Bowszyc-Dmochowska M, Hashimoto T, Dmochowski M, Nishikawa T
Department of Dermatology, University School of Medicine, Poznań, Poland.
J Dermatol. 1997 Apr;24(4):217-22. doi: 10.1111/j.1346-8138.1997.tb02777.x.
There are reports in which an immunohistochemical technique with a monoclonal antibody to type IV collagen has been employed for differentiating between bullous pemphigoid (BP) and epidermolysis bullosa acquisita (EBA). The aim of this study was to determine whether this method could be used routinely. Biopsies (paraffin-embedded lesional skin containing a blister) from currently diagnosed patients with clinical features suggesting BP or EBA were examined by an avidin-biotin-peroxidase (ABC) technique. Sera were tested by indirect immunofluorescence on salt-split skin (IF) and immunoblotting (IB). In all cases which exhibited clear type IV collagen staining, the results of the ABC technique agreed with results of both IF and IB. In one confirmed EBA case, it was impossible to unequivocally localize type IV collagen, because it stained very faintly. Taking into consideration the results of our study, data indicating that the level of blistering might not coincide with the localization of immunoreactants in EBA cases and the possibility of an enzymatic destruction of lamina densa, we conclude that the ABC method is unsuitable for differentiation between BP and EBA.
有报告称，已采用针对IV型胶原的单克隆抗体的免疫组织化学技术来鉴别大疱性类天疱疮（BP）和获得性大疱性表皮松解症（EBA）。本研究的目的是确定该方法是否可常规使用。通过抗生物素蛋白-生物素-过氧化物酶（ABC）技术检查了来自目前诊断为具有提示BP或EBA临床特征的患者的活检标本（石蜡包埋的含有水疱的病变皮肤）。通过盐裂皮肤间接免疫荧光（IF）和免疫印迹（IB）检测血清。在所有显示清晰IV型胶原染色的病例中，ABC技术的结果与IF和IB的结果一致。在1例确诊的EBA病例中，无法明确地定位IV型胶原，因为其染色非常淡。考虑到我们的研究结果、表明在EBA病例中水疱形成水平可能与免疫反应物定位不一致的数据以及致密板层酶解破坏的可能性，我们得出结论，ABC方法不适用于BP和EBA的鉴别。
