DIFFERENTIATING ANTI-LAMINA LUCIDA AND ANTI-SUBLAMINA DENSA ANTI-BMZ ANTIBODIES BY INDIRECT IMMUNOFLUORESCENCE ON 1.0M SODIUM CHLORIDE-SEPARATED SKIN
DIFFERENTIATING ANTI-LAMINA LUCIDA AND ANTI-SUBLAMINA DENSA ANTI-BMZ ANTIBODIES BY INDIRECT IMMUNOFLUORESCENCE ON 1.0M SODIUM CHLORIDE-SEPARATED SKIN
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DOI：
10.1111/1523-1747.ep12259692
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发表时间：
1984-01-01
影响因子：
6.5
通讯作者：
WHEELER, CE
中科院分区：
文献类型：
--
作者：
GAMMON, WR;BRIGGAMAN, RA;WHEELER, CE
通过间接免疫荧光法对完整皮肤和通过在1.0 M NaCl中孵育的透明板分离的皮肤上含有IgG抗BMZ [基底膜区]抗体的大疱病血清进行检查。Al血清在1：10或更高的稀释度下在完整皮肤上产生不可区分的线性免疫荧光图案。在分离的皮肤上，抗体结合到分离的表皮（表皮模式）、真皮（真皮模式）或表皮和真皮（组合模式）侧。结合模式在来自几个供体的分离皮肤上是一致的，并且分离皮肤上的抗BMZ抗体滴度与完整皮肤上的那些相当。3例妊娠疱疹（HG）、36例类天疱疮（BP）和1例获得性大疱性表皮病（EBA）患者的血清显示表皮型。9例BP患者血清呈混合型，6例EBA患者和6例具有BP临床和组织学特征的患者血清呈真皮型。所选血清的间接免疫电镜显示产生表皮和组合模式的抗体是抗透明板抗体，而产生真皮模式的抗体是抗致密板下抗体。分离皮肤间接免疫荧光法是鉴别大疱病抗透明板和抗致密板抗体的可靠方法。区分抗体对于某些患者的准确诊断至关重要。BP抗透明板抗体可具有> 1的抗原特异性。
Bullous disease sera containing IgG anti-BMZ [basement membrane zone] antibodies were examined by indirect immunofluorescence on intact skin and skin separated through the lamina lucida by incubation in 1.0 M NaCl. Al sera produced an indistinguishable pattern of linear immunofluorescence on intact skin at dilutions of 1:10 or higher. On separated skin, antibodies bound to either the epidermal (epidermal pattern), dermal (dermal pattern) or epidermal and dermal (combined pattern) sides of the separation. The binding patterns were consistent on separated skin from several donors and titers of anti-BMZ antibodies on separated skin were comparable to those on intact skin. Sera from 3 patients with herpes gestationis (HG), 36 patients with bollous pemphigoid (BP), and 1 patient with clinical and histological features of epidermolysis bullosa acquisita (EBA) showed an epidermal pattern. Sera from 9 patients with BP showed a combined pattern and sera from 6 patients with EBA and 6 patients with clinical and histologic features of BP showed a dermal pattern. Indirect immunoelectron microscopy of selected sera showed antibodies producing the epidermal and combined patterns were anti-lamina lucida antibodies and those producing the dermal pattern were anti-sublamina densa antibodies. Indirect immunofluorescence on separated skin is a dependable method for differentiating bullous disease anti-lamina lucida and anti-sublamina densa antibodies. Differentiating between the antibodies is essential for accurate diagnosis in some patients. BP anti-lamina lucida antibodies may have > 1 antigenic specificity.