The landscape of the immunoglobulin repertoire in endemic pemphigus foliaceus

Pemphigus foliaceus (PF) is an uncommon antibody-mediated autoimmune blistering skin disease. PF has a sporadic occurrence worldwide, but reaches a prevalence of 3% in the endemic areas of Brazil, the highest ever registered for any autoimmune disease. We performed next generation sequencing of the immune repertoire of three group of patients with PF living in the endemic region of the disease: i) non-treated patients (n=5), ii) patients under immunosuppressive treatment (n=5), iii) patients in remission without treatment (n=6); and two control groups: iv) from the endemic (n=6) and v) non-endemic areas in Brazil (n=4). We used total RNA extracted from peripheral blood mononuclear cells and performed a comprehensive characterization of the immunoglobulin heavy chain (IGH) and the variable region of IgG and IgM.