Howard Anne, Dean Diane, Cooper Susan, Kirtshig Gudula, Wojnarowska Fenella
Dermatology Department, Western Hospital, Melbourne, Victoria, Australia.
Australas J Dermatol. 2004 Feb;45(1):12-5. doi: 10.1111/j.1440-0960.2004.00026.x.
This study was undertaken to investigate the prevalence of basement membrane zone (BMZ) antibodies, their subtypes and clinical correlations in 96 patients attending the Oxford vulval clinic with lichen sclerosus (LS) of the vulva. Indirect immunofluorescence of serum (intact and split skin) to immunoglobulin (Ig)G was performed looking for the presence or absence of staining at the BMZ. Eighteen patients' sera (14 with positive indirect immunofluorescence to IgG) were examined for IgG antibodies of subclasses IgG1, 2 and 3, and 23 sera were examined for IgG4 subclass. Immunoblotting was performed in seven patients, and showed antibodies to BP180 in six patients and BP230 in one. One-third of patients with vulval LS had BMZ antibodies binding to the epidermal side of salt split skin. Immunoblotting showed antibodies to BP180 collagen XVII (six of seven patients) and BP230 in one. The subclasses were chiefly IgG1 and 2, different from those seen in bullous pemphigoid. No clinical correlation was found between the presence of antibodies and the presence of erosions, severity of scarring, age of onset of disease or response to treatment. These antibodies may be a reflection of a tendency to produce autoantibodies or be relevant to pathogenesis.
本研究旨在调查96例就诊于牛津外阴诊所的外阴硬化性苔藓（LS）患者中基底膜带（BMZ）抗体的患病率、其亚型及临床相关性。采用血清（完整皮肤和分离皮肤）对免疫球蛋白（Ig）G进行间接免疫荧光检测，观察BMZ处有无染色。对18例患者的血清（14例对IgG间接免疫荧光呈阳性）检测IgG1、2和3亚类的IgG抗体，对23例血清检测IgG4亚类。对7例患者进行免疫印迹检测，6例显示抗BP180抗体，1例显示抗BP230抗体。三分之一的外阴LS患者的BMZ抗体与盐裂皮肤的表皮侧结合。免疫印迹显示7例患者中有6例存在抗BP180胶原蛋白XVII抗体，1例存在抗BP230抗体。亚类主要为IgG1和2，与大疱性类天疱疮所见不同。未发现抗体的存在与糜烂的存在、瘢痕形成的严重程度、疾病发病年龄或治疗反应之间存在临床相关性。这些抗体可能反映了产生自身抗体的倾向或与发病机制有关。
