title: Enzyme-linked immunosorbent assay using multimers of the 16th non-collagenous domain of the BP180 antigen for sensitive and specific detection of pemphigoid autoantibodies.
abstract: Bullous pemphigoid (BP) and pemphigoid gestationis (PG) are acquired autoimmune subepidermal blistering diseases characterized by autoantibodies against the hemidesmosomal proteins BP180/type XVII collagen and BP230. In the vast majority of BP and PG patients, these autoantibodies bind to epitopes clustered within the 16th non-collagenous domain of BP180. An ELISA system for the detection of these autoantibodies was developed and evaluated using 16th non-collagenous domain (NC16A) tetramers instead of monomers. In contrast to antigens fused to large proteins used in the past for the detection of autoantibodies against type XVII collagen, tetrameric antigen fragments bearing a small hexahistidine tag allow for high expression levels without the need to cleave off the fusion partner. Using tetrameric BP180 NC16A, positive reactions were found in 106 (89.8%) of 118 randomly selected BP sera and in all of 20 (100%) randomly selected PG sera, whereas only 2.2% of a large cohort of control subjects were positive in this assay, including patients with rheumatoid arthritis (two of 107), progressive systemic sclerosis (two of 50), systemic lupus erythematosus (one of 72), and healthy blood donors (10 of 494). Thus, the sensitivity and specificity of the new anti-tetrameric NC16A ELISA were 89.9% and 97.8% respectively. Levels of circulating autoantibodies against BP180 paralleled disease activity in the pemphigoid patients. In conclusion, the use of tetrameric NC16A in ELISA results in a sensitive and specific tool for diagnosis and monitoring of BP and PG.
authors: Department of Dermatology, University of Lübeck, Ratzeburger Allee 160, Lübeck, Germany. csitaru@fastmail.fm
authors: Cassian
authors: C
authors: Sitaru
authors: Cornelia
authors: C
authors: Dähnrich
authors: Christian
authors: C
authors: Probst
authors: Lars
authors: L
authors: Komorowski
authors: Inga
authors: I
authors: Blöcker
authors: Enno
authors: E
authors: Schmidt
authors: Wolfgang
authors: W
authors: Schlumberger
authors: Christian
authors: C
authors: Rose
authors: Winfried
authors: W
authors: Stöcker
authors: Detlef
authors: D
authors: Zillikens
mesh_terms: D001323:Autoantibodies / Q000276:immunology*; D001324:Autoantigens / Q000276:immunology*; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods*; D005260:Female; D006801:Humans; D024041:Non-Fibrillar Collagens / Q000276:immunology*; D006559:Pemphigoid Gestationis / Q000175:diagnosis / Q000276:immunology*; D010391:Pemphigoid, Bullous / Q000175:diagnosis / Q000276:immunology*; D010455:Peptides / Q000276:immunology; D011247:Pregnancy; D017434:Protein Structure, Tertiary; D011994:Recombinant Proteins / Q000276:immunology; D012680:Sensitivity and Specificity; D000097805:Collagen Type XVII
chemical_list: D001323:Autoantibodies; D001324:Autoantigens; D024041:Non-Fibrillar Collagens; D010455:Peptides; D011994:Recombinant Proteins; D000097805:Collagen Type XVII