title: Serological studies in bullous pemphigoid: a literature review of antibody titers at presentation and in clinical remission.
abstract: Bullous pemphigoid is associated with antibodies to a 230 kDa and a 180 kDa protein. In a literature review we investigated the role of auto-antibodies as detected by different serological assays. Nine reports containing data on 143 patients were analyzed. Pre-treatment data showed that indirect immunofluorescence, enzyme-linked immunosorbent assay (ELISA) and immunoblotting offer an 82.2% or greater probability of being positive. At the end of the study period, all patients had clinically improved, whether or not they were on therapy. Auto-antibodies were present in 29% of patients evaluated by monkey esophagus immunofluorescence and 75% of those evaluated by human skin immunofluorescence. Positive titers were also reported in 67.6% of patients evaluated by ELISA. In 100% of patients in whom immunoblotting was performed the titers became negative. In 3 patients (5.3%) using human skin immunofluorescence and in one patient (1.4%) using ELISA the titers were increased at the end of the study period. The correlation between anti-basement membrane zone antibodies and the clinical course of bullous pemphigoid requires further and long-term studies.
authors.affiliation: Department of Odontostomatological and Maxillo Facial Sciences, Federico II University of Naples, Italy. arahmedmd@msn.com
authors.forename: Stefania
authors.initials: S
authors.lastname: Leuci
authors.forename: Hakan M
authors.initials: HM
authors.lastname: Gürcan
authors.forename: A Razzaque
authors.initials: AR
authors.lastname: Ahmed
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D001323:Autoantibodies / Q000097:blood*; D001324:Autoantigens / Q000276:immunology; D015415:Biomarkers / Q000097:blood; D002352:Carrier Proteins / Q000276:immunology*; D003598:Cytoskeletal Proteins / Q000276:immunology*; D000071821:Dystonin; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005455:Fluorescent Antibody Technique; D000882:Haplorhini; D006801:Humans; D015151:Immunoblotting; D007159:Immunologic Tests / Q000379:methods; D008297:Male; D008875:Middle Aged; D009419:Nerve Tissue Proteins / Q000276:immunology*; D024041:Non-Fibrillar Collagens / Q000276:immunology; D010391:Pemphigoid, Bullous / Q000175:diagnosis* / Q000276:immunology / Q000628:therapy*; D011237:Predictive Value of Tests; D012074:Remission Induction; D012680:Sensitivity and Specificity; D013997:Time Factors; D016896:Treatment Outcome; D000097805:Collagen Type XVII
chemical_list: D001323:Autoantibodies; D001324:Autoantigens; D015415:Biomarkers; D002352:Carrier Proteins; D003598:Cytoskeletal Proteins; D000071821:Dystonin; D009419:Nerve Tissue Proteins; D024041:Non-Fibrillar Collagens; D000097805:Collagen Type XVII; C486268:DST protein, human