IntroductionSince urticaria is a persisting inflammatory disease it is important to establish the prognostic factors for the duration and severity of the disease.AimTo evaluate serum concentrations of selected acute-phase proteins (APP) in patients with various forms of urticaria as compared to healthy volunteers and also to analyze these concentrations in different types of urticaria. Additionally, to evaluate the correlation between serum levels of selected APP and disease activity.Material and methodsSerum concentrations of C-reactive protein (CRP), α1-acid glycoprotein (AGP), α1-antichymotrypsin (ACT), α1-antitrypsin (AT), ceruloplasmin (Cp), transferrin (Tf), α2-macroglobulin (α2M) and haptoglobin (Hp) were measured. Quantitative measurement was conducted using the rocket immunoelectrophoresis. Disease activity was assessed with the use of total symptom score.ResultsAnalysis of serum APP concentrations revealed statistically higher serum concentrations of CRP, AGP and ACT in the entire group of patients with urticaria in comparison with the control group. In the entire group of patients with urticaria, CRP, AGP, ACT, Cp and Hp correlated positively with disease activity, intensity of pruritus and the number and size of urticarial wheals. Statistically lower serum concentrations of CRP, ACT, Cp and Hp were detected in the group of patients with acute urticaria (AU) and angioedema together, compared to the patients suffering from AU only.ConclusionsPatients with symptoms of various forms of urticaria present a distinct profile of serum APP concentrations. A significant correlation observed between CRP, AGP, ACT, Cp, Hp and clinical activity score points to the potential role of APP as markers of the urticarial activity.

Bullous pemphigoid (BP) is an autoimmune blistering dermatosis of the elderly mediated by IgG and IgE antibodies to skin hemidesmosomal proteins, BP180 and/or BP230, that occur physiologically also in neuronal tissue. It was reported that BP is associated with neurodegenerative diseases (ND). We performed a retrospective study in a setting of a Central European university dermatology department on prevalence of ND in 94 BP patients. 26 out of 94 BP patients had at least one ND. ND included: Parkinson’s disease, dementia, stroke, hear loss, tinnitus, blindness, vertigo, neurosyphilis, systemic sclerosis, and epilepsy. Since population aging is conceivably responsible for the rising number of BP cases as a result of immunosenescence-related phenomena, the plausible BP-specific immunopathogenetic relationship between BP and ND deserves to be further experimentally explored.

IntroductionPemphigus and bullous pemphigoid (BP) are identified by autoantibodies (abs) against desmoglein 1, 3 (DSG1/3) and BP180/BP230, respectively. A novel mosaic to indirect immunofluorescence (IIF) using purified BP180 recombinant proteins spotted on slide and transfected cells expressing BP230, DSG1, DSG3 is available. The commercial (IgG detection) and modified (IgG4 detection) mosaic for indirect immunofluorescence (IIFc – IIF commercial, IIFm – IIF modified) and IgG ELISAs were evaluated in pemphigus and bullous pemphigoid (BP) molecular diagnostics.AimTo compare diagnostic accuracy of commercial (IgG detection) and modified (IgG4 detection) mosaic IIF assay and to examine the diagnostic value of ELISAs in relation to mosaic IIF in routine laboratory diagnostics of pemphigus and BP.Material and methodsSera from 37 BP and 19 pemphigus patients were studied. Associations between tests were assessed using Fisher’s exact test.ResultsThere are associations between the positive/negative samples detected by IIFc with desmoglein1 (DSG1)/desmoglein3 (DSG3)/BP230 transfected cells and ELISAs and no association between anti-BP180 IgG detection by IIFc and ELISA. IIFm with DSG1 and DSG3 showed both 100% sensitivity and 100% and 78% specificity, respectively, and 100% and 83% positive predictive value in relation to IIFc. IIFm with BP230 had 87% specificity, 55% sensitivity, whereas IIFm with BP180 had a 100% sensitivity and 13% specificity in relation to IIFc.ConclusionsThe IIFc with DSG1/DSG3/BP230 transfected cells, excluding BP180 spots, is an alternative method to ELISA in pemphigus/BP diagnostics. IgG4 antibodies, both pathogenically and diagnostically important, are inconsistently detectable with IIFm.

HereweinvestigatedthecutaneousCD32AandCD89expressioninrelationto theneutrophilelastase(NE)expressionandserumlevelofanti-desmoglein1and3 (DSG1/DSG3)IgGinpemphigus,anti-BP180/BP230IgGinbullouspemphigoid (BP),anti-gliadinnonapeptides(npG),tissue(tTG),andepidermaltransglutaminases(eTG)IgAindermatitisherpetiformis(DH). Theexaminedmaterialconsistedofskin/mucosaltissuesandsera.Intotal,87pa-tients were studied. Immunohistochemistry on paraffin-embedded sections with quantitativedigitalmorphometrywasusedtomeasuretheintensityofCD32A/ CD89/NEexpressions.Levelsofanti-DSG1/DSG3IgG,anti-BP180/BP230IgG, andanti-npG/tTG/eTGIgAwereevaluatedwithELISAs. CD32AwasabundantlyexpressedincutaneouslesionsinpemphigusandBP.We found nostatisticallysignificant correlationbetweentheCD32A/CD89 andNE expressionintensitiesinpemphigus,BP,andDH.Therewasasignificantcorrelation between CD89 expression and anti-npG IgA in DH. Our results revealed alackofcorrelationbetweenCD32Aexpressionsandanti-DSG1/DSG3IgGlevels inpemphigus,anti-BP180/BP230IgGinBPaswellasCD89expressionandan-ti-tTG/eTGIgAinDH. CD89seemstobelinkedwithglutenintoleranceinDHratherthanwithproteo-lyticdestructionofdermal-epidermaljunction.CD32Aappearstoplayanimport-antroleinmediatingskininjuryinpemphigusandBP,butprobablyindependently fromspecificautoantibodies.

Multivariant ELISA test combined with clinical examinations and DIF is recommended as a minimal approach to diagnosing ABDs in ethnic Slavs.