title: Correlation of IgE autoantibody to BP180 with a severe form of bullous pemphigoid.
abstract: OBJECTIVE
  To determine the prevalence, immunoglobulin subclass distribution, and clinical correlation of antibodies (Abs), especially of IgE Abs, to BP180 and BP230 in patients with bullous pemphigoid (BP).
  
  
  METHODS
  Retrospective case series analysis.
  
  
  METHODS
  Department of Dermatology, Nagasaki University Graduate School of Biomedical Science.
  
  
  METHODS
  Serum samples from 37 patients with BP, 6 with pemphigus vulgaris, 5 with pemphigus foliaceus, and 26 healthy controls (n = 26) were examined by enzyme-linked immunosorbent assay.
  
  
  METHODS
  Prevalence, immunoglobulin subclass distribution, and clinical correlation of Abs, especially of IgE Abs, to BP180 and BP230.
  
  
  RESULTS
  IgG anti-BP180 and anti-BP230 Abs were detected in 35 (95%) and 26 (70%) of the 37 BP serum samples, respectively. IgG1 and IgG4 isotypes were positive in 32 (87%) and 25 (68%), respectively, of the BP serum samples for anti-BP180 Abs, while they were detected in 16 (44%) and 26 (70%), respectively, for anti-BP230 Abs. IgE anti-BP180 and anti-BP230 Abs were equally detected in 8 (22%) of the BP serum samples. Similar to IgG anti-BP180 Abs, the presence or levels of IgE anti-BP180 Abs was associated with broader skin lesions. Furthermore, patients with BP positive for IgE anti-BP180 Abs required longer duration for remission, higher dosage of prednisolone, and more intensive therapies for remission. By contrast, this was not true for those with of IgE anti-BP230 Abs. Remarkably, when analyzed in patients with BP who had a high titer of IgG anti-BP180 Abs, the presence or levels of IgE anti-BP180 Abs, but not IgG anti-BP180 Abs, were associated with a more severe form.
  
  
  CONCLUSIONS
  The present study suggests that IgE anti-BP180 Abs are related to the disease severity and activity of BP. Moreover, it may be possible to identify treatment-refractory patients with BP more specifically by assessing the presence or levels of IgE anti-BP180 Abs in those with a high IgG anti-BP180 Ab titer.
authors.affiliation: Department of Dermatology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan. s-sato@nagasaki-u.ac.jp
authors.forename: Yohei
authors.initials: Y
authors.lastname: Iwata
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Komura
authors.forename: Masanari
authors.initials: M
authors.lastname: Kodera
authors.forename: Toshikazu
authors.initials: T
authors.lastname: Usuda
authors.forename: Yoko
authors.initials: Y
authors.lastname: Yokoyama
authors.forename: Toshihide
authors.initials: T
authors.lastname: Hara
authors.forename: Eiji
authors.initials: E
authors.lastname: Muroi
authors.forename: Fumihide
authors.initials: F
authors.lastname: Ogawa
authors.forename: Motoi
authors.initials: M
authors.lastname: Takenaka
authors.forename: Shinichi
authors.initials: S
authors.lastname: Sato
mesh_terms: D000368:Aged; D001323:Autoantibodies / Q000097:blood*; D001324:Autoantigens / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D007564:Japan; D008297:Male; D008875:Middle Aged; D024041:Non-Fibrillar Collagens / Q000097:blood*; D010391:Pemphigoid, Bullous / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology*; D011241:Prednisone / Q000627:therapeutic use*; D011336:Probability; D012016:Reference Values; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D000097805:Collagen Type XVII
chemical_list: D001323:Autoantibodies; D001324:Autoantigens; D015415:Biomarkers; D007073:Immunoglobulin E; D024041:Non-Fibrillar Collagens; D011241:Prednisone; D000097805:Collagen Type XVII