Correlation Analyses Of IgG/IgE Anti-BP180-NC16A Autoantibodies In Serum And Blister Fluid With Clinical Characteristics Of Bullous Pemphigoid

Bullous pemphigoid(BP)is an acquired autoimmune bullous disease characterized by pruritic urticarial erythema and tensely subepidermal blisters,affecting mainly elderly people aged over 70.The two crucial basement membrane zone(BMZ)autoantigens targeted by autoantibodies of BP are hemidesmosome proteins BP180(180 kDa)and BP230(230 kDa).The extracellular non-collagenous 16A(NC16A)domain of BP180 contains immune-dominant epitopes.At present,the correlations between IgG/IgE antiBP180-NC16A autoantibodies and the clinical characteristics of BP remains controversial.This study investigated the correlations of IgG/IgE anti-BP180-NC16A autoantibodies in serum and blister fluid with clinical characteristics of BP.Part 1 Correlation analyses between IgG anti-BP180-NC16A autoantibodies and clinical characteristics of bullous pemphigoidObjective:To clarify the correlations of IgG anti-BP180-NC1 6A autoantibodies in serum and blister fluid with clinical characteristics of BP.Methods:IgG anti-BP180-NC16A autoantibodies in serum and blister fluid samples of 34 BP patients before and after treatment were detected by enzyme-linked immunosorbent assay(ELISA),and the correlations with clinical features of BP were statistically analyzed.The Bullous Pemphigoid Disease Area Index(BPDAI)was used to measure disease activity of BP.Results:The mean baseline levels of IgG anti-BP180-NC16A autoantibodies in serum and blister fluid samples of untreated BP patients were 75.3 U/ml and 1.54(A450,cutoff:0.126).IgG anti-BP180-NC16A autoantibody levels in serum samples were positively associated with that in blister fluid samples.IgG anti-BP180-NC16A autoantibody levels in both serum and blister fluid samples of BP patients were positively associated with BPDAI Erosion/Blister Score,BPDAI without Damage Score and BPDAI Total Score.Conclusion:IgG anti-BP180-NC16A autoantibodies in both serum and blister fluid samples were positively correlated with the disease activity of BP,especially with the erosion/blister clinical phenotype.Part 2 Correlation analyses between IgE anti-BP180-NC16A autoantibodies and clinical characteristics of bullous pemphigoidObjective:To determine the levels of IgE anti-BP180-NC16A autoantibody in both serum and blister fluid samples of BP patients,and its clinical significance.Methods:IgE anti-BP180-NC16A autoantibodies in serum and blister fluid samples of 34 untreated BP patients were detected by ELISA,and their correlations with clinical features of BP were statistically analyzed.The BPDAI score was used to measure disease activity of BP.Results:IgE anti-BP180-NC16A autoantibodies were positive in 21.9%serum and 14.7%blister fluid samples of untreated BP patients.IgE anti-BP 180-NC16A autoantibody levels in untreated serum samples were positively correlated with that in untreated blister fluid samples(r=0.983,p<0.05).IgE anti-BP180-NC16A autoantibody levels in both serum and blister fluid samples of untreated BP patients had no correlation with corresponding IgG anti-BP180-NC16A autoantibodies,age,the extent of elevated peripheral blood eosinophils,BPDAI Erosion/Blister Score,BPDAI Urticaria/Erythema Score,BPDAIPruritus Score,BPDAI without Damage Score and BPDAI Total Score(all p>0.05).No statistical difference was found on diseases activity parameters between positive and negative for anti-BP180-NC16A IgE autoantibodies(all p>0.05).Conclusion:IgE anti-BP180-NC16A autoantibodies in both serum and blister fluid samples have no correlation with BP activity.