Center for Blistering Diseases, Department of Dermatology, University Medical Center Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands.
Eur J Dermatol. 2009 Sep-Oct;19(5):456-60. doi: 10.1684/ejd.2009.0740. Epub 2009 Aug 7.
Diagnosis of pure ocular mucous membrane pemphigoid (OMMP) is based on the demonstration of linear depositions of IgG, IgA, C3 or combinations thereof alongside the epithelial basal membrane zone with direct immunofluorescence (DIF) or immunoperoxidase (DIP) analysis of a freeze biopsy of the conjunctiva in patients with cicatrizing kerato-conjunctivitis. The aims of this study were: 1) to investigate whether the direct immunoperoxidase method is more sensitive than direct immunofluorescence; 2) to analyse whether circulating antibodies against basement membrane autoantigens can be detected in DIF positive and DIF negative patients and which method is the most sensitive for this. In 11 patients with exclusively cicatrizing keratoconjunctivitis, biopsies were evaluated with DIF and DIP. Serum was investigated with indirect immunofluorescence and immunoblot. Immunofluorescence analysis revealed linear IgG and/or IgA depositions in five out of 11 conjunctival biopsies. These depositions were less intense with immunoperoxidase analysis. Serum immunofluorescence analysis was positive in only one case (20%); immunoblot analysis for circulating antibodies was positive in 4 of 5 patients (80%) with pure OMMP. With the methods used in this study: a) the immunoperoxidase analysis was no more sensitive than direct immunofluorescence, and b) the immunoblot was more sensitive in demonstrating circulating antibodies than indirect immunofluorescence.
单纯性眼黏膜炎型黏膜类天疱疮（OMMP）的诊断基于直接免疫荧光（DIF）或结膜冷冻活检免疫过氧化物酶（DIP）分析，在伴有瘢痕性角结膜炎的患者中显示 IgG、IgA、C3 或其组合沿上皮基底膜带的线性沉积。本研究的目的是：1）探讨直接免疫过氧化物酶法是否比直接免疫荧光法更敏感；2）分析在 DIF 阳性和 DIF 阴性患者中是否可以检测到针对基底膜自身抗原的循环抗体，以及哪种方法最敏感。在 11 例仅患有瘢痕性角结膜炎的患者中，用 DIF 和 DIP 评估活检。用间接免疫荧光和免疫印迹法检测血清。免疫荧光分析显示，在 11 例结膜活检中有 5 例存在线性 IgG 和/或 IgA 沉积。过氧化物酶分析的沉积强度较低。血清免疫荧光分析仅在 1 例（20%）中阳性；免疫印迹分析显示，在 4 例（80%）单纯 OMMP 患者中存在循环抗体。用本研究中使用的方法：a）免疫过氧化物酶分析不如直接免疫荧光法敏感，b）免疫印迹法比间接免疫荧光法更能检测到循环抗体。
