Correlation between Profile of Circulating Mononuclear Cells and Clinical Manifestations in Patients with Pemphigus Vulgaris

Phenotypes of 38 samples of mononuclear (PBMC) cells from 11 different patients with pemphigus vulgaris (PV) at different stages of the disease were explored looking for a possible relationship between cell immunity, mucocutaneous or mucosal lesion intensity and capacity of serum autoantibodies to elicit the disease in mice. PBMC from 5 patients with mucocutaneous lesions and sera with IgG capable of inducing the disease in neonatal mice had a high proportion of mature monocytes with CD14^lowDR ^gh and co-expresing CD16 and CDllb. In addition, a high proportion of CD19⁺CD5⁺ activated B cells and a very low proportion of naive CD4⁺CD45RA⁺ and CD8⁺CDllb⁺ T lymphocytes was observed. Monocytes from these patients expressed inducible nitric oxide synthase (iNOS). In contrast, PBMC from 6 patients, with lesions restricted to mucosal membranes and IgG lacking the capacity to induce the disease in mice, contained a high proportion of CD14^hlg DR^low co-expressing CD16 circulating macrophages, CD8⁺CDllb⁺ T cells, and a low proportion of activated B lymphocytes. The results suggest a possible association between proportion of different antigen presenting cells (monocytes with high HLA-DR and low CD 14 expression and activated B lymphocytes, or differentiated monocytes/macrophages), type of PV and capacity of serum autoantibodies to elicit the disease in mice