72.7%, specificity 95.0%) and IgA GAF3X ELISA (69.0%, specificity 98.5%). Conclusions: Serum IgA and IgG autoantibodies against endomysium, TG2/tTG, TG3/eTG and deamidated gliadin are highly prevalent in DH. Indirect IF microscopy on monkey oesophagus (IgA) provides the highest diagnostic accuracy that can be further enhanced by 4.5% when combined with IgA TG2/tTG ELISA.

Original language	English
Journal	Clinical and Experimental Dermatology
Volume	49
Issue number	1
Pages (from-to)	53-57
Number of pages	5
ISSN	0307-6938
DOIs	https://doi.org/10.1093/ced/llad319
Publication status	Published - 19.12.2023

Research Areas and Centers

Academic Focus: Center for Infection and Inflammation Research (ZIEL)
Centers: Center for Research on Inflammation of the Skin (CRIS)

DFG Research Classification Scheme

205-19 Dermatology
204-05 Immunology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1093/ced/llad319

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Boch, K., Heck, F., Hammers, C. M., Antiga, E., Caproni, M., Juhl, D., Goletz, S., Horváth, O. N., Huilaja, L., Khil'chenko, S., Sina, C., Tasanen, K., Vassileva, S., Schlumberger, W., Zillikens, D., Shahid, M., Drenovska, K., Zone, J. J., Koszorú, K., ... Schmidt, E. (2023). Serum reactivity in dermatitis herpetiformis: an international multicentre study. Clinical and Experimental Dermatology, 49(1), 53-57. https://doi.org/10.1093/ced/llad319

@article{c87c4fb4d6e24790b8227befb5e92017,

title = "Serum reactivity in dermatitis herpetiformis: an international multicentre study",

abstract = "Background: Dermatitis herpetiformis (DH) is a rare gluten-induced skin disorder characterized predominantly by IgA autoantibodies against endomysium, tissue transglutaminase (TG2/tTG), epidermal transglutaminase (TG3/eTG) and deamidated gliadin. To date, circulating autoantibody reactivity has not been systematically described. Objectives: Characterization of serum reactivities in DH. Methods: This multicentre international study analysed sera from 242 patients with DH taken at the time of initial diagnosis. DH-specific IgA and IgG serum autoantibodies were analysed by indirect immunofluorescence (IF) on monkey oesophagus, and by enzyme-linked immunosorbent assay (ELISA) based on recombinant TG2/tTG, TG3/eTG and deamidated gliadin (GAF3X). Results: IgA indirect IF microscopy on monkey oesophagus revealed the highest reactivity (84.3%; specificity 100%) followed by IgA TG2/tTG ELISA (78.5%, specificity 99.0%), IgA TG3/eTG ELISA (72.7%, specificity 95.0%) and IgA GAF3X ELISA (69.0%, specificity 98.5%). Conclusions: Serum IgA and IgG autoantibodies against endomysium, TG2/tTG, TG3/eTG and deamidated gliadin are highly prevalent in DH. Indirect IF microscopy on monkey oesophagus (IgA) provides the highest diagnostic accuracy that can be further enhanced by 4.5% when combined with IgA TG2/tTG ELISA.",

author = "Katharina Boch and Florian Heck and Hammers, {Christoph M.} and Emiliano Antiga and Marzia Caproni and David Juhl and Stephanie Goletz and Horv{\'a}th, {Orsolya N.} and Laura Huilaja and Stanislav Khil'chenko and Christian Sina and Kaisa Tasanen and Snejina Vassileva and Wolfgang Schlumberger and Detlef Zillikens and Martin Shahid and Kossara Drenovska and Zone, {John J.} and Kamilla Koszor{\'u} and Kai Fechner and Cornelia D{\"a}hnrich and K{\"o}nig, {Inke R.} and Enno Schmidt",

year = "2023",

month = dec,

day = "19",

doi = "10.1093/ced/llad319",

language = "English",

volume = "49",

pages = "53--57",

journal = "Clinical and Experimental Dermatology",

issn = "0307-6938",

number = "1",

}

Boch, K, Heck, F, Hammers, CM, Antiga, E, Caproni, M, Juhl, D , Goletz, S, Horváth, ON, Huilaja, L, Khil'chenko, S, Sina, C, Tasanen, K, Vassileva, S, Schlumberger, W, Zillikens, D, Shahid, M, Drenovska, K, Zone, JJ, Koszorú, K, Fechner, K, Dähnrich, C, König, IR & Schmidt, E 2023, 'Serum reactivity in dermatitis herpetiformis: an international multicentre study', Clinical and Experimental Dermatology, vol. 49, no. 1, pp. 53-57. https://doi.org/10.1093/ced/llad319

TY - JOUR

T1 - Serum reactivity in dermatitis herpetiformis

T2 - an international multicentre study

AU - Boch, Katharina

AU - Heck, Florian

AU - Hammers, Christoph M.

AU - Antiga, Emiliano

AU - Caproni, Marzia

AU - Juhl, David

AU - Goletz, Stephanie

AU - Horváth, Orsolya N.

AU - Huilaja, Laura

AU - Khil'chenko, Stanislav

AU - Sina, Christian

AU - Tasanen, Kaisa

AU - Vassileva, Snejina

AU - Schlumberger, Wolfgang

AU - Zillikens, Detlef

AU - Shahid, Martin

AU - Drenovska, Kossara

AU - Zone, John J.

AU - Koszorú, Kamilla

AU - Fechner, Kai

AU - Dähnrich, Cornelia

AU - König, Inke R.

AU - Schmidt, Enno

PY - 2023/12/19

Y1 - 2023/12/19

N2 - Background: Dermatitis herpetiformis (DH) is a rare gluten-induced skin disorder characterized predominantly by IgA autoantibodies against endomysium, tissue transglutaminase (TG2/tTG), epidermal transglutaminase (TG3/eTG) and deamidated gliadin. To date, circulating autoantibody reactivity has not been systematically described. Objectives: Characterization of serum reactivities in DH. Methods: This multicentre international study analysed sera from 242 patients with DH taken at the time of initial diagnosis. DH-specific IgA and IgG serum autoantibodies were analysed by indirect immunofluorescence (IF) on monkey oesophagus, and by enzyme-linked immunosorbent assay (ELISA) based on recombinant TG2/tTG, TG3/eTG and deamidated gliadin (GAF3X). Results: IgA indirect IF microscopy on monkey oesophagus revealed the highest reactivity (84.3%; specificity 100%) followed by IgA TG2/tTG ELISA (78.5%, specificity 99.0%), IgA TG3/eTG ELISA (72.7%, specificity 95.0%) and IgA GAF3X ELISA (69.0%, specificity 98.5%). Conclusions: Serum IgA and IgG autoantibodies against endomysium, TG2/tTG, TG3/eTG and deamidated gliadin are highly prevalent in DH. Indirect IF microscopy on monkey oesophagus (IgA) provides the highest diagnostic accuracy that can be further enhanced by 4.5% when combined with IgA TG2/tTG ELISA.

AB - Background: Dermatitis herpetiformis (DH) is a rare gluten-induced skin disorder characterized predominantly by IgA autoantibodies against endomysium, tissue transglutaminase (TG2/tTG), epidermal transglutaminase (TG3/eTG) and deamidated gliadin. To date, circulating autoantibody reactivity has not been systematically described. Objectives: Characterization of serum reactivities in DH. Methods: This multicentre international study analysed sera from 242 patients with DH taken at the time of initial diagnosis. DH-specific IgA and IgG serum autoantibodies were analysed by indirect immunofluorescence (IF) on monkey oesophagus, and by enzyme-linked immunosorbent assay (ELISA) based on recombinant TG2/tTG, TG3/eTG and deamidated gliadin (GAF3X). Results: IgA indirect IF microscopy on monkey oesophagus revealed the highest reactivity (84.3%; specificity 100%) followed by IgA TG2/tTG ELISA (78.5%, specificity 99.0%), IgA TG3/eTG ELISA (72.7%, specificity 95.0%) and IgA GAF3X ELISA (69.0%, specificity 98.5%). Conclusions: Serum IgA and IgG autoantibodies against endomysium, TG2/tTG, TG3/eTG and deamidated gliadin are highly prevalent in DH. Indirect IF microscopy on monkey oesophagus (IgA) provides the highest diagnostic accuracy that can be further enhanced by 4.5% when combined with IgA TG2/tTG ELISA.

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U2 - 10.1093/ced/llad319

DO - 10.1093/ced/llad319

M3 - Scientific review articles

C2 - 37793183

AN - SCOPUS:85180593342

SN - 0307-6938

VL - 49

SP - 53

EP - 57

JO - Clinical and Experimental Dermatology

JF - Clinical and Experimental Dermatology

IS - 1

ER -

Serum reactivity in dermatitis herpetiformis: an international multicentre study

Abstract

Research Areas and Centers

DFG Research Classification Scheme

UN SDGs

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