In vitro effects of pemphigus antibodies on skin

Acantholysis occurring in rhesus monkey skin explants cultured on sera of 9 pemphigus patients was found to be largely dependent on the titre of intercellular antibody, and not on the participation of complement. Skin explants cultured on normal human sera and pemphigoid sera failed to give rise to intercullular staining or to develop lesions. Six of eight 'negative' pemphigus sera with intercellular antibody titres of less than 20 on skin (and titres ranging from 20 to 160 on monkey esophagus) reacted with the skin explants as revealed by direct immunofluorescence with an anti-IgG conjugate. The binding of antibodies from 3 of these 6 reactive sera resulted in some pathological changes in the explants. At least two of these 3 'negative' sera came from pemphigus patients with skin lesions.