Comparative sensitivity of indirect immunofluorescence to immunoblot assay for the detection of circulating antibodies to bullous pemphigoid antigens 1 and 2

Ghohestani, Reza F.; Kanitakis, Jean; Nicolas, J.‐F.; Cozzani, Emanuele; Claudy, A

doi:10.1111/j.1365-2133.1996.tb03611.x

Cited by 42 publications

(18 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…17 Serological techniques (mainly immunochemical) are not very sensitive, especially for non-BP subepidermal AIBDs. 25 Anti-BMZ antibodies are detectable in 70% of patients with BP, 20% of those with CP, and 50% of those with EBA, [25][26][27][28][29][30] and by immunoblotting and/or indirect immunofluorescence on salt-split skin in 80% to 85%. 28,31 When standard indirect immunofluorescence is negative, they are detectable in only 45% of these cases.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Clinical Criteria for Diagnosis of Bullous Pemphigoid

Vaillant¹

1998

Arch Dermatol

172

132

View full text Add to dashboard Cite

To check the potential usefulness of clinical criteria for the diagnosis of bullous pemphigoid when state-of-the-art techniques such as Western immunoblotting, immunoprecipitation, and indirect immunofluorescence on salt-split skin or direct immunoelectron microscopy are not available.Design: Comparison of the clinical criteria between 2 groups (with and without bullous pemphigoid) as defined by immunoelectron microscopy used as standard criterion, in a prospective study. Multivariate logistic regression analysis was carried out by including all items that were statistically significant (at PϽ.05 level) in univariate analysis.Setting: Five dermatology departments in teaching hospitals. Patients:The 231 patients studied had subepidermal autoimmune bullous diseases with linear IgG or C3 deposits in the basement membrane zone (157 with bullous pemphigoid, 33 with cicatricial pemphigoid, 30 with epidermolysis bullosa acquisita, 5 with lupus erythem-atosus, and 6 others). A second set of patients was used to calculate predictive values. Results:The multivariate logistic stepwise analysis resulted in a final set of predictors that included only 4 items: absence of atrophic scars, absence of head and neck involvement, absence of mucosal involvement, and age greater than 70 years. No additional variables met the .05 significance level to enter into the model. If 3 of these 4 characteristics were present, a diagnosis of bullous pemphigoid could be made with a sensitivity of 90% and a specifity of 83%; these predictive values were calculated on a sample of 70 new cases.Conclusions: With an estimated incidence of bullous pemphigoid among subepidermal autoimmune bullous diseases of 80%, the presence of 3 of the 4 significant criteria allows the diagnosis of bullous pemphigoid, with a positive predictive value of 95%. Our set of' clinical criteria thus allows the diagnosis of bullous pemphigoid with good validity for both clinical practice and therapeutic trials.

show abstract

Section: Discussionmentioning

confidence: 99%

Evaluation of Clinical Criteria for Diagnosis of Bullous Pemphigoid

Vaillant¹

1998

Arch Dermatol

172

132

View full text Add to dashboard Cite

show abstract

“…The dermal-epidermal junction was separated by 1 M NaCl containing 50 M phenylmethylsulfonyl fluoride and 0.1 M EDTA (10).…”

Section: Methodsmentioning

confidence: 99%

The α5 Chain of Type IV Collagen Is the Target of IgG Autoantibodies in a Novel Autoimmune Disease with Subepidermal Blisters and Renal Insufficiency

Ghohestani¹,

Hudson²,

Claudy³

et al. 2000

Journal of Biological Chemistry

View full text Add to dashboard Cite

We describe a novel autoimmune disease characterized by severe subepidermal bullous eruptions and renal insufficiency with IgG autoantibodies directed against the NC1 domain of the ␣5(IV) collagen chain. In vivo deposits of IgG and C3 were found along the dermal-epidermal junction of skin lesions. The identity of the target antigen was determined by immunochemical analyses of candidate antigens using the patients' autoantibodies. The patients' IgG autoantibodies reacted with a 185-kDa polypeptide that was distinguished from the known autoantigens of the extracellular matrix including type XVII collagen, type VII collagen, or the ␣3, ␤3, and ␥2 chains of laminin 5. Preincubation of the serum with recombinant ␣5(IV)NC1 domain of type IV collagen abolished immunoreactivity with the 185-kDa antigen. The serum reacted specifically with the ␣5(IV)NC1, among the six NC1 domains of type IV collagen, by Western blot and enzyme-linked immunosorbent assay analyses. The patients' autoantibodies reacted with normal skin and renal glomerulus but not with skin and glomerulus of a patient with Alport syndrome in which the basement membranes are devoid of the ␣5(IV) collagen chain. This study provided for the first time unambiguous evidence for the ␣5(IV) collagen chain as the target antigen in a novel autoimmune disease characterized by skin and renal involvement.

show abstract

“…Moreover, a rapid and reliable differentiation between these diseases is also required for multicenter studies, especially epidemiological studies and therapeutic trials [18]. Indirect immunofluorescence using salt-split skin has been proposed to identify BP, CP and EBA, since most BP patients have circulating antibodies that bind the epidermal side of salt-split skin, whereas autoantibodies from patients with EBA bind to the dermal side [19, 20]. However, this simple technique cannot be considered as the gold standard diagnostic test since: (i) many patients with CP or EBA have no circulating antibodies [20, 21, 22]and (ii) a dual labeling of both the dermal and epidermal sides of salt-split skin may be observed with both BP and CP sera [23, 24].…”

Section: Introductionmentioning

confidence: 99%

Clinical Criteria for the Diagnosis of Bullous Pemphigoid: A Reevaluation according to Immunoblot Analysis of Patient Sera

et al. 2004

View full text Add to dashboard Cite

Background: We previously proposed a set of 4 clinical criteria for the diagnosis of bullous pemphigoid (BP) that consisted of age greater than 70 years, absence of atrophic scars, absence of mucosal involvement and absence of predominant bullous lesions on the neck and head. These results have been challenged because direct immunoelectron microscopy (IEM), which was used as the standard diagnostic criterion in our initial study, does not identify the different antigens of the basement membrane zone. Objective: To reassess the validity of these clinical criteria for the diagnosis of BP using immunoblot analysis of patient sera as the main diagnostic criterion, in order to precisely identify the antigens recognized by patient sera. Methods: One hundred and eighty-nine sera from patients with various subepidermal autoimmune blistering diseases (AIBDs) were tested by immunoblotting using dermal and epidermal extracts. IEM was used as a complementary diagnostic procedure in a few patients whose serum recognized BPAG2 exclusively or was negative in immunoblotting. Results: 142 patients (75%) had at least 3 of the 4 clinical diagnostic criteria. Sera from patients who lacked the set of BP clinical criteria were more frequently immunoblot negative (34%) than sera from patients who had the criteria (18%; p = 0.025). BPAG1 was more frequently recognized by sera from patients with the set of BP clinical criteria (78%) than by sera from patients without the criteria (45%; p = 5·10^–4). In contrast, BPAG2 was recognized by a great number of sera from patients who lacked the criteria of BP (71%), which was in accordance with the presence of numerous patients with cicatricial pemphigoid in this group. Among patients with various subepidermal AIBDs, the diagnosis of BP could be made with a sensitivity of 86%, a specificity of 90% and an excellent prognostic positive value over 95%, if 3 of these clinical criteria were present. Conclusion: These results confirm the interest of this set of clinical criteria for the rapid diagnosis of BP.

show abstract

Comparative sensitivity of indirect immunofluorescence to immunoblot assay for the detection of circulating antibodies to bullous pemphigoid antigens 1 and 2

Cited by 42 publications

References 25 publications

Evaluation of Clinical Criteria for Diagnosis of Bullous Pemphigoid

Evaluation of Clinical Criteria for Diagnosis of Bullous Pemphigoid

The α5 Chain of Type IV Collagen Is the Target of IgG Autoantibodies in a Novel Autoimmune Disease with Subepidermal Blisters and Renal Insufficiency

Clinical Criteria for the Diagnosis of Bullous Pemphigoid: A Reevaluation according to Immunoblot Analysis of Patient Sera

Contact Info

Product

Resources

About