Detection of IgE autoantibodies to BP180 and BP230 and their relationship to clinical features in bullous pemphigoid

Abstract

Background

IgE autoantibodies are considered to be involved in pathogenesis of bullous pemphigoid (BP), particularly inflammatory and erythematous phenotypes.

Objective

To develop reliable ELISAs for detection of IgE autoantibodies to both BP180 and BP230 in BP sera, and to compare the ELISA results with clinical features.

Methods

We used commercially available IgG ELISAs to develop IgE ELISAs for both BP180 and BP230. To determine the influence of excess amount of IgG autoantibodies, all normal and BP sera were tested before and after IgG adsorption. The results of IgE ELISAs were statistically compared among various ELISAs, and with various clinical parameters, including our own severity scores and BP phenotypes.

Results

IgG adsorption generally showed no changes in sensitivity and specificity of IgE ELISAs, although slight cross-reactivity of anti-IgE secondary antibody to IgG and interference of excess amount of IgG autoantibodies to IgE reactivity were suggested. IgE autoantibodies to BP180 and BP230 were found in 21 and 18 of 36 BP sera, respectively. The results of IgG and IgE ELISAs for both BP180 and BP230 well correlated. IgG and IgE anti-BP180 antibodies, but not IgG and IgE anti-BP230 autoantibodies, correlated with disease activity. IgE anti-BP30 autoantibodies correlated with nodular phenotype but not erythematous phenotype.

Conclusion

The results in this study indicated that IgE autoantibodies to both BP180 and BP230 are frequently detected in BP sera. IgE anti-BP180 autoantibodies seemed to be pathogenic, while association between IgE autoantibodies and inflammatory BP phenotype was not indicated.

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