Cozzani E, Kanitakis J, Nicolas J F, Schmitt D, Thivolet J
Laboratory of Dermatopathology/Department of Dermatology, Hôpital Edouard Herriot, Lyon, France.
Arch Dermatol Res. 1994;286(6):295-9. doi: 10.1007/BF00402218.
The diagnosis of pemphigus relies on immunopathological criteria including the detection of circulating autoantibodies to desmosomal components. In the present work we compared the usefulness of immunoblotting (IB) and indirect immunofluorescence (IIF) in the diagnosis of pemphigus using monkey oesophagus (MO) and rabbit lip (RL) as epithelial substrates. Among 54 sera from patients with well-documented pemphigus (40 pemphigus vulgaris, PV, and 14 pemphigus foliaceus, PF), 46 (85%) proved positive by IIF (46 on MO and 41 on RL) as compared with 44 (81.5%) positive by IB. IIF and IB were equally sensitive (90%) for the diagnosis of PV whereas IIF (on RL) was more sensitive (71%) than IB (57%) for the detection of PF autoantibodies. However, when the two techniques were considered in combination, the sensitivity of the detection of pemphigus autoantibodies rose to 94.5%. An IB study would therefore be warranted in the presence of an (alleged) pemphigus serum that was IIF-negative since approximately 10% of these were found to be positive. Furthermore, the pattern of IB reactivity may assist in classification, since the 130- and the 160-kDa antigens seem specifically correlated with PV and PF, respectively.
天疱疮的诊断依赖于免疫病理学标准，包括检测针对桥粒成分的循环自身抗体。在本研究中，我们比较了免疫印迹法（IB）和间接免疫荧光法（IIF）在以猴食管（MO）和兔唇（RL）作为上皮底物诊断天疱疮中的效用。在54例有充分记录的天疱疮患者的血清中（40例寻常型天疱疮，PV，和14例落叶型天疱疮，PF），IIF检测显示46例（85%）呈阳性（46例在MO上呈阳性，41例在RL上呈阳性），而IB检测显示44例（81.5%）呈阳性。IIF和IB对PV诊断的敏感性相同（90%），而对于PF自身抗体的检测，IIF（在RL上）比IB（57%）更敏感（71%）。然而，当两种技术联合使用时，天疱疮自身抗体检测的敏感性升至94.5%。因此，对于IIF检测呈阴性的（疑似）天疱疮血清，有必要进行IB研究，因为其中约10%被发现呈阳性。此外，IB反应模式可能有助于分类，因为130 kDa和160 kDa抗原似乎分别与PV和PF特异性相关。
