title: Analysis of antigens targeted by circulating IgG and IgA autoantibodies in 50 patients with cicatricial pemphigoid.
abstract: In this study we investigated sera from 50 typical cicatricial pemphigoid (CP) patients. By indirect immunofluorescence on 1 M NaCl-split human skin sections, IgG of 17 sera and IgA of 22 sera reacted with the epidermal side of the split, while IgG of two sera reacted with the dermal side. These latter two sera were later confirmed to be anti-epiligrin CP. By immunoblotting of epidermal extracts, IgG of 14 sera reacted with the 230 kD bullous pemphigoid (BP) antigen (BP230). IgG of 15 sera and IgA of 11 sera reacted with the 180 kD BP antigen (BP180). Interestingly, a bacterial fusion protein containing the BP180 NC16a domain was recognized by IgG of 18 sera but not by IgA of any sera. Fusion proteins containing the C-terminal region of BP180 were recognized by IgG of 20 sera, but it was detected by IgA of only two sera. Our results suggest that, although CP sera show very low titers of autoantibodies, a considerable number of sera contain IgG antibodies to BP180 (either NC16a or C-terminal domain), confirming previous studies. In addition, we showed that greater numbers of IgA antibodies react with BP180, seemingly with different types of epitopes from those for IgG antibodies. Because the specificity of IgG antibodies is not very different from those in BP, IgA antibodies may play a specific role for the development of characteristic clinical features in CP. Future studies should elucidate the pathogenic role of the IgA antibodies in CP.
authors.affiliation: Department of Dermatology, Keio University School of Medicine, Tokyo, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Murakami
authors.forename: S
authors.initials: S
authors.lastname: Nishioka
authors.forename: J
authors.initials: J
authors.lastname: Setterfield
authors.forename: B S
authors.initials: BS
authors.lastname: Bhogal
authors.forename: M M
authors.initials: MM
authors.lastname: Black
authors.forename: D
authors.initials: D
authors.lastname: Zillikens
authors.forename: K B
authors.initials: KB
authors.lastname: Yancey
authors.forename: S D
authors.initials: SD
authors.lastname: Balding
authors.forename: G J
authors.initials: GJ
authors.lastname: Giudice
authors.forename: L A
authors.initials: LA
authors.lastname: Diaz
authors.forename: T
authors.initials: T
authors.lastname: Nishikawa
authors.forename: C
authors.initials: C
authors.lastname: Kiyokawa
authors.forename: T
authors.initials: T
authors.lastname: Hashimoto
mesh_terms: D000818:Animals; D001323:Autoantibodies / Q000276:immunology*; D001324:Autoantigens / Q000032:analysis* / Q000276:immunology*; D019084:Fluorescent Antibody Technique, Indirect; D006801:Humans; D015151:Immunoblotting; D007070:Immunoglobulin A / Q000276:immunology*; D007074:Immunoglobulin G / Q000276:immunology*; D051379:Mice; D010390:Pemphigoid, Benign Mucous Membrane / Q000276:immunology* / Q000378:metabolism; D011233:Precipitin Tests; D011993:Recombinant Fusion Proteins / Q000378:metabolism; D012867:Skin / Q000737:chemistry; D014020:Tissue Extracts / Q000276:immunology
chemical_list: D001323:Autoantibodies; D001324:Autoantigens; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D011993:Recombinant Fusion Proteins; D014020:Tissue Extracts