title: Autoimmune bullous diseases the spectrum of infectious agent antibodies and review of the literature.
abstract: Pemphigus and bullous pemphigoid are two autoimmune diseases that have a similar pathogenesis. Both have a genetic predisposition which promotes the production of auto-antibodies targeted against different components of the epidermal desmosome and hemidesmosome. Environmental factors play an important role in the pathogenesis of this autoimmune disease. Among these, the role of infectious agents was debated as a causative factor. We sought to determine a possible connection between various infectious agents and autoimmune bullous disease (ABD). A cohort of 148 serum samples of patients with pemphigus, bullous pemphigoid and controls was screened for evidence of a prior infection with HBV, HCV, EBV, CMV, Helicobacter pylori, Toxoplasma gondii and Treponema pallidum, utilizing the Bio-Rad BioPlex 2200 system as well as ELISA assays to complete the panel. HBV, HCV, H. pylori, T. gondii and CMV were demonstrated to have significantly higher prevalence of antibodies in patients with pemphigus and bullous pemphigoid in comparison to controls. Among them, we found a novel association between H. pylori and ABD. Our study suggests a contributing role for HBV, HCV, H. pylori, T. gondii and CMV in inducing ABD in the genetically susceptible host.
authors.affiliation: Department of Dermatology, Sheba Medical Center, Tel Hashomer, Israel.
authors.forename: Lior
authors.initials: L
authors.lastname: Sagi
authors.forename: Sharon
authors.initials: S
authors.lastname: Baum
authors.forename: Nancy
authors.initials: N
authors.lastname: Agmon-Levin
authors.forename: Yaniv
authors.initials: Y
authors.lastname: Sherer
authors.forename: Bat Sheva Porat
authors.initials: BS
authors.lastname: Katz
authors.forename: Ori
authors.initials: O
authors.lastname: Barzilai
authors.forename: Maya
authors.initials: M
authors.lastname: Ram
authors.forename: Nicola
authors.initials: N
authors.lastname: Bizzaro
authors.forename: Marielle
authors.initials: M
authors.lastname: SanMarco
authors.forename: Henri
authors.initials: H
authors.lastname: Trau
authors.forename: Yehuda
authors.initials: Y
authors.lastname: Shoenfeld
mesh_terms: D000328:Adult; D000368:Aged; D000907:Antibodies, Bacterial / Q000097:blood*; D000913:Antibodies, Protozoan / Q000097:blood*; D000914:Antibodies, Viral / Q000097:blood*; D001419:Bacteria / Q000276:immunology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010391:Pemphigoid, Bullous / Q000097:blood* / Q000276:immunology*; D010392:Pemphigus / Q000097:blood / Q000276:immunology*; D012189:Retrospective Studies; D014122:Toxoplasma / Q000276:immunology; D014780:Viruses / Q000276:immunology
chemical_list: D000907:Antibodies, Bacterial; D000913:Antibodies, Protozoan; D000914:Antibodies, Viral