Circulating antibodies and immune complexes in oral mucosal diseases

This paper reviews the use of measurement of circulating auto-antibodies and antibodies to food proteins, and of circulating immune complexes (CIC) for diagnosis of various systemic diseases with oral involvement. Results of a study of 29 patients suffering from chronic oral mucosal disease, in which such methods were applied are reported. Auto-antibodies against epithelial intercellular substance (AICSA) were found in three patients, two of whom had pemphigus. Only one of the two patients diagnosed as having pemphigoid had circulating antibodies to basement membrane zone (ABMZA). Auto-antibodies to reticulin (IgA-ARA) were found in one patient in whom a diagnosis of coeliac disease (CD) was confirmed by intestinal biopsy. In addition to the patient with CD, another patient had IgA class antibodies against gliadin (IgA-AGA). IgG-AGA were found in five other patients, in one of whom dermatitis herpetiformis (DH) was diagnosed. Antibodies to cow's milk (ACMA) were detected in 10 patients and CIC in 4 patients. Case reports are given to illustrate the important role of antibody determination coupled with histopathological and immunofluorescence examination of tissue biopsy material in the diagnosis of serious oral disease.