Highlights
- •Bullous pemphigoid (BP) mostly involves the elderly.
- •Anti-BP180 NC16A IgG antibodies could be used for enzyme-linked immunosorbent assay (ELISA) in BP diagnosis.
- •The level of anti-BP180 NC16A IgG parallels to the disease activity.
- •The immune colloidal gold technique (ICGT) shows perfect concordance with the conventional ELISA in BP antibody detection.
- •Compared with ELISA, ICGT has undeniable advantages: flexible, inexpensive, easy-to-operate and quick read-out.
- •ICGT shows high potential as a rapid and stable option for the diagnosis and monitoring of BP.
Abstract
Background
Bullous pemphigoid (BP) mostly involves elderly patients. The diagnosis of BP requires
special immunological tests, which makes some patients unable to be diagnosed and
treated timely.
Objective
The accuracy and application value of immune colloidal gold technique (ICGT) in BP
were evaluated. The colloidal gold was conjugated with recombinant BP180 NC16A protein
and mouse IgG antibody. As the test and control lines, the mouse-anti-human IgG and
goat-anti-mouse IgG, respectively, were blotted on the nitrocellulose membrane.
Methods
414 serum samples of consecutive patients with suspected BP and 15 samples from healthy
donors were recruited. The consistency between ICGT and ELISA, and between serum and
plasma/whole blood were evaluated. Subgroup analyses were performed in terms of clinical
characteristics. We also followed up 65 BP patients’ strip results to explore the
predictive value of ICGT.
Results
Strong agreements between ICGT and ELISA(κ = 0.902) and between plasma/whole blood
and serum samples (κ = 0.980) with good stability were observed. The ICGT achieved
sensitivity of 93.9%, and specificity of 97.6%. In subgroup analysis, the sensitivity
was significantly higher in older patients (96.3%), and with more typical lesions
such as blisters (96.2%) and erosions (92.4%). In follow-up, we also found BP patients
who kept ICGT-negative in remission state all got consecutive positive strips 1–3
weeks prior to mild new activity or flare.
Conclusion
ICGT shows high potential as a rapid and stable option for the diagnosis and monitoring
of BP. Further investigations are needed to re-evaluate this technique in a prospective
study with a multicenter design.
Keywords
Abbreviations:
AIBD (autoimmune blistering disease), BP (bullous pemphioid), ELISA (enzyme linked immunosorbent assay), ICGT (immune colloidal gold technique)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: December 24, 2022
Accepted:
December 20,
2022
Received in revised form:
November 26,
2022
Received:
October 26,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Japanese Society for Investigative Dermatology. Published by Elsevier B.V. All rights reserved.
