Relationship Between Anti-BP180 Antibody Titer And Bullous Pemphigoid Disease Activity And Review Of Treatment

Objective:To systematically review the relationship between the anti-BP 180 antibody titer and the severity of bullous pemphigoid in 50 patients with bullous pemphigoid in 3 years,and to summarize the corresponding treatment experience.Methods:The anti-BP180 antibody titer of the 50 patients diagnosed with bullous pemphigoid in September 2015 to February 2018 was examined by enzyme-linked immunosorbent assay;To collect and observe the cases of 50 BP patients,including the patient’s gender,age,skin lesion distribution area,the number of blister and anti-BP180 specific antibody titers;The treatment of 50 patients with bullous pemphigoid was retrospectively reviewed.According to the lesion area,there were 13 patients in the mild group,19 in the moderate group,and 18 in the severe group.Taking prednisone as the standard,glucocorticoids 30-40 mg/d,40-60 mg/d,and 60-80 mg/d were given as initial doses.For patients with poor treatment and poor disease control,glucocorticoid doses were 10-20 mg/day after 7-10 days.Insufficient patients were treated with intravenous methylprednisolone 0.5 or 1 g/d for 3 days.In addition,immunosuppressive agents are used in most critically ill patients and in some patients with persistent and mild disease.After the condition improved and was controlled,the dose of glucocorticoid was gradually reduced to the maintenance dose;Using statistical software SPSS 19.0 bivariate correlation statistical analysis to obtain a linear regression equation and plot a scatter plot to analyze whether the anti-BP 180-specific antibody titer is related to the status of bullous pemphigoid.The t-test was applied to the measurement data of the three groups of patients,and the χ2 test was used for the count data.Results:Anti-BP180 antibody titer measured by enzyme-linked immunosorbent assay was significantly correlated with the severity of illness(P<0.01).Linear regression equation:BP activity score=1.253+0.017×anti-BP180 antibody titer;Significant statistical differences in initial doses between mild,moderate and severe groups;There was no significant difference in gender and age between the three groups;There was no statistically significant difference in expression of IgM,IgG and C3 between different conditions.Conclusions:Anti-BP180-specific antibody titers were positively correlated with BP disease activity;The anti-BP 180-specific antibody titer measured by ELISA can be used as a criterion for assessing the condition and prognosis of bullous pemphigoid,and guide the formulation of treatment plan and adjustment of hormone dosage;The heavier the condition of BP patients,the greater initial dose of glucocorticoids should be given;According to the changes of the patient’s condition,proper dosage adjustment and the addition of immunosuppressants can better control the progression of the disease;The principle of hormone reduction during follow-up should follow the principle of slow,regular and individualized.