Feng Suying, Lin Lin, Jin Peiying, Wu Qinxue, Zhou Wuqing, Sang Honggui, Shao Changgeng
Institute of Dermatology, Chinese Academy of Medical Sciences, Peking Union Medical College, Nanjing, China.
Int J Dermatol. 2008 Jan;47(1):24-8. doi: 10.1111/j.1365-4632.2007.03531.x.
Autoantibodies of bullous pemphigoid (BP) patients react with two components of the hemidesmosome of stratified epithelia: the BP antigen 230 (BP230) and the BP antigen 180 (BP180). Recently, strong evidence has been provided that autoantibodies to BP180 play a key role in subepidermal blister formation in BP patients, and NC16A contains an important antigen determinant of BP.
To study the role of BP180NC16a enzyme-linked immunosorbent assay (BP180NC16a-ELISA) in the diagnosis of BP in China.
Sera from BP patients (n = 42) and control subjects (normal controls, n = 24; pemphigus patients, n = 18) were measured by BP180NC16a-ELISA. All BP sera were obtained at presentation from patients who had not received previous systemic treatment. The values of immunoglobulin G (IgG) antibody levels measured by ELISA were compared with those measured by indirect immunofluorescence (IIF) (gold standard for the diagnosis of BP) on salt-split skin.
Using BP180NC16a-ELISA, 41 of the 42 BP sera were positive, whereas only one of the serum samples from 24 normal controls was positive and all the pemphigus sera showed a negative result. Thus, the sensitivity and specificity of BP180NC16a-ELISA were both 97.62%. There was no correlation between the mean ELISA values and IIF titers. The ELISA and IIF results were further compared and analyzed using a 2 x 2 contingency table, which showed that they were not significantly different.
It is suggested that BP180NC16a-ELISA is a useful tool for the diagnosis of BP.
大疱性类天疱疮（BP）患者的自身抗体与复层上皮半桥粒的两种成分发生反应：BP抗原230（BP230）和BP抗原180（BP180）。最近，有强有力的证据表明，针对BP180的自身抗体在BP患者的表皮下疱形成中起关键作用，且NC16A包含BP的一个重要抗原决定簇。
研究BP180NC16a酶联免疫吸附测定（BP180NC16a-ELISA）在中国BP诊断中的作用。
采用BP180NC16a-ELISA检测BP患者（n = 42）和对照受试者（正常对照，n = 24；天疱疮患者，n = 18）的血清。所有BP血清均取自未接受过先前全身治疗的患者初诊时。将ELISA法检测的免疫球蛋白G（IgG）抗体水平值与盐裂皮肤间接免疫荧光法（IIF）（BP诊断的金标准）检测的值进行比较。
使用BP180NC16a-ELISA，42份BP血清中有41份呈阳性，而24份正常对照血清样本中只有1份呈阳性，所有天疱疮血清均呈阴性结果。因此，BP180NC16a-ELISA的敏感性和特异性均为97.62%。ELISA平均值与IIF滴度之间无相关性。使用2×2列联表对ELISA和IIF结果进行进一步比较和分析，结果显示两者无显著差异。
提示BP180NC16a-ELISA是诊断BP的一种有用工具。
