Tags

Type your tag names separated by a space and hit enter

Serological diagnostics in the detection of IgG autoantibodies against human collagen VII in epidermolysis bullosa acquisita: a multicentre analysis.
Br J Dermatol. 2017 12; 177(6):1683-1692.BJ

Abstract

BACKGROUND

Epidermolysis bullosa acquisita (EBA) is a rare, potentially devastating autoimmune disease of the skin. IgG autoantibodies directed against type VII collagen (Col7), the major component of anchoring fibrils, induce skin fragility leading to cutaneous and mucocutaneous blister formation, which is mostly of a scarring phenotype. Thus, powerful and reproducible diagnostic assays are critical to establish the diagnosis of EBA early to avoid irreversible sequelae.

OBJECTIVES

The present international, retrospective multicentre study included a large cohort of patients with EBA and evaluated the diagnostic power of four different diagnostic assays for the detection of anti-Col7 IgG autoantibodies.

METHODS

Overall, 95 EBA sera and 200 control sera consisting of 100 bullous pemphigoid sera, 50 pemphigus vulgaris sera and 50 sera of healthy controls were tested for anti-Col7 IgG autoantibodies using indirect immunofluorescence (IIF), two commercial enzyme-linked immunosorbent assay (ELISA) systems and Western blot (WB) analysis. EBA sera were taken from patients with positive direct immunofluorescence and IgG reactivity in at least one of the immunoserological assays (IIF, ELISA, WB).

RESULTS

A Col7-NC1/NC2 ELISA (MBL, Nagoya, Japan) showed the highest sensitivity (97·9%), followed by a Col7-NC1 ELISA (Euroimmun, Lübeck, Germany) (89·5%), WB with Col7-NC1 (85·3%), and IIF on saline-split human skin (74·7%). The specificities of both ELISA systems were comparable (NC1 98·7%, NC1/NC2 99·3%). Furthermore, WB was more sensitive than IIF, which was more specific.

CONCLUSIONS

The two commercially available ELISA systems allow for a highly sensitive and specific diagnosis of EBA. The sensitivity of the Col7-NC1/NC2 ELISA is significantly higher compared with the ELISA based on the Col7-NC1 domain only.

Authors+Show Affiliations

Department of Dermatology and Allergology, Philipps-University, Marburg, D-35043, Germany.Department of Dermatology and Allergology, Philipps-University, Marburg, D-35043, Germany.Department of Dermatology and Allergology, Philipps-University, Marburg, D-35043, Germany.Department of Dermatology and Allergology, Philipps-University, Marburg, D-35043, Germany.Istituto Dermopatico dell'Immacolata, Rome, Italy.Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Università degli Studi di Milano - Unità Operativa di Dermatologia, IRCCS Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.Department of Dermatology, Venereology and Allergology, Julius-Maximilians-University Würzburg, Würzburg, Germany.Dermatology, IRCCS AOU San Martino Di.S.Sal., Genoa, Italy.Department of Dermatology, Medical Center, University of Freiburg, Freiburg, Germany.Department of Dermatology, Medical Center, University of Freiburg, Freiburg, Germany.Department of Dermatovenerology, University of Zagreb, Zagreb, Croatia.München, Department of Dermatology and Allergology, Ludwig Maximilians University Munich, Munich, Germany.Department of Dermatology and Venereology, Faculty of Medicine, Akdeniz University, Antalya, Turkey.Department of Dermatovenereology, St. Anna University Hospital, Masaryk University, Brno, Czech Republic.Department of Dermatology, University Hospital of Schleswig-Holstein, Kiel, Germany.Medical and Biological Laboratories, Co. Ltd, Nagoya, Japan.Department of Dermatology and Allergology, Philipps-University, Marburg, D-35043, Germany.Department of Dermatology and Allergology, Philipps-University, Marburg, D-35043, Germany.Department of Dermatology, Kurume University School of Medicine, Kurume, Japan.Institute of Biometry and Statistics, Philipps-University Marburg, D-35043, Marburg, Germany.Department of Dermatology, Kurume University School of Medicine, Kurume, Japan.Department of Dermatology and Allergology, Philipps-University, Marburg, D-35043, Germany.

Pub Type(s)

Evaluation Study
Journal Article
Multicenter Study

Language

eng

PubMed ID

28703393

Citation

Schmidt, T, et al. "Serological Diagnostics in the Detection of IgG Autoantibodies Against Human Collagen VII in Epidermolysis Bullosa Acquisita: a Multicentre Analysis." The British Journal of Dermatology, vol. 177, no. 6, 2017, pp. 1683-1692.
Schmidt T, Hoch M, Lotfi Jad SS, et al. Serological diagnostics in the detection of IgG autoantibodies against human collagen VII in epidermolysis bullosa acquisita: a multicentre analysis. Br J Dermatol. 2017;177(6):1683-1692.
Schmidt, T., Hoch, M., Lotfi Jad, S. S., Solimani, F., Di Zenzo, G., Marzano, A. V., Goebeler, M., Cozzani, E., Kern, J. S., Sitaru, C., Lakoš Jukić, I., Sárdy, M., Uzun, S., Jedlickova, H., Gläser, R., Kaneda, M., Eming, R., Göpel, G., Ishii, N., ... Hertl, M. (2017). Serological diagnostics in the detection of IgG autoantibodies against human collagen VII in epidermolysis bullosa acquisita: a multicentre analysis. The British Journal of Dermatology, 177(6), 1683-1692. https://doi.org/10.1111/bjd.15800
Schmidt T, et al. Serological Diagnostics in the Detection of IgG Autoantibodies Against Human Collagen VII in Epidermolysis Bullosa Acquisita: a Multicentre Analysis. Br J Dermatol. 2017;177(6):1683-1692. PubMed PMID: 28703393.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Serological diagnostics in the detection of IgG autoantibodies against human collagen VII in epidermolysis bullosa acquisita: a multicentre analysis. AU - Schmidt,T, AU - Hoch,M, AU - Lotfi Jad,S S, AU - Solimani,F, AU - Di Zenzo,G, AU - Marzano,A V, AU - Goebeler,M, AU - Cozzani,E, AU - Kern,J S, AU - Sitaru,C, AU - Lakoš Jukić,I, AU - Sárdy,M, AU - Uzun,S, AU - Jedlickova,H, AU - Gläser,R, AU - Kaneda,M, AU - Eming,R, AU - Göpel,G, AU - Ishii,N, AU - Greene,B, AU - Hashimoto,T, AU - Hertl,M, Y1 - 2017/12/01/ PY - 2017/06/28/accepted PY - 2017/7/14/pubmed PY - 2019/3/26/medline PY - 2017/7/14/entrez SP - 1683 EP - 1692 JF - The British journal of dermatology JO - Br J Dermatol VL - 177 IS - 6 N2 - BACKGROUND: Epidermolysis bullosa acquisita (EBA) is a rare, potentially devastating autoimmune disease of the skin. IgG autoantibodies directed against type VII collagen (Col7), the major component of anchoring fibrils, induce skin fragility leading to cutaneous and mucocutaneous blister formation, which is mostly of a scarring phenotype. Thus, powerful and reproducible diagnostic assays are critical to establish the diagnosis of EBA early to avoid irreversible sequelae. OBJECTIVES: The present international, retrospective multicentre study included a large cohort of patients with EBA and evaluated the diagnostic power of four different diagnostic assays for the detection of anti-Col7 IgG autoantibodies. METHODS: Overall, 95 EBA sera and 200 control sera consisting of 100 bullous pemphigoid sera, 50 pemphigus vulgaris sera and 50 sera of healthy controls were tested for anti-Col7 IgG autoantibodies using indirect immunofluorescence (IIF), two commercial enzyme-linked immunosorbent assay (ELISA) systems and Western blot (WB) analysis. EBA sera were taken from patients with positive direct immunofluorescence and IgG reactivity in at least one of the immunoserological assays (IIF, ELISA, WB). RESULTS: A Col7-NC1/NC2 ELISA (MBL, Nagoya, Japan) showed the highest sensitivity (97·9%), followed by a Col7-NC1 ELISA (Euroimmun, Lübeck, Germany) (89·5%), WB with Col7-NC1 (85·3%), and IIF on saline-split human skin (74·7%). The specificities of both ELISA systems were comparable (NC1 98·7%, NC1/NC2 99·3%). Furthermore, WB was more sensitive than IIF, which was more specific. CONCLUSIONS: The two commercially available ELISA systems allow for a highly sensitive and specific diagnosis of EBA. The sensitivity of the Col7-NC1/NC2 ELISA is significantly higher compared with the ELISA based on the Col7-NC1 domain only. SN - 1365-2133 UR - https://www.unboundmedicine.com/medline/citation/28703393/Serological_diagnostics_in_the_detection_of_IgG_autoantibodies_against_human_collagen_VII_in_epidermolysis_bullosa_acquisita:_a_multicentre_analysis_ L2 - https://doi.org/10.1111/bjd.15800 DB - PRIME DP - Unbound Medicine ER -