Volume 48, Issue 9 pp. 1372-1380

ORIGINAL ARTICLE

BP230 IgE autoantibodies in topical-steroid-resistant bullous pemphigoid

Yen-chi Shih,

Yen-chi Shih

orcid.org/0000-0002-5424-1331

Department of Dermatology, School of Medicine, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China

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Huijie Yuan,

Huijie Yuan

Department of Dermatology, School of Medicine, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China

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Jia Shen,

Jia Shen

Department of Dermatology, School of Medicine, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China

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Jie Zheng,

Jie Zheng

orcid.org/0000-0002-7961-6427

Department of Dermatology, School of Medicine, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China

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Meng Pan,

Corresponding Author

Meng Pan

[email protected]

Department of Dermatology, School of Medicine, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China

Correspondence

Meng Pan, Department of Dermatology, School of Medicine, Ruijin Hospital, Shanghai Jiao Tong University, 197 Ruijin Er Rd Shanghai 200025, China.

Email: [email protected]

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Yen-chi Shih,

Yen-chi Shih

orcid.org/0000-0002-5424-1331

Department of Dermatology, School of Medicine, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China

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Huijie Yuan,

Huijie Yuan

Department of Dermatology, School of Medicine, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China

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Jia Shen,

Jia Shen

Department of Dermatology, School of Medicine, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China

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Jie Zheng,

Jie Zheng

orcid.org/0000-0002-7961-6427

Department of Dermatology, School of Medicine, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China

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Meng Pan,

Corresponding Author

Meng Pan

[email protected]

Department of Dermatology, School of Medicine, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China

Correspondence

Meng Pan, Department of Dermatology, School of Medicine, Ruijin Hospital, Shanghai Jiao Tong University, 197 Ruijin Er Rd Shanghai 200025, China.

Email: [email protected]

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First published: 14 June 2021

https://doi.org/10.1111/1346-8138.15952

Citations: 3

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Abstract

Background

IgE autoantibodies targeting BP230 can be identified in 38%–68% of bullous pemphigoid (BP) patients, yet the diagnostic and pathogenic value of anti-BP230 IgE still remains inconclusive.

Objective

We intend to investigate the clinical and immunological characteristics of anti-BP230 IgE in BP patients.

Methods and Results

Fifty-four BP patients were divided into two groups based on the responsiveness of a topical steroid. We investigated clinical features and IgE autoantibodies profiles by indirect immunofluorescence, ELISA and western blot between the two groups. BP disease area index (BPDAI) scores, total IgE, peripheral eosinophil counts, and anti-BP230 IgE level were significantly higher in the topical-steroid-resistant group. The majority of topical-steroid-resistant patients present with blister/erythematous phenotype (64.3%) and anti-BP230 IgE (59.5%), which correlates with total IgE levels. ELISAs of domain-specific BP230 recombinant proteins indicated that IgE in the topical-steroid-resistant group can react with all seven domains of BP230 and more frequently with the BP230-R1 epitope.

Conclusion

Anti-BP230 IgE is more frequently observed in topical-steroid-therapy-resistant patients and the prefers R1 domain of BP230, which is not included in commercially available testing kits. Our study further suggests the pathogenic role of anti-BP230 IgE in BP. Performing anti-BP230 IgE detection can serve as an indicator for initiating systemic steroid therapy.

CONFLICT OF INTEREST

None declared.

Supporting Information

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Citing Literature

Volume48, Issue9

September 2021

Pages 1372-1380

Filename	Description
jde15952-sup-0001-FigS1-S2.docxWord document, 85.3 KB	Figures S1. The correlation between BPDAI and albumin level-S2. The correlation between BP230 IgE and BPDAI level
jde15952-sup-0002-TableS1.docxWord document, 28.6 KB	Table S1. Patients characteristics

BP230 IgE autoantibodies in topical-steroid-resistant bullous pemphigoid

Abstract

Background

Objective

Methods and Results

Conclusion

CONFLICT OF INTEREST

Supporting Information

REFERENCES

Citing Literature

References

Information

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BP230 IgE autoantibodies in topical-steroid-resistant bullous pemphigoid

Abstract

Background

Objective

Methods and Results

Conclusion

CONFLICT OF INTEREST

Supporting Information

REFERENCES

Citing Literature

References

Related

Information