Second, during the next phase, these detached desmosomes expose Desmoglein antigens.
When I began Rituxan® in January 2013, my Desmoglein levels had jumped from 75 to 128.
Since these mice possessed no Desmoglein 3, some other antigen(s)
must have been the target of the disease-causing pemphigus antibodies.
However, I now believe that antibodies to Desmoglein 3 may be only incidental and that
antibodies directed to other antigens may be more directly responsible for causing the disease.
Since Desmoglein 3 knockout mice were bred have
no Desmoglein 3, and since we documented that there was no anti-Desmoglein 1 antibody in the serum, we conclude that the blister-causing antibody is not directed toward a Desmoglein protein.
Although Desmoglein 3(Dsg3) has been well established
as a primary target of immunoglobulin(Ig) autoantibodies in PV, there remain several questions regarding the overall distribution of anti-Dsg3 Ig subtypes among patient subsets and considerable controversy regarding whether an isotype switch can be observed.
In some areas of the body, there are two Desmogleins present, and both have to be damaged to cause cell detachment- in some areas only one Desmoglein may be present at some level in the skin or mucous membrane,
and there only one Desmoglein has to be damaged to cause cell detachment.