A New Solid-Phase Immunosorbent for Selective Binding of Desmoglein 3 Autoantibodies in Patients with Pemphigus Vulgaris

Abstract

Autoantibodies, immunoglobulins G (IgG) againstthe desmosomal proteins desmogleins 1 and 3, play a significant role in the pathogenesis of pemphigus vulgaris. The basic therapy for pemfigus includes systemic corticosteroids, but their use should be as briefas possible because of the severe side effects. In cases of corticosteroid-resistant pemfigus, adjuvant therapy, in particularextracorporeal methods, is used. The most effective and safest extracorporeal therapy is immunosorbtion. Immunosorbtion is based on the removal of pemphigus antibodies from the blood using an affinity sorbent during a therapeutic apheresis procedure. Existing immunosorbents are nonselective and increase the risk of infection. We designed an immunosorbent based on an agarose matrix, Affi-Gel 15, and human recombinant desmoglein 3, as aligand, for a selective removal of autoantibodies from pemphigus patients sera. It was shown on a pemphigus experimental modelin vivo(neonatal Balb/c mouse model) andin vitrothat the immunosorbent can effectively remove desmoglein 3-associated autoantibodies. The experimental results demonstrate that the solid-phase matrix immunosorbent Affi-Gel 15Dsg3 is a promising product for the development of pemphigus therapy.