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Clinical and Diagnostic Laboratory Immunology, July 2004, p. 762-765, Vol. 11, No. 4
1071-412X/04/$08.00+0     DOI: 10.1128/CDLI.11.4.762-765.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.

Evaluation of Recombinant Antigen-Based Assays for Diagnosis of Bullous Autoimmune Diseases

G. D'Agosto,1 A. Latini,2 M. Carducci,2 A. Mastroianni,2 A. Vento,1 and P. Cordiali Fei1*

Laboratory of Clinical Pathology,1 Clinical Dermatology Division, Istituto San Gallicano IRCCS, Rome, Italy2

Received 18 February 2004/ Returned for modification 1 April 2004/ Accepted 15 April 2004

The diagnosis of autoimmune bullous diseases is based on clinical observation and on the presence of autoantibodies directed to molecules involved in the adhesion systems of the skin. Immunofluorescence assays are the currently accepted method for detection of autoantibodies; such assays depend greatly on the skill of operators and are difficult to standardize. Recombinant desmoglein-1 (Dsg1), Dsg3, and BP180 peptides, the main autoantigens in pemphigus or bullous pemphigoid, have been used to develop new quantitative enzyme immunoassays (EIA) for the detection of specific antibodies. The present study was undertaken to evaluate the sensitivity and specificity of these immunoassays and to determine the correlation between the results and the clinical aspects of diseases. Serum samples from patients with pemphigus vulgaris, pemphigus foliaceus, bullous pemphigoid, or mucous membrane pemphigoid, from healthy individuals, and from patients with unrelated autoimmune conditions were tested. Anti-desmoglein reactivity was detected in all the patients with pemphigus and in none of the controls. Patients with the more benign form of cutaneous disease had anti-Dsg1 antibodies, while patients with deeper cutaneous lesions or with mucosal involvement had anti-Dsg3 reactivity also, or exclusively. The BP180-based assay was positive for 66.6% of patients with bullous pemphigoid and for none of the patients with mucous membrane pemphigoid, and no reactivity was detected in the control sera. In conclusion, the anti-Dsg1 and anti-Dsg3 assays are useful in the diagnosis of pemphigus and provide information on the clinical phenotype of the disease. However, the sensitivity of EIA for detection of autoantibodies in bullous pemphigoid should be improved by the use of additional antigens or epitopes.

* Corresponding author. Mailing address: Laboratory of Clinical Pathology, Istituto San Gallicano IRCCS, Via Elio Chianesi, 53, 00144 Rome, Italy. Phone: 39 06 5266 5245. Fax: 39 06 5266 6118. E-mail: cordiali-fei{at}ifo.it.

Clinical and Diagnostic Laboratory Immunology, July 2004, p. 762-765, Vol. 11, No. 4
1071-412X/04/$08.00+0     DOI: 10.1128/CDLI.11.4.762-765.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.





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