比较 3 种 VII 型胶原蛋白（C7）检测方法在获得性大疱性表皮松解症（EBA）血清学诊断中的应用。
Comparison of 3 type VII collagen (C7) assays for serologic diagnosis of epidermolysis bullosa acquisita (EBA).
机构信息
Department of Dermatology, APHP, Avicenne Hospital, Bobigny, France.
Department of Immunology, Assistance Publique des Hôpitaux de Paris (APHP), Saint-Louis Hospital, Paris, France.
出版信息
J Am Acad Dermatol. 2016 Jun;74(6):1166-72. doi: 10.1016/j.jaad.2016.01.005. Epub 2016 Mar 3.
BACKGROUND
Serologic diagnosis of epidermolysis bullosa acquisita (EBA) relies on the detection of circulating autoantibodies to type VII collagen (C7).
OBJECTIVE
We sought to compare the diagnostic performances of a commercialized enzyme-linked immunosorbent assay (ELISA) using C7 noncollagenous (NC) domains (C7-NC1/NC2 ELISA) and indirect immunofluorescence (IIF) biochip test on NC1-C7-expressing transfected cells (IIFT), with a full-length-C7 ELISA developed in our laboratory.
METHODS
C7-NC1/NC2 ELISA, IIFT, and full-length-C7 ELISA were run on 77 nonselected consecutive EBA sera.
RESULTS
C7-NC1/NC2 ELISA, IIFT, and full-length-C7 ELISA were positive, respectively, for: 30%, 27%, and 65% of the 77 sera; 43%, 32%, and 80% of 44 sera labeling the salt-split-skin (SSS) floor (F) by IIF (SSS/F(+)); 9%, 22%, and 47% of 32 SSS/F(-) sera; 28%, 28%, and 58% of classic EBA; 41%, 41%, and 82% of inflammatory EBA; and 18%, 0%, and 55% of mucous-membrane-predominant EBA. Significant differences for all sera were found between: the 2 ELISAs for the 77 sera, SSS/F(+) and SSS/F(-) sera, and IIFT versus full-length-C7 ELISA.
LIMITATIONS
The retrospective design was a limitation.
CONCLUSION
C7-NC1/NC2 ELISA and IIFT sensitivities for serologic diagnoses of EBA were low. Full-length-C7 ELISA was significantly more sensitive and could serve as a reference test.
背景
获得性大疱性表皮松解症（EBA）的血清学诊断依赖于对 VII 型胶原蛋白（C7）循环自身抗体的检测。
目的
我们旨在比较使用 C7 非胶原（NC）结构域（C7-NC1/NC2 ELISA）的商业化酶联免疫吸附测定（ELISA）和在表达全长 C7 的转染细胞上进行的间接免疫荧光（IIF）生物芯片检测（IIFT）与我们实验室开发的全长 C7 ELISA 的诊断性能。
方法
对 77 例非选择性连续 EBA 血清进行 C7-NC1/NC2 ELISA、IIFT 和全长 C7 ELISA 检测。
结果
C7-NC1/NC2 ELISA、IIFT 和全长 C7 ELISA 分别对 77 例血清中的 30%、27%和 65%、44 例通过 IIF 标记盐裂皮肤（SSS）底层（F）的血清中的 43%、32%和 80%、32 例 SSS/F（-）血清中的 9%、22%和 47%、32 例经典 EBA 血清中的 28%、28%和 58%、41%、41%和 82%的炎症性 EBA 血清和 18%、0%和 55%的黏膜优势 EBA 血清呈阳性。对所有血清进行检测，均发现 2 种 ELISA 之间、SSS/F（+）和 SSS/F（-）血清之间以及 IIFT 与全长 C7 ELISA 之间存在显著差异。
局限性
回顾性设计是一个限制。
结论
C7-NC1/NC2 ELISA 和 IIFT 对 EBA 的血清学诊断敏感性较低。全长 C7 ELISA 显著更敏感，可作为参考试验。
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