IgG anti-laminin-332 autoantibodies are present in a subset of patients with mucous membrane, but not buflous, pemphigoid

被引:40
作者
Lazarova, Zelmira [1 ]
Salato, Valerie K. [1 ]
Lanschuetzer, Christoph M. [1 ]
Janson, Marleen [1 ]
Fairley, Janet A. [1 ]
Yancey, Kim B. [1 ]
机构
[1] Med Coll Wisconsin, Dept Dermatol, Milwaukee, WI 53226 USA
关键词
D O I
10.1016/j.jaad.2008.02.035
中图分类号
R75 [皮肤病学与性病学];
学科分类号
100206 ;
摘要
Background: Antiepiligrin cicatricial pemphigoid is a mucosal-predominant subepidermal blistering disease associated with an increased relative risk of cancer. in contrast to prior reports showing that antilaminin (L)-332 autoantibodies are a reliable marker for patients with antiepiligrin cicatricial pemphigoid, a recent report suggested that as many as 40% of patients with bullous pemphigoid (BP) have IgG reactive with this laminin isoform. Objective. We sought to determine whether patients with BP possess circulating IgG anti-L-332 autoantibodies. Methods. Sera from 100 adults with BP were analyzed by indirect immunofluorescence testing of intact skin, immunoblot studies of human keratinocyte (HK) extracts, and a new L-332 enzyme-linked immunosorbent assay. Sera showing reactivity suggestive of anti-L-332 autoantibodies in these assays were further analyzed in immunoblot studies of HK extracellular matrix and immunoprecipitation studies of biosynthetically radiolabeled HK extracts. Results: IgG from all patients with BP bound intact epidermal basement membrane by indirect iminunofluorescence microscopy and immunoblotted bullous pemphigoid antigen-1, -2, or both in HK extracts. None of these sera immunoblotted L-332 in HK extracts, although 13 did score above the cut point of a new IgG(4) L-332 enzyme-linked immunosorbent assay (sensitivity = 0.91, specificity = 0.98, Youden index = 0.89). Further analysis of sera from these 13 patients found: (1) all had IgG that bound the epidermal side of 1 mol/L NaCl split skin by indirect immunofluorescence microscopy; (2) none immunoblotted L-332 purified from HK extracellular matrix; and (3) none immunoprecipitated L-332 from biosynthetically radiolabeled HK extracts. Limitations: The basis of false-positive enzyme-linked immunosorbent assay determinations for anti-L-332 IgG among patients with BP is unknown. Conclusion: Anti-L-332 autoantibodies remain a reliable marker for patients with antiepiligrin cicatricial pemphigoid.
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页码:951 / 958
页数:8
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共 30 条
  • [1] AIRIO A, 1995, J RHEUMATOL, V22, P1300
  • [2] IgG autoantibodies to type VII collagen and an exclusive IgG3 reactivity to the laminin α3 chain in a patient with an autoimmune subepidermal blistering disease
    Baican, A
    Hirako, Y
    Lazarova, Z
    Yancey, KB
    Zillikens, D
    Sitaru, C
    [J]. JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY, 2005, 53 (03) : 517 - 522
  • [3] Detection of laminin 5-specific auto-antibodies in mucous membrane and bullous pemphigoid sera by ELISA
    Bekou, V
    Thoma-Uszynski, S
    Wendler, O
    Uter, W
    Schwietzke, S
    Hunziker, T
    Zouboulis, CC
    Schuler, G
    Sorokin, L
    Hertl, M
    [J]. JOURNAL OF INVESTIGATIVE DERMATOLOGY, 2005, 124 (04) : 732 - 740
  • [4] CARTER BZ, 1991, LAB INVEST, V65, P610
  • [5] Chamberlain Alexander J, 2004, Australas J Dermatol, V45, P136, DOI 10.1111/j.1440-0960.2004.00068.x
  • [6] IMMUNE-MEDIATED SUBEPITHELIAL BLISTERING DISEASES OF MUCOUS-MEMBRANES - PURE OCULAR CICATRICIAL PEMPHIGOID IS A UNIQUE CLINICAL AND IMMUNOPATHOLOGICAL ENTITY DISTINCT FROM BULLOUS PEMPHIGOID AND OTHER SUBSETS IDENTIFIED BY ANTIGENIC SPECIFICITY OF AUTOANTIBODIES
    CHAN, LS
    YANCEY, KB
    HAMMERBERG, C
    SOONG, HK
    REGEZI, JA
    JOHNSON, K
    COOPER, KD
    [J]. ARCHIVES OF DERMATOLOGY, 1993, 129 (04) : 448 - 455
  • [7] ANTIEPILIGRIN CICATRICIAL PEMPHIGOID - A SUBEPITHELIAL BULLOUS DISORDER
    DOMLOGEHULTSCH, N
    ANHALT, GJ
    GAMMON, WR
    LAZAROVA, Z
    BRIGGAMAN, R
    WELCH, M
    JABS, DA
    HUFF, C
    YANCEY, KB
    [J]. ARCHIVES OF DERMATOLOGY, 1994, 130 (12) : 1521 - 1529
  • [8] EPILIGRIN, THE MAJOR HUMAN KERATINOCYTE INTEGRIN LIGAND, IS A TARGET IN BOTH AN ACQUIRED AUTOIMMUNE AND AN INHERITED SUBEPIDERMAL BLISTERING SKIN-DISEASE
    DOMLOGEHULTSCH, N
    GAMMON, WR
    BRIGGAMAN, RA
    GIL, SG
    CARTER, WG
    YANCEY, KB
    [J]. JOURNAL OF CLINICAL INVESTIGATION, 1992, 90 (04) : 1628 - 1633
  • [9] Anti-epiligrin cicatricial pemphigoid - Clinical findings, immunopothogenesis, and significant associations
    Egan, CA
    Lazarova, Z
    Darling, TN
    Yee, C
    Yancey, KB
    [J]. MEDICINE, 2003, 82 (03) : 177 - 186
  • [10] Anti-epiligrin cicatricial pemphigoid and relative risk for cancer
    Egan, CA
    Lazarova, Z
    Darling, TN
    Yee, C
    Cotê, T
    Yancey, KB
    [J]. LANCET, 2001, 357 (9271) : 1850 - 1851