Tsuji-Abe Yukiko, Akiyama Masashi, Yamanaka Yasuko, Kikuchi Toshiro, Sato-Matsumura Kazuko C, Shimizu Hiroshi
Department of Dermatology, Hokkaido University Graduate School of Medicine, Kita-ku, Sapporo 060-8638, Japan.
J Dermatol Sci. 2005 Mar;37(3):145-9. doi: 10.1016/j.jdermsci.2004.10.007. Epub 2004 Dec 2.
Titres of circulating autoantibodies detected by indirect immunofluorescence (IIF) have been used for the diagnosis and evaluation of disease activity in bullous pemphigoid (BP). In BP, the major pathogenic epitope is known to be the non-collagenous extracellular domain (NC16A) of the 180-kDa transmembrane hemidesmosomal protein (BPAG2). Recently, an enzyme-linked immunosorbent assay (ELISA) kit using the NC16A domain recombinant protein (BP180 ELISA kit) has become commercially available to measure the quantities of pathogenic autoantibodies circulating in BP patients.
To investigate the correlation of clinical severity and ELISA indices in BP.
Fourteen patients with a typical form of BP and one refractory BP patient who died despite extensive treatment were included in this study. Antibody titres in sera from these patients were measured using BP180 ELISA kit and an analysis of ELISA indices with disease activity was performed.
ELISA indices were significantly reduced after successful therapy, although IIF titres did not always show apparent correlations. In the patient with refractory BP, ELISA indices also showed a good correlation with disease course. ELISA indices measured using the BP180 ELISA kit were well correlated with the disease activity.
This commercially available kit more closely followed disease activities than the IIF titres. The BP ELISA system may be a useful tool to evaluate the disease activity and to assess the effectiveness of the treatment of BP.
通过间接免疫荧光法（IIF）检测的循环自身抗体滴度已用于大疱性类天疱疮（BP）的诊断和疾病活动评估。在BP中，主要致病表位已知为180 kDa跨膜半桥粒蛋白（BPAG2）的非胶原细胞外结构域（NC16A）。最近，一种使用NC16A结构域重组蛋白的酶联免疫吸附测定（ELISA）试剂盒（BP180 ELISA试剂盒）已上市，可用于测量BP患者循环中致病自身抗体的量。
研究BP患者临床严重程度与ELISA指标之间的相关性。
本研究纳入了14例典型BP患者和1例尽管接受了广泛治疗仍死亡的难治性BP患者。使用BP180 ELISA试剂盒测量这些患者血清中的抗体滴度，并对ELISA指标与疾病活动进行分析。
成功治疗后ELISA指标显著降低，尽管IIF滴度并不总是显示出明显的相关性。在难治性BP患者中，ELISA指标也与疾病病程显示出良好的相关性。使用BP180 ELISA试剂盒测量的ELISA指标与疾病活动密切相关。
这种市售试剂盒比IIF滴度更能紧密跟踪疾病活动。BP ELISA系统可能是评估BP疾病活动和评估治疗效果的有用工具。
