title: BP180 ELISA using bacterial recombinant NC16a protein as a diagnostic and monitoring tool for bullous pemphigoid.
abstract: Bullous pemphigoid (BP) is an acquired autoimmune subepidermal blistering disease against hemidesmosomal cytoplasmic BP230 and transmembrane BP180 proteins. Epitope mapping studies have shown that the membrane-proximal noncollagenous (NC) 16a domain of BP180 harbors clusters of antigenic sites recognized by the vast majority of BP sera. In this study, we developed an enzyme-linked immunosorbent assay (ELISA) using bacterial recombinant NC16a protein and evaluated its clinical benefit for diagnosis and monitoring disease activity. Fifty four (84.4%) of 64 sera from BP patients were positive, while only one (1.1%) of 91 sera from collagen disease patients and five (1.5%) of 336 sera from normal control barely exceeded the cut-off value. None of 69 pemphigus vulgaris sera and none of 42 pemphigus foliaceus sera exceeded the cut-off value. Thus, the sensitivity and specificity of NC16a ELISA were 84.4 and 98.9%, respectively. The correlation between ELISA scores and disease activity along the time course was examined using seven BP patients. NC16a ELISA scores tended to fluctuate in parallel with the disease activity along the time course and reflected the disease activity much better than indirect immunofluorescence. These findings indicate that NC16a ELISA will be a valuable tool not only for the diagnosis of patients with BP but also for the monitoring of the disease activity.
authors.affiliation: Department of Dermatology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan. masakazu@saichu.jp
authors.forename: Masakazu
authors.initials: M
authors.lastname: Kobayashi
authors.forename: Masayuki
authors.initials: M
authors.lastname: Amagai
authors.forename: Keiko
authors.initials: K
authors.lastname: Kuroda-Kinoshita
authors.forename: Takashi
authors.initials: T
authors.lastname: Hashimoto
authors.forename: Yuji
authors.initials: Y
authors.lastname: Shirakata
authors.forename: Koji
authors.initials: K
authors.lastname: Hashimoto
authors.forename: Takeji
authors.initials: T
authors.lastname: Nishikawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001324:Autoantigens / Q000737:chemistry*; D001426:Bacterial Proteins; D002352:Carrier Proteins; D016022:Case-Control Studies; D003094:Collagen / Q000737:chemistry*; D003095:Collagen Diseases / Q000276:immunology; D003598:Cytoskeletal Proteins; D000071821:Dystonin; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009419:Nerve Tissue Proteins; D024041:Non-Fibrillar Collagens; D010391:Pemphigoid, Bullous / Q000175:diagnosis* / Q000276:immunology / Q000503:physiopathology*; D017434:Protein Structure, Tertiary / Q000502:physiology; D011994:Recombinant Proteins; D012680:Sensitivity and Specificity; D000097805:Collagen Type XVII
chemical_list: D001324:Autoantigens; D001426:Bacterial Proteins; D002352:Carrier Proteins; D003094:Collagen; D003598:Cytoskeletal Proteins; D000071821:Dystonin; D009419:Nerve Tissue Proteins; D024041:Non-Fibrillar Collagens; D011994:Recombinant Proteins; D000097805:Collagen Type XVII; C486268:DST protein, human