Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
15th National Conference of the IAOMFP, Chennai, 2006
Abstract
Abstracts from current literature
Acne in India: Guidelines for management - IAA Consensus Document
Addendum
Announcement
Art & Psychiatry
Article
Articles
Association Activities
Association Notes
Award Article
Book Review
Brief Report
Case Analysis
Case Letter
Case Letters
Case Notes
Case Report
Case Reports
Clinical and Laboratory Investigations
Clinical Article
Clinical Studies
Clinical Study
Commentary
Conference Oration
Conference Summary
Continuing Medical Education
Correspondence
Corrigendum
Cosmetic Dermatology
Cosmetology
Current Best Evidence
Current Issue
Current View
Derma Quest
Dermato Surgery
Dermatopathology
Dermatosurgery Specials
Dispensing Pearl
Do you know?
Drug Dialogues
e-IJDVL
Editor Speaks
Editorial
Editorial Remarks
Editorial Report
Editorial Report - 2007
Editorial report for 2004-2005
Errata
Erratum
Focus
Fourth All India Conference Programme
From Our Book Shelf
From the Desk of Chief Editor
General
Get Set for Net
Get set for the net
Guest Article
Guest Editorial
History
How I Manage?
IADVL Announcement
IADVL Announcements
IJDVL Awards
IJDVL AWARDS 2015
IJDVL Awards 2018
IJDVL Awards 2019
IJDVL Awards 2020
IJDVL International Awards 2018
Images in Clinical Practice
Images in Dermatology
In Memorium
Inaugural Address
Index
Knowledge From World Contemporaries
Leprosy Section
Letter in Response to Previous Publication
Letter to Editor
Letter to the Editor
Letter to the Editor - Case Letter
Letter to the Editor - Letter in Response to Published Article
LETTER TO THE EDITOR - LETTERS IN RESPONSE TO PUBLISHED ARTICLES
Letter to the Editor - Observation Letter
Letter to the Editor - Study Letter
Letter to the Editor - Therapy Letter
Letter to the Editor: Articles in Response to Previously Published Articles
Letters in Response to Previous Publication
Letters to the Editor
Letters to the Editor - Letter in Response to Previously Published Articles
Letters to the Editor: Case Letters
Letters to the Editor: Letters in Response to Previously Published Articles
Media and news
Medicolegal Window
Messages
Miscellaneous Letter
Musings
Net Case
Net case report
Net Image
Net Images
Net Letter
Net Quiz
Net Study
New Preparations
News
News & Views
Obituary
Observation Letter
Observation Letters
Oration
Original Article
ORIGINAL CONTRIBUTION
Original Contributions
Pattern of Skin Diseases
Pearls
Pediatric Dermatology
Pediatric Rounds
Perspective
Presedential Address
Presidential Address
Presidents Remarks
Quiz
Recommendations
Regret
Report
Report of chief editor
Report of Hon : Treasurer IADVL
Report of Hon. General Secretary IADVL
Research Methdology
Research Methodology
Resident page
Resident's Page
Resident’s Page
Residents' Corner
Residents' Corner
Residents' Page
Retraction
Review
Review Article
Review Articles
Reviewers 2022
Revision Corner
Self Assessment Programme
SEMINAR
Seminar: Chronic Arsenicosis in India
Seminar: HIV Infection
Short Communication
Short Communications
Short Report
Snippets
Special Article
Specialty Interface
Studies
Study Letter
Study Letters
Supplement-Photoprotection
Supplement-Psoriasis
Symposium - Contact Dermatitis
Symposium - Lasers
Symposium - Pediatric Dermatoses
Symposium - Psoriasis
Symposium - Vesicobullous Disorders
SYMPOSIUM - VITILIGO
Symposium Aesthetic Surgery
Symposium Dermatopathology
Symposium-Hair Disorders
Symposium-Nails Part I
Symposium-Nails-Part II
Systematic Review and Meta-Analysis
Systematic Reviews and Meta-analyses
Systematic Reviews and Meta-analysis
Tables
Technology
Therapeutic Guideline-IADVL
Therapeutic Guidelines
Therapeutic Guidelines - IADVL
Therapeutics
Therapy
Therapy Letter
Therapy Letters
View Point
Viewpoint
What’s new in Dermatology
Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
15th National Conference of the IAOMFP, Chennai, 2006
Abstract
Abstracts from current literature
Acne in India: Guidelines for management - IAA Consensus Document
Addendum
Announcement
Art & Psychiatry
Article
Articles
Association Activities
Association Notes
Award Article
Book Review
Brief Report
Case Analysis
Case Letter
Case Letters
Case Notes
Case Report
Case Reports
Clinical and Laboratory Investigations
Clinical Article
Clinical Studies
Clinical Study
Commentary
Conference Oration
Conference Summary
Continuing Medical Education
Correspondence
Corrigendum
Cosmetic Dermatology
Cosmetology
Current Best Evidence
Current Issue
Current View
Derma Quest
Dermato Surgery
Dermatopathology
Dermatosurgery Specials
Dispensing Pearl
Do you know?
Drug Dialogues
e-IJDVL
Editor Speaks
Editorial
Editorial Remarks
Editorial Report
Editorial Report - 2007
Editorial report for 2004-2005
Errata
Erratum
Focus
Fourth All India Conference Programme
From Our Book Shelf
From the Desk of Chief Editor
General
Get Set for Net
Get set for the net
Guest Article
Guest Editorial
History
How I Manage?
IADVL Announcement
IADVL Announcements
IJDVL Awards
IJDVL AWARDS 2015
IJDVL Awards 2018
IJDVL Awards 2019
IJDVL Awards 2020
IJDVL International Awards 2018
Images in Clinical Practice
Images in Dermatology
In Memorium
Inaugural Address
Index
Knowledge From World Contemporaries
Leprosy Section
Letter in Response to Previous Publication
Letter to Editor
Letter to the Editor
Letter to the Editor - Case Letter
Letter to the Editor - Letter in Response to Published Article
LETTER TO THE EDITOR - LETTERS IN RESPONSE TO PUBLISHED ARTICLES
Letter to the Editor - Observation Letter
Letter to the Editor - Study Letter
Letter to the Editor - Therapy Letter
Letter to the Editor: Articles in Response to Previously Published Articles
Letters in Response to Previous Publication
Letters to the Editor
Letters to the Editor - Letter in Response to Previously Published Articles
Letters to the Editor: Case Letters
Letters to the Editor: Letters in Response to Previously Published Articles
Media and news
Medicolegal Window
Messages
Miscellaneous Letter
Musings
Net Case
Net case report
Net Image
Net Images
Net Letter
Net Quiz
Net Study
New Preparations
News
News & Views
Obituary
Observation Letter
Observation Letters
Oration
Original Article
ORIGINAL CONTRIBUTION
Original Contributions
Pattern of Skin Diseases
Pearls
Pediatric Dermatology
Pediatric Rounds
Perspective
Presedential Address
Presidential Address
Presidents Remarks
Quiz
Recommendations
Regret
Report
Report of chief editor
Report of Hon : Treasurer IADVL
Report of Hon. General Secretary IADVL
Research Methdology
Research Methodology
Resident page
Resident's Page
Resident’s Page
Residents' Corner
Residents' Corner
Residents' Page
Retraction
Review
Review Article
Review Articles
Reviewers 2022
Revision Corner
Self Assessment Programme
SEMINAR
Seminar: Chronic Arsenicosis in India
Seminar: HIV Infection
Short Communication
Short Communications
Short Report
Snippets
Special Article
Specialty Interface
Studies
Study Letter
Study Letters
Supplement-Photoprotection
Supplement-Psoriasis
Symposium - Contact Dermatitis
Symposium - Lasers
Symposium - Pediatric Dermatoses
Symposium - Psoriasis
Symposium - Vesicobullous Disorders
SYMPOSIUM - VITILIGO
Symposium Aesthetic Surgery
Symposium Dermatopathology
Symposium-Hair Disorders
Symposium-Nails Part I
Symposium-Nails-Part II
Systematic Review and Meta-Analysis
Systematic Reviews and Meta-analyses
Systematic Reviews and Meta-analysis
Tables
Technology
Therapeutic Guideline-IADVL
Therapeutic Guidelines
Therapeutic Guidelines - IADVL
Therapeutics
Therapy
Therapy Letter
Therapy Letters
View Point
Viewpoint
What’s new in Dermatology
View/Download PDF

Translate this page into:

Letter in Response to Previous Publication
87 (
2
); 237-238
doi:
10.25259/IJDVL_506_20

A cluster of differentiation 19 + B-lymphocyte cell as a predictor of relapse in pemphigus vulgaris

GCS Medical College Hospital and Research Centre, Ahmedabad, Gujarat, India

Corresponding author: Dr. Jignaben Krunal Padhiyar, Department of Dermatology, Venereology and Leprology, GCS Medical College Hospital and Research Centre, Ahmedabad, Gujarat, India. dr.jignapadhiyar@gmail.com

Licence
This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

How to cite this article: Patel NH, Padhiyar JK, Raval RC. A cluster of differentiation 19+ B-lymphocyte cell as a predictor of relapse in pemphigus vulgaris. Indian J Dermatol Venereol Leprol 2021;87:237-8.

Sir,

We read with keen interest the article “Identification of clinical and immunological factors associated with clinical relapse of pemphigus vulgaris in remission” published in the Indian Journal of Dermatology, Venereology and Leprology, issue 3, Volume 86.1 The study methodology of using one-time assessment of cluster of differentiation 19+ B-lymphocyte cells and cluster of differentiation 19+ cluster of differentiation 27+ memory B cells’ count in an equal number of controls to have data regarding their counts in normal north Indian population does not seem to have enough external validity. Though a sample size of 40 for a rare disease like pemphigus seems acceptable, to derive the normal value of the cluster of differentiation 19+ B-lymphocyte cells in a population from 40 controls seems questionable given that the sample size is too small. Besides, the authors have not mentioned characteristics of controls in terms of age, sex, inclusion and exclusion criteria. A cluster of differentiation 19+ B-lymphocyte cell count can be confounded by many factors including immunogenetics of controls, recent infections and so on. Interestingly, data for normal values of various lymphocyte subpopulations in healthy Indians is available from a study conducted by a national task force constituted by the Indian Council of Medical Research.2 Is there any specific reason for not using this data which was based on a much larger sample size and had the authors’ institute as one of the centers in the study?

A peripheral cluster of differentiation 19+ B-lymphocyte cell count is significantly influenced by steroid use and steroid withdrawal as reported in other conditions.3 Rituximab is the most potent cluster of differentiation 19+ B-lymphocyte depleter among all the previous treatments received by the patients in the study. Taking baseline cluster of differentiation 19+ B-lymphocyte cell count across the study population, which was treated with different treatment modalities in past with a few of them being on steroid and a few off steroid, add to the confounders in the final calculation of odds ratio. During a discussion of results, authors have compared their findings with that published by Albers et al., a study that was strictly limited to B cell repopulation after rituximab therapy.4 Correlation of disease relapse and repopulation of cluster of differentiation 19+ B-lymphocyte after B cell depletion therapies are well-studied now for pemphigus and other autoimmune disorders. Authors’ assumption that “B cell repopulation must occur irrespective of treatment modality used, preceding clinical relapse in a prototype immunoglobulin G-mediated disease,” seems too generalized considering that no other treatment like steroid, azathioprine or dexamethasone-cyclophosphamide pulse is known to deplete B-cell from circulation as thoroughly as rituximab.

Analysis of patients previously treated with rituximab vis-a-vis other treatment modalities and performing baseline cluster of differentiation 19+ B-lymphocyte cell count among them and exploring subsequent trends in both the groups would have thrown more light on this very interesting aspect of relapse in pemphigus vulgaris. Pilot study on a cluster of differentiation 19+ B-lymphocyte cell behavior with various treatment modalities may also help understand more about this immunological marker in pemphigus.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

  1. , , , , , , . Identification of clinical and immunological factors associated with clinical relapse of pemphigus vulgaris in remission. Indian Journal of Dermatology, Venereology, and Leprology. 2020;86(3):233.
    [CrossRef] [PubMed] [Google Scholar]
  2. , , , , , , et al. Normal ranges of some select lymphocyte sub-populations in peripheral blood of normal healthy Indians. Curr Sci. 2004;86:969-75.
    [Google Scholar]
  3. , , , , , , , , . Peripheral blood lymphocyte subsets change after steroid withdrawal in renal allograft recipients: a prospective study. Scientific reports. 2019;9(1):1.
    [CrossRef] [PubMed] [Google Scholar]
  4. , , , , . Developing biomarkers for predicting clinical relapse in pemphigus patients treated with rituximab. J Am Acad Dermatol. 2017;77:1074-82.
    [CrossRef] [PubMed] [Google Scholar]

Fulltext Views
3,252

PDF downloads
2,296
View/Download PDF
Download Citations
BibTeX
RIS
Show Sections