Stanley J R, Klaus-Kovtun V, Sampaio S A
J Invest Dermatol. 1986 Aug;87(2):197-201. doi: 10.1111/1523-1747.ep12695334.
Fogo selvagem (FS) is clinically, histologically, and immunopathologically similar to sporadic pemphigus foliaceus (PF, as seen in North America and Europe), although the epidemiology of these 2 diseases differs markedly. It has been proposed that FS is identical to PF but, for some reason, occurs in an endemic focus in central Brazil. If this hypothesis is correct, the autoantibodies in FS and PF should have similar antigenic specificities. We studied sera from 13 patients with FS from central Brazil, and compared them with 20 sera from patients with PF from the United States. All these sera had circulating antibodies that bound the cell surface of epithelial cells in identical patterns by indirect immunofluorescence on monkey esophagus or normal human skin. In immunoprecipitation studies none of the 13 FS sera precipitated the pemphigus vulgaris (PV) antigen from radiolabeled extracts of cultured human keratinocytes. This is similar to the findings with PF sera of which 19 of 20 sera did not react with PV antigen, but in sharp contrast to the results with PV sera which, as previously reported, all immunoprecipitate the PV antigen. Immunoblotting performed on extracts of normal human epidermis demonstrated that 7 of 20 PF sera specifically and intensely bound an approximately 160 kD polypeptide, previously identified as desmoglein I, a desmosomal glycoprotein. Similarly, 3 of 13 FS sera specifically bound a 160 kD polypeptide. Thirteen normal sera from North America, 8 normal and disease control sera from central Brazil, 11 PV sera, and 12 bullous pemphigoid sera did not specifically bind this polypeptide. Two-dimensional gel electrophoresis confirmed that the 160 kD polypeptides identified by the subgroup of PF and FS sera were identical. These studies demonstrate that, although the exact molecular specificities of the majority of PF and FS sera remain to be determined, FS autoantibodies do not bind the PV antigen and a subgroup of FS autoantibodies have molecular specificity identical to that of a subgroup of PF autoantibodies.
巴西寻常型天疱疮(FS)在临床、组织学及免疫病理学方面与散发性落叶型天疱疮(PF,见于北美和欧洲)相似,尽管这两种疾病的流行病学情况显著不同。有人提出,FS与PF相同,但由于某种原因,它发生在巴西中部的一个地方性疫源地。如果这一假设正确,那么FS和PF中的自身抗体应具有相似的抗原特异性。我们研究了来自巴西中部的13例FS患者的血清,并将其与来自美国的20例PF患者的血清进行比较。所有这些血清中循环抗体通过对猴食管或正常人皮肤进行间接免疫荧光,以相同模式结合上皮细胞的细胞表面。在免疫沉淀研究中,13例FS血清中没有一种能从培养的人角质形成细胞的放射性标记提取物中沉淀出寻常型天疱疮(PV)抗原。这与PF血清的研究结果相似,20例血清中有19例不与PV抗原反应,但与PV血清的结果形成鲜明对比,如先前报道,PV血清均能免疫沉淀PV抗原。对正常人表皮提取物进行免疫印迹分析表明,20例PF血清中有7例特异性且强烈地结合一种约160kD的多肽,该多肽先前被鉴定为桥粒芯糖蛋白I,一种桥粒糖蛋白。同样,13例FS血清中有3例特异性结合一种160kD的多肽。来自北美的13例正常血清、来自巴西中部的8例正常及疾病对照血清、11例PV血清和12例大疱性类天疱疮血清均未特异性结合该多肽。二维凝胶电泳证实,PF和FS血清亚组鉴定出的160kD多肽是相同的。这些研究表明,尽管大多数PF和FS血清的确切分子特异性仍有待确定,但FS自身抗体不结合PV抗原,且FS自身抗体的一个亚组具有与PF自身抗体的一个亚组相同的分子特异性。