scholarly journals Evaluation of Recombinant Antigen-Based Assays for Diagnosis of Bullous Autoimmune Diseases

2004 ◽  
Vol 11 (4) ◽  
pp. 762-765 ◽  
Author(s):  
G. D'Agosto ◽  
A. Latini ◽  
M. Carducci ◽  
A. Mastroianni ◽  
A. Vento ◽  
...  
Keyword(s):  
Bullous Pemphigoid ◽  
Mucous Membrane ◽  
Pemphigus Vulgaris ◽  
Clinical Aspects ◽  
Mucous Membrane Pemphigoid ◽  
Pemphigus Foliaceus ◽  
Serum Samples ◽  
Cutaneous Lesions ◽  
Autoimmune Bullous Diseases ◽  
Mucosal Involvement

ABSTRACT The diagnosis of autoimmune bullous diseases is based on clinical observation and on the presence of autoantibodies directed to molecules involved in the adhesion systems of the skin. Immunofluorescence assays are the currently accepted method for detection of autoantibodies; such assays depend greatly on the skill of operators and are difficult to standardize. Recombinant desmoglein-1 (Dsg1), Dsg3, and BP180 peptides, the main autoantigens in pemphigus or bullous pemphigoid, have been used to develop new quantitative enzyme immunoassays (EIA) for the detection of specific antibodies. The present study was undertaken to evaluate the sensitivity and specificity of these immunoassays and to determine the correlation between the results and the clinical aspects of diseases. Serum samples from patients with pemphigus vulgaris, pemphigus foliaceus, bullous pemphigoid, or mucous membrane pemphigoid, from healthy individuals, and from patients with unrelated autoimmune conditions were tested. Anti-desmoglein reactivity was detected in all the patients with pemphigus and in none of the controls. Patients with the more benign form of cutaneous disease had anti-Dsg1 antibodies, while patients with deeper cutaneous lesions or with mucosal involvement had anti-Dsg3 reactivity also, or exclusively. The BP180-based assay was positive for 66.6% of patients with bullous pemphigoid and for none of the patients with mucous membrane pemphigoid, and no reactivity was detected in the control sera. In conclusion, the anti-Dsg1 and anti-Dsg3 assays are useful in the diagnosis of pemphigus and provide information on the clinical phenotype of the disease. However, the sensitivity of EIA for detection of autoantibodies in bullous pemphigoid should be improved by the use of additional antigens or epitopes.

scholarly journals Detection of circulating anti-skin antibodies by indirect immunofluorescence and by ELISA: a comparative systematic review and meta-analysis

2020 ◽  
Vol 58 (10) ◽  
pp. 1623-1633
Author(s):  
Otto Van de gaer ◽  
Petra de Haes ◽  
Xavier Bossuyt
Keyword(s):  
Bullous Pemphigoid ◽  
Indirect Immunofluorescence ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Pemphigus Vulgaris ◽  
Pemphigus Foliaceus ◽  
Bullous Pemphigoid Antigen ◽  
Autoimmune Bullous Diseases ◽  
Pubmed Database

AbstractBackgroundBoth enzyme-linked immunosorbent assays (ELISAs) and indirect immunofluorescence (IIF) are available for the diagnosis of autoimmune bullous diseases (AIBD). Many studies have reported on the performance of ELISAs and concluded that ELISAs could replace IIF. This study compares the diagnostic accuracy of ELISA and IIF for the detection of autoantibodies to desmoglein 1 (DSG1), desmoglein 3 (DSG3), bullous pemphigoid antigen 2 (BP180) and bullous pemphigoid antigen 1 (BP230) to support the diagnosis of pemphigus vulgaris (PV), pemphigus foliaceus (PF) and bullous pemphigoid (BP).MethodsA literature search was performed in the PubMed database. The meta-analysis was performed using summary values and a bivariate random effect model.ResultsThe five included studies on PV did not demonstrate significant differences between IIF and DSG3-ELISA (sensitivity 82.3% vs. 81.6%, p = 0.9284; specificity 95.6% vs. 93.9%, p = 0.5318; diagnostic odds ratio [DOR] 101.60 vs. 67.760, p = 0.6206). The three included studies on PF did not demonstrate significant differences between IIF and DSG1-ELISA (sensitivity 80.6% vs. 83.1%, p = 0.8501; specificity 97.5% vs. 93.9%, p = 0.3614; DOR 160.72 vs. 75.615, p = 0.5381). The eight included studies on BP showed that BP230-ELISA differed significantly from both IIF on monkey esophagus (MO) and BP180-ELISA with regard to DOR (11.384 vs. 68.349, p = 0.0008; 11.384 vs. 41.699, p = 0.0125, respectively)ConclusionsOur meta-analysis shows that ELISA performs as well as IIF for diagnosing PV, PF and BP.

scholarly journals Pemphigus Vulgaris and Bullous Pemphigoid: Update on Diagnosis and Treatment

2020 ◽  
pp. e2020050 ◽  
Author(s):  
Vito Di Lernia ◽  
Dahiana M. Casanova ◽  
Mohamad Goldust ◽  
Cinzia Ricci
Keyword(s):  
Bullous Pemphigoid ◽  
Pemphigus Vulgaris ◽  
Screening Tools ◽  
Enzyme Linked Immunosorbent Assay ◽  
Pemphigus Foliaceus ◽  
Line Treatment ◽  
First Line ◽  
Systemic Corticosteroids ◽  
Autoimmune Bullous Diseases ◽  
First Line Treatment

Autoimmune bullous disorders are a heterogeneous spectrum of skin disorders characterized by the production of autoantibodies against adhesion molecules of the skin. The 2 major groups of diseases are “pemphigus diseases” and “autoimmune bullous diseases of the pemphigoid type.” Pemphigus diseases are a group of autoimmune blistering diseases of the skin and mucous membranes characterized by intraepithelial cleft and acantholysis. The main subtypes of pemphigus include pemphigus vulgaris, pemphigus foliaceus, and paraneoplastic pemphigus. Diagnosis is based on clinical manifestations and confirmed with histological, immunofluorescence, and serological testing. Recently multivariant enzyme‐linked immunosorbent assay systems have been developed as practical screening tools for patients with suspected autoimmune bullous dermatoses. The current first-line treatment of pemphigus is based on systemic corticosteroids that are often combined with immunosuppressive adjuvants, such as azathioprine, mycophenolate mofetil, and the anti-CD20 monoclonal antibody rituximab, usually at initiation of treatment. Rituximab efficacy is higher when it is administered early in the course of the disease. Therefore, it should be used as first-line treatment to improve efficacy and reduce cumulative doses of corticosteroids and their side effects. Treatment of bullous pemphigoid is based on disease extension. Localized and mild forms can be treated with superpotent topical corticosteroids or with nonimmunosuppressive agents. In patients with generalized disease or whose disease is resistant to the treatments described above, systemic corticosteroids are preferred and effective. Adjuvant immunosuppressants are often combined with steroids for their steroid-sparing effect.

scholarly journals Case Report: Variety of Target Antigens During 1 Year Follow-Up of a Patient Initially Diagnosed With Bullous Pemphigoid

2022 ◽  
Vol 12 ◽  
Author(s):  
Hua Qian ◽  
Zhijun Zhou ◽  
Luhuai Shi ◽  
Huicheng Li ◽  
Weijun Liu ◽  
...  
Keyword(s):  
Case Report ◽  
Bullous Pemphigoid ◽  
Pemphigus Vulgaris ◽  
Disease Course ◽  
Serum Samples ◽  
Dominant Type ◽  
Time Points ◽  
Autoimmune Bullous Diseases ◽  
Bullous Diseases

Autoimmune bullous diseases (AIBDs), presenting cutaneous and/or mucosal bullous lesions, are classified into pemphigus and pemphigoid diseases. A longtime observation for complicated AIBD cases is rarely reported. In this study, serum samples of one AIBD patient were collected at seven different time points during the disease course including a relapse, which were examined by our conventional and newly developed methods for the detection of autoantibodies. Interestingly, we found changes of both the presence and the titers of various autoantibodies in accordance with the changes of clinical features during the whole disease course, which indicated that the patient started as bullous pemphigoid and relapsed as concurrence of bullous pemphigoid and mucosal-dominant-type pemphigus vulgaris.

Bullous disorders

2018 ◽  
Author(s):  
Emily Davies
Keyword(s):  
Basement Membrane ◽  
Dermatitis Herpetiformis ◽  
Pemphigus Vulgaris ◽  
Basement Membrane Zone ◽  
Mucous Membrane Pemphigoid ◽  
Pemphigus Foliaceus ◽  
Pemphigoid Gestationis ◽  
Bullous Disease ◽  
Adhesion Junctions ◽  
Linear Iga Disease

This chapter focuses on immunobullous diseases. The immunobullous disorders are a group of diseases in which pathogenic autoantibodies bind to target antigens either in desmosomes (intra-epidermal intracellular adhesion junctions) or in part of the basement membrane zone, resulting in loss of adhesion, and blister formation. This chapter will focus on pemphigus vulgaris, pemphigus foliaceus, bullous pemphigoid, linear IgA disease, chronic bullous disease of childhood, and dermatitis herpetiformis; it will also mention mucous membrane pemphigoid, pemphigoid gestationis, and epidermolysis bullosa acquisita.

Ocular Mucous Membrane Pemphigoid and Ocular Pemphigus Vulgaris Treated Topically With Tacrolimus Ointment

2003 ◽  
Vol 139 (8) ◽  
Author(s):  
Virginia C. Hall ◽  
Thomas J. Liesegang ◽  
David A. Kostick ◽  
Donald P. Lookingbill
Keyword(s):  
Mucous Membrane ◽  
Pemphigus Vulgaris ◽  
Mucous Membrane Pemphigoid ◽  
Tacrolimus Ointment

scholarly journals Frequency of IgA Antibodies in Pemphigus, Bullous Pemphigoid and Mucous Membrane Pemphigoid

2004 ◽  
Vol 84 (5) ◽  
pp. 381-384 ◽  
Author(s):  
Emanuele Cozzani ◽  
Massimo Drosera ◽  
Aurora Parodi ◽  
Marco Carrozzo ◽  
Sergio Gandolfo ◽  
...  
Keyword(s):  
Bullous Pemphigoid ◽  
Mucous Membrane ◽  
Mucous Membrane Pemphigoid ◽  
Iga Antibodies
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