Correlation of IgE autoantibody to BP180 with a severe form of bullous pemphigoid.
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.
Iwata
Yohei
Y
Department of Dermatology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan. s-sato@nagasaki-u.ac.jp
Komura
Kazuhiro
K
Kodera
Masanari
M
Usuda
Toshikazu
T
Yokoyama
Yoko
Y
Hara
Toshihide
T
Muroi
Eiji
E
Ogawa
Fumihide
F
Takenaka
Motoi
M
Sato
Shinichi
S
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
D001323:Autoantibodies; D001324:Autoantigens; D015415:Biomarkers; D007073:Immunoglobulin E; D024041:Non-Fibrillar Collagens; D011241:Prednisone; D000097805:Collagen Type XVII