Possible correlation of IgE autoantibody to BP180 with disease activity in bullous pemphigoid

Aoyama, Yumi; Nöda, Keisuke; Miyake, Tomoko; Yamaguchi, Mari; Hamada, Takeshi; Tokura, Y.; Iwatsuki, Keiji

doi:10.1016/j.jdermsci.2015.02.009

Cited by 22 publications

(19 citation statements)

References 9 publications

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“…[102,106] In line, serum levels of anti-NC16A IgE significantly correlated with disease severity in individual BP patients. [96,99,106,107] These data are further supported by Delaporte et al and Kalowska et al, who found the disappearance of IgE anti-BP180 autoantibodies to be associated with clinical remission. [101,102] Interestingly, in two infants with BP, no IgE reactivity against the NC16A domain was detectable.…”

Section: Bp180-specific Ige Autoantibodiessupporting

confidence: 63%

IgE-mediated mechanisms in bullous pemphigoid and other autoimmune bullous diseases

Beek

Schulze

Zillikens

et al. 2015

Expert Review of Clinical Immunology

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Autoimmune bullous diseases (AIBDs) are characterized by autoantibodies against structural proteins of the dermal-epidermal junction (in pemphigoid diseases) and the epidermal/ epithelial desmosomes (in pemphigus diseases). By far, the most common AIBD is bullous pemphigoid, which is immunopathologically characterized by autoantibodies against BP180 (type XVII collagen) and BP230. IgG and, to a lesser extent, IgA autoantibodies are the major autoantibody isotypes in these disorders. IgE autoantibodies are increasingly reported in particular in bullous pemphigoid. The development of specific and sensitive anti-BP180 IgE ELISA systems, the report of two experimental murine models employing IgE autoantibodies against BP180, and the successful treatment of bullous pemphigoid with the anti-IgE antibody omalizumab have raised interest in the role of IgE autoantibodies and the modulation of their production in AIBDs. Here, the relevance of IgE autoantibodies in the diagnosis, pathophysiology, and treatment decisions of AIBDs, with a focus on bullous pemphigoid, is reviewed. ARTICLE HISTORY

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Section: Bp180-specific Ige Autoantibodiessupporting

confidence: 63%

IgE-mediated mechanisms in bullous pemphigoid and other autoimmune bullous diseases

Beek

Schulze

Zillikens

et al. 2015

Expert Review of Clinical Immunology

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“…In our study, all patients were diagnosed with bullous pemphigoid with typical clinical features of tense blisters. The levels of circulating IgE anti-BP180NC16A in sera could generally reflect disease severity throughout the course of the disease, like other papers published [2,6,7].…”

mentioning

confidence: 55%

“…This study also provides early evidence that IgE class autoantibodies are capable of inducing early bullous pemphigoid like lesions in mice. Kamiya et al report the IgE BP180 antibody levels correlated with BPDAI for erythema, while IgG BP180 antibody levels correlated with BPDAI for erosions/blisters in a BP patient by carefully and frequently monitored IgG and IgE BP180 antibodies [6]. These observations indicate that IgE anti-BP180NCA16A antibodies may be involved in the erythematous lesions in BP.…”

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confidence: 96%

Is anti-BP180 IgE associated with clinical phenotype? Reply to the letter to the editor

Zuo

2015

Arch Dermatol Res

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“…Yu et al [5] found that peripheral blood eosinophil counts followed disease activity most closely during omalizumab therapy in BP patients. Also, some authors carefully observed the clinical features and the titers of autoantibodies in the BP patient, and they found that circulating levels of IgE autoantibodies correlate well with urticarial erythema and that those of IgG autoantibodies are instead associated with blister formation [10]. Until a larger, controlled trial is performed, it seems most prudent to use omalizumab in patients with recalcitrant disease who have elevated IgE levels, eosinophilia, or both [3].…”

Section: Discussionmentioning

confidence: 99%

Successful Treatment of a Bullous Pemphigoid Patient with Rituximab Who Was Refractory to Corticosteroid and Omalizumab Treatments

et al. 2017

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Omalizumab is a humanized monoclonal antibody which is an FDA-approved treatment of severe allergic asthma and inhibits IgE binding to FcεRI. According to increasing evidence of IgE inhibition, omalizumab was suggested as a therapeutic approach for bullous pemphigoid (BP). Rituximab has been reported to be effective in various autoimmune diseases, including autoimmune bullous dermatoses. A specific protocol for the use of rituximab to treat BP patients is not yet available. There are only small case series and case reports about the efficacy and safety of rituximab in BP. Here we present a young BP patient who responded well to rituximab therapy and was refractory to conventional and omalizumab therapies although he had elevated IgE levels and eosinophilia. Our case supports the knowledge about the effectiveness and safety of rituximab not only in pemphigus but also in BP. On the other hand, although it did not work in our case, omalizumab may be a potentially effective agent in some carefully selected patients with certain subtypes of BP.

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Possible correlation of IgE autoantibody to BP180 with disease activity in bullous pemphigoid

Cited by 22 publications

References 9 publications

IgE-mediated mechanisms in bullous pemphigoid and other autoimmune bullous diseases

IgE-mediated mechanisms in bullous pemphigoid and other autoimmune bullous diseases

Is anti-BP180 IgE associated with clinical phenotype? Reply to the letter to the editor

Successful Treatment of a Bullous Pemphigoid Patient with Rituximab Who Was Refractory to Corticosteroid and Omalizumab Treatments

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