Serum levels of autoantibodies to BP180 correlate with disease activity in patients with bullous pemphigoid
Serum levels of autoantibodies to BP180 correlate with disease activity in patients with bullous pemphigoid
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DOI：
10.1111/j.1365-4632.2008.03473.x
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发表时间：
2008-03-01
影响因子：
3.6
通讯作者：
Shao, Changgeng
中科院分区：
文献类型：
--
作者：
Feng, Suying;Wu, Qinxue;Shao, Changgeng
背景：180 kDa跨膜半桥粒蛋白(BPAG2)是大疱性类天疱疮(BP)的重要自身抗原。目的探讨BP180自身抗体与BP180自身抗体的相关性。方法采用BP180NC16a-EL ISA检测20例BP患者血清中的抗体效价，并分析其与疾病活动性的相关性。每名BP患者至少采集三次血清：在开始治疗前，在疾病完全控制期间，在皮质类固醇减少之前，以及当皮质类固醇剂量成功地减少到初始剂量的一半时。在20例患者中，3例因决定停止治疗而导致晚期复发，并在复发早期获得血清。结果治疗成功后，间接免疫荧光滴度并不总是显示明显的相关性，但ELISA指标显著降低。用BP180NC16a-EL ISA测定的各项指标与疾病活动性有很好的相关性。3例患者决定停药，随后(1-2周内)水泡复发，BP180抗体水平上升至接近治疗前水平。结论BP180抗体滴度与疾病活动性的相关性比间接免疫荧光滴度更密切。BP180抗体滴度可作为评估BP疾病活动性和治疗效果的有用工具。
Background The 180-kDa transmembrane hemidesmosomal protein (BPAG2) has been identified as an important autoantigen in bullous pemphigoid (BP). Using the NC16A domain as the antigenic target, a highly sensitive and specific enzyme-linked immunosorbent assay (ELISA) for the detection of autoantibodies to BP180 was developed.Aim To investigate the correlation of clinical severity and ELISA indices in BP.Methods Antibody titers in the sera from 20 patients were measured using BP180NC16a-ELISA, and an analysis of the correlation of ELISA indices with disease activity was performed. Serum was obtained from each patient with BP at least three times: before the initiation of treatment, during complete disease control just before the decrease in corticosteroid, and when the dosage of corticosteroid was successfully decreased to half the initial dose. Of the 20 patients, three showed recurrence at a later stage, caused by their decision to stop treatment; serum was obtained at the early stage of recurrence.Results ELISA indices were significantly decreased after successful therapy, although indirect immunofluorescence titers did not always show apparent correlations. Indices measured using BP180NC16a-ELISA were well correlated with disease activity. Three patients decided to stop taking their medication; subsequently (within 1-2 weeks), blisters recurred, and the levels of antibodies to BP180 increased to close to those before the initiation of treatment.Conclusion BP180 antibody titers showed a closer correlation than indirect immunofluorescence titers to disease activity. The titer of BP180 antibody may be a useful tool for the evaluation of disease activity and for the assessment of the effectiveness of treatments in BP.