Hashimoto T, Ebihara T, Nishikawa T
Department of Dermatology, Keio University School of Medicine, Tokyo, Japan.
J Dermatol Sci. 1996 Apr;12(1):10-7. doi: 10.1016/0923-1811(95)00449-1.
We have examined autoantigens for IgA anti-keratinocyte cell surface antibodies in 17 intercellular IgA vesiculopustular dermatosis (IAVPD) cases showing only IgA antibodies and 5 cases showing both IgG and IgA antibodies (G A cases). IAVPD cases were divided into two subtypes: (1) intraepidermal neutrophilic IgA dermatosis type showing pustule formation throughout the epidermis and IgA antibodies reactive with the entire epidermis and (2) subcorneal pustular dermatosis type containing IgA antibodies reactive with the uppermost portion of the epidermis. Most G A cases showed atypical clinical features. With immunoblot analysis of normal human epidermal extracts, IgA antibodies in these cases showed no specific reactivity with either pemphigus foliaceus antigen (desmoglein 1) or pemphigus vulgaris antigen (desmoglein 3), except that IgC antibodies in one G/A case each recognized one of the two antigens. With immunoblotting of desmosome enriched fraction obtained from bovine snout epidermis, IgA antibodies in 10 IAVPD and 3 G/A cases and IgG antibodies in 4 G/A cases showed reactivity with either desmoglein 1 or desmocollin another desmosomal cadherin. These results indicate that IAVPD and G/A cases are heterogeneous in terms of both clinical features and antigens and that the IgA autoantibodies in these cases may react with different antigens from those for IgG autoantibodies.
我们检测了17例仅显示IgA抗体的细胞间IgA水疱脓疱性皮肤病（IAVPD）患者和5例同时显示IgG和IgA抗体的患者（GA病例）中IgA抗角质形成细胞表面抗体的自身抗原。IAVPD病例分为两个亚型：（1）表皮内嗜中性IgA皮肤病型，表现为整个表皮形成脓疱，且IgA抗体与整个表皮反应；（2）角层下脓疱性皮肤病型，含有与表皮最上部反应的IgA抗体。大多数GA病例表现出非典型临床特征。通过对正常人表皮提取物进行免疫印迹分析，这些病例中的IgA抗体与落叶型天疱疮抗原（桥粒芯糖蛋白1）或寻常型天疱疮抗原（桥粒芯糖蛋白3）均无特异性反应，不过在1例GA病例中的IgC抗体各自识别这两种抗原中的一种。通过对从牛鼻表皮获得的富含桥粒的组分进行免疫印迹分析，10例IAVPD和3例GA病例中的IgA抗体以及4例GA病例中的IgG抗体与桥粒芯糖蛋白1或桥粒胶蛋白（另一种桥粒钙黏附蛋白）发生反应。这些结果表明，IAVPD和GA病例在临床特征和抗原方面均具有异质性，并且这些病例中的IgA自身抗体可能与IgG自身抗体的抗原不同。
