Analysis of antigens targeted by circulating IgG and IgA antibodies in patients with mucous membrane pemphigoid predominantly affecting the oral cavity.
BACKGROUND
Mucous membrane pemphigoid (MMP) includes a range of variants frequently having oral, particularly gingival, lesions. It has been suggested that MMP exclusively involving the oral cavity could be a distinct subset, but the immunological status of patients with predominantly oral lesions has received little attention.


METHODS
Indirect immunofluorescence (IIF) on normal human skin and normal human salt-split skin (SSS) as a substrate and immunoblotting on extracts of human keratinocyte cultures and normal human skin were carried out in 28 consecutive patients with MMP predominantly affecting the gingiva.


RESULTS
There was no significant difference between frequency of positive SSS-IIF among patients with exclusive oral lesions (42%) and with MMP not restricted to the oral cavity (78%) (P = 0.114). By immunoblotting, IgG of 13 sera (46%) reacted with the 180 kD bullous pemphigoid antigen (BPAg2), six (21%) reacted with the 230 kD bullous pemphigoid antigen (BPAg1), and two (7%) reacted with an antigen of 200 kD. IgA of three sera (11%) reacted with BPAg2 and three (11%) reacted with BPAg1. There was no significant difference between frequency of positive immunoblotting among patients with exclusive oral lesions (68%) and with MMP not restricted to the oral cavity (67%) (P = 1.00).


CONCLUSIONS
Most of the MMP sera contain IgG and IgA antibodies to the two major bullous pemphigoid antigens, independent of clinical presentation. Thus, in the majority of cases, patients with exclusively gingival pemphigoid lesions do not appear to have a distinct variety of mucous membrane pemphigoid.
Carrozzo
Marco
M
Department of Biomedical Sciences and Oncology, Oral Medicine Section, School of Medicine and Dentistry, University of Turin, Turin, Italy. marco.carrozzo@unito.it
Cozzani
Emanuele
E
Broccoletti
Roberto
R
Carbone
Mario
M
Pentenero
Monica
M
Arduino
Paolo
P
Parodi
Aurora
A
Gandolfo
Sergio
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001323:Autoantibodies / Q000032:analysis / Q000097:blood*; D001324:Autoantigens / Q000032:analysis / Q000097:blood*; D002352:Carrier Proteins / Q000032:analysis; D003598:Cytoskeletal Proteins / Q000032:analysis; D000071821:Dystonin; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D005500:Follow-Up Studies; D005882:Gingival Diseases / Q000276:immunology; D006801:Humans; D015151:Immunoblotting; D007070:Immunoglobulin A / Q000032:analysis / Q000097:blood*; D007074:Immunoglobulin G / Q000032:analysis / Q000097:blood*; D015603:Keratinocytes / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009059:Mouth Diseases / Q000276:immunology*; D009419:Nerve Tissue Proteins / Q000032:analysis; D024041:Non-Fibrillar Collagens / Q000032:analysis; D010390:Pemphigoid, Benign Mucous Membrane / Q000276:immunology*; D010391:Pemphigoid, Bullous / Q000276:immunology; D012189:Retrospective Studies; D012867:Skin / Q000276:immunology; D000097805:Collagen Type XVII
D001323:Autoantibodies; D001324:Autoantigens; D002352:Carrier Proteins; D003598:Cytoskeletal Proteins; D000071821:Dystonin; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D009419:Nerve Tissue Proteins; D024041:Non-Fibrillar Collagens; D000097805:Collagen Type XVII; C486268:DST protein, human