Novel Serum Oxidative Stress Biomarkers in Pemphigus Vulgaris: Clinical Insights and Implications for Pathogenesis.

Introduction: Pemphigus vulgaris is an autoimmune disorder characterized by blistering of the skin and mucous membranes due to the loss of cohesion between keratinocytes. Oxidative stress, a condition caused by an excess of reactive oxygen species that overwhelms the body's antioxidant defenses, has been implicated in various autoimmune diseases, including pemphigus vulgaris.

Objectives: This study aimed to evaluate serum levels of advanced glycation end products and advanced oxidation protein products as novel biomarkers of oxidative stress in pemphigus vulgaris patients and to correlate these levels with disease activity.

Methods: Sixty participants were included, divided into three equal groups: 20 patients with active mucocutaneous pemphigus vulgaris not on systemic treatment, 20 patients in remission on minimal therapy, and 20 healthy controls. Serum levels of advanced glycation end products and advanced oxidation protein products were measured using the enzyme-linked immunosorbent assay.

Results: Serum levels of advanced glycation end products and advanced oxidation protein products were significantly higher in the active pemphigus vulgaris patient group compared to both the remission group and healthy controls (P<0.001). No significant correlation was found between the oxidative stress markers, desmoglein 3, and the Pemphigus Disease Activity Index.

Conclusions: The findings of the present study demonstrate that oxidative stress may not play a primary role in the pathogenesis or severity of pemphigus vulgaris but could instead be a secondary effect associated with tissue damage. Factors such as diet and ethnicity could have influenced the results, indicating the need for larger scale, population-specific studies.