Özkesici Birgül, Mutlu Derya, Dönmez Levent, Uzun Soner
Prof. Soner Uzun, MD, Department of Dermatology and Venerology Akdeniz University, School of Medicine, 07058 Antalya, Turkey;
Acta Dermatovenerol Croat. 2017 Oct;25(3):202-209.
Autoimmune bullous diseases (ABD) are a rarely seen group of diseases, of which pemphigus and bullous pemphigoid (BP) are the major groups. Diagnosis is generally based on the combination of clinical features, histopathologic and immunofluorescence (IF) findings, and/or enzyme-linked immunosorbent assay (ELISA). Aims of the work were to determine the value of the innovative BIOCHIP mosaic-based indirect IF technique in the diagnosis of pemphigus and BP in Turkish patients. A total of 63 patients (45 pemphigus and 18 BP) in the active phase of the disease alongside 35 healthy controls were included in the study. All sera from patients and controls were tested using the BIOCHIP technique, and the results were compared with direct IF and/or ELISA. The sensitivity and specificity of this new technique were calculated for validity. The sensitivity and specificity of BIOCHIP in the diagnosis of pemphigus was found to be 91.1% and 97.1%, respectively. In detection of anti-Dsg1 and anti-Dsg3 autoantibodies, the correlation between BIOCHIP and ELISA was statistically significant (P<0.01). The sensitivity and specificity of BIOCHIP in the diagnosis of BP was found to be 94.4% and 94.3%, respectively. In detection of anti-BP180 autoantibodies, the correlation between the BIOCHIP and ELISA was statistically significant (P<0.01). The main limitations are the relatively low number of samples and testing with only one dilution. Direct IF was not performed in all patients, and the low rate of DIF positivity also can be a bias in comparison with BIOCHIP. The new BIOCHIP technique is a highly sensitive and specific tool in the diagnosis of pemphigus and BP.
自身免疫性大疱性疾病（ABD）是一组罕见疾病，其中天疱疮和大疱性类天疱疮（BP）是主要类型。诊断通常基于临床特征、组织病理学和免疫荧光（IF）结果及/或酶联免疫吸附测定（ELISA）的综合判断。本研究的目的是确定基于生物芯片镶嵌的创新间接IF技术在诊断土耳其患者天疱疮和BP中的价值。该研究纳入了63例处于疾病活动期的患者（45例天疱疮和18例BP）以及35名健康对照。使用生物芯片技术检测了患者和对照的所有血清，并将结果与直接IF和/或ELISA进行比较。计算了这项新技术的敏感性和特异性以评估其有效性。发现生物芯片诊断天疱疮的敏感性和特异性分别为91.1%和97.1%。在检测抗桥粒芯糖蛋白1（Dsg1）和抗桥粒芯糖蛋白3（Dsg3）自身抗体时，生物芯片与ELISA之间的相关性具有统计学意义（P<0.01）。发现生物芯片诊断BP的敏感性和特异性分别为94.4%和94.3%。在检测抗BP180自身抗体时，生物芯片与ELISA之间的相关性具有统计学意义（P<0.01）。主要局限性在于样本数量相对较少且仅用一种稀释度进行检测。并非所有患者都进行了直接IF检测，与生物芯片相比，直接免疫荧光（DIF）阳性率较低也可能是一个偏差。新的生物芯片技术是诊断天疱疮和BP的高度敏感且特异的工具。
