The Second Study of Clinical and Immunological Findings in Anti-laminin 332-Type Mucous Membrane Pemphigoid Examined at Kurume University—Diagnosis Criteria Suggested by Summary of 133 Cases

BackgroundRecently, we published an article retrospectively summarizing the results in 55 anti-laminin 332 (LM332)-type mucous membrane pemphigoid (MMP) cases examined at Kurume University, which were diagnosed by strict inclusion criteria, including positive reactivity in direct immunofluorescence...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Hua Qian, Yohei Natsuaki, Hiroshi Koga, Tamihiro Kawakami, Chiharu Tateishi, Daisuke Tsuruta, Norito Ishii, Xiaoguang Li, Takashi Hashimoto
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	anti-laminin-332-type mucous membrane pemphigoid immunoblotting immunofluorescence pathogenesis diagnostic criteria Immunologic diseases. Allergy RC581-607
Acceso en línea:	https://doaj.org/article/9d093b45db3643eeaf5450e9133bbbcf
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:9d093b45db3643eeaf5450e9133bbbcf
record_format	dspace
spelling	oai:doaj.org-article:9d093b45db3643eeaf5450e9133bbbcf2021-12-01T04:44:10ZThe Second Study of Clinical and Immunological Findings in Anti-laminin 332-Type Mucous Membrane Pemphigoid Examined at Kurume University—Diagnosis Criteria Suggested by Summary of 133 Cases1664-322410.3389/fimmu.2021.771766https://doaj.org/article/9d093b45db3643eeaf5450e9133bbbcf2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fimmu.2021.771766/fullhttps://doaj.org/toc/1664-3224BackgroundRecently, we published an article retrospectively summarizing the results in 55 anti-laminin 332 (LM332)-type mucous membrane pemphigoid (MMP) cases examined at Kurume University, which were diagnosed by strict inclusion criteria, including positive reactivity in direct immunofluorescence and absence of antibodies to non-LM332 autoantigens. However, indirect immunofluorescence using 1M-NaCl-split normal human skin (ssIIF) is also valuable for diagnosis of anti-LM332-type MMP.MethodsIn this second study, we selected 133 anti-LM332-type MMP cases, which were diagnosed by our different inclusion criteria: (i) immunoglobulin G (IgG) deposition to basement membrane zone (BMZ) by direct immunofluorescence or IgG reactivity with dermal side of split skin by ssIIF, (ii) positivity for at least one of the three subunits of LM332 by immunoblotting of purified human LM332, and (iii) the presence of mucosal lesions. Clinical, histopathological, and immunological findings were summarized and analyzed statistically. Although these cases included the 55 previous cases, the more detailed study for larger scale of patients was conducted for further characterization.ResultsClinically, among the 133 patients, 89% and 43% patients had oral and ocular mucosal lesions, respectively, 71% had cutaneous lesions, and 17% had associated malignancies. Histopathologically, 93% patients showed subepidermal blisters. The sensitivities of ssIIF and direct immunofluorescence are similar but are significantly higher than indirect immunofluorescence using non-split human skin (both p < 0.001). In immunoblotting of purified LM332, patient IgG antibodies most frequently reacted with LMγ2 subunit (58%), followed by LMα3 (49%) and LMβ3 (36%). Thirty-four percent patients recognized additional non-LM332 autoantigens. Statistical analysis revealed that autoantibodies against non-LM332 autoantigens might stimulate the production of anti-LMγ2 antibodies.ConclusionsThis retrospective study further characterized in more detail the clinical and immunological features of 133 cases of anti-LM332-type MMP, in which the new diagnostic criteria without positive direct immunofluorescence reactivity were useful for the diagnosis. Higher frequency with anti-LMγ2 antibodies suggested more significant pathogenic role of this subunit. Additional autoantibodies to non-LM332 autoantigens detected in one-third of the patients may contribute to complexity in anti-LM332-type MMP, including the induction of anti-LMγ2 antibodies.Hua QianHua QianYohei NatsuakiHiroshi KogaTamihiro KawakamiChiharu TateishiDaisuke TsurutaDaisuke TsurutaNorito IshiiXiaoguang LiXiaoguang LiTakashi HashimotoTakashi HashimotoFrontiers Media S.A.articleanti-laminin-332-type mucous membrane pemphigoidimmunoblottingimmunofluorescencepathogenesisdiagnostic criteriaImmunologic diseases. AllergyRC581-607ENFrontiers in Immunology, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	anti-laminin-332-type mucous membrane pemphigoid immunoblotting immunofluorescence pathogenesis diagnostic criteria Immunologic diseases. Allergy RC581-607
spellingShingle	anti-laminin-332-type mucous membrane pemphigoid immunoblotting immunofluorescence pathogenesis diagnostic criteria Immunologic diseases. Allergy RC581-607 Hua Qian Hua Qian Yohei Natsuaki Hiroshi Koga Tamihiro Kawakami Chiharu Tateishi Daisuke Tsuruta Daisuke Tsuruta Norito Ishii Xiaoguang Li Xiaoguang Li Takashi Hashimoto Takashi Hashimoto The Second Study of Clinical and Immunological Findings in Anti-laminin 332-Type Mucous Membrane Pemphigoid Examined at Kurume University—Diagnosis Criteria Suggested by Summary of 133 Cases
description	BackgroundRecently, we published an article retrospectively summarizing the results in 55 anti-laminin 332 (LM332)-type mucous membrane pemphigoid (MMP) cases examined at Kurume University, which were diagnosed by strict inclusion criteria, including positive reactivity in direct immunofluorescence and absence of antibodies to non-LM332 autoantigens. However, indirect immunofluorescence using 1M-NaCl-split normal human skin (ssIIF) is also valuable for diagnosis of anti-LM332-type MMP.MethodsIn this second study, we selected 133 anti-LM332-type MMP cases, which were diagnosed by our different inclusion criteria: (i) immunoglobulin G (IgG) deposition to basement membrane zone (BMZ) by direct immunofluorescence or IgG reactivity with dermal side of split skin by ssIIF, (ii) positivity for at least one of the three subunits of LM332 by immunoblotting of purified human LM332, and (iii) the presence of mucosal lesions. Clinical, histopathological, and immunological findings were summarized and analyzed statistically. Although these cases included the 55 previous cases, the more detailed study for larger scale of patients was conducted for further characterization.ResultsClinically, among the 133 patients, 89% and 43% patients had oral and ocular mucosal lesions, respectively, 71% had cutaneous lesions, and 17% had associated malignancies. Histopathologically, 93% patients showed subepidermal blisters. The sensitivities of ssIIF and direct immunofluorescence are similar but are significantly higher than indirect immunofluorescence using non-split human skin (both p < 0.001). In immunoblotting of purified LM332, patient IgG antibodies most frequently reacted with LMγ2 subunit (58%), followed by LMα3 (49%) and LMβ3 (36%). Thirty-four percent patients recognized additional non-LM332 autoantigens. Statistical analysis revealed that autoantibodies against non-LM332 autoantigens might stimulate the production of anti-LMγ2 antibodies.ConclusionsThis retrospective study further characterized in more detail the clinical and immunological features of 133 cases of anti-LM332-type MMP, in which the new diagnostic criteria without positive direct immunofluorescence reactivity were useful for the diagnosis. Higher frequency with anti-LMγ2 antibodies suggested more significant pathogenic role of this subunit. Additional autoantibodies to non-LM332 autoantigens detected in one-third of the patients may contribute to complexity in anti-LM332-type MMP, including the induction of anti-LMγ2 antibodies.
format	article
author	Hua Qian Hua Qian Yohei Natsuaki Hiroshi Koga Tamihiro Kawakami Chiharu Tateishi Daisuke Tsuruta Daisuke Tsuruta Norito Ishii Xiaoguang Li Xiaoguang Li Takashi Hashimoto Takashi Hashimoto
author_facet	Hua Qian Hua Qian Yohei Natsuaki Hiroshi Koga Tamihiro Kawakami Chiharu Tateishi Daisuke Tsuruta Daisuke Tsuruta Norito Ishii Xiaoguang Li Xiaoguang Li Takashi Hashimoto Takashi Hashimoto
author_sort	Hua Qian
title	The Second Study of Clinical and Immunological Findings in Anti-laminin 332-Type Mucous Membrane Pemphigoid Examined at Kurume University—Diagnosis Criteria Suggested by Summary of 133 Cases
title_short	The Second Study of Clinical and Immunological Findings in Anti-laminin 332-Type Mucous Membrane Pemphigoid Examined at Kurume University—Diagnosis Criteria Suggested by Summary of 133 Cases
title_full	The Second Study of Clinical and Immunological Findings in Anti-laminin 332-Type Mucous Membrane Pemphigoid Examined at Kurume University—Diagnosis Criteria Suggested by Summary of 133 Cases
title_fullStr	The Second Study of Clinical and Immunological Findings in Anti-laminin 332-Type Mucous Membrane Pemphigoid Examined at Kurume University—Diagnosis Criteria Suggested by Summary of 133 Cases
title_full_unstemmed	The Second Study of Clinical and Immunological Findings in Anti-laminin 332-Type Mucous Membrane Pemphigoid Examined at Kurume University—Diagnosis Criteria Suggested by Summary of 133 Cases
title_sort	second study of clinical and immunological findings in anti-laminin 332-type mucous membrane pemphigoid examined at kurume university—diagnosis criteria suggested by summary of 133 cases
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/9d093b45db3643eeaf5450e9133bbbcf
work_keys_str_mv	AT huaqian thesecondstudyofclinicalandimmunologicalfindingsinantilaminin332typemucousmembranepemphigoidexaminedatkurumeuniversitydiagnosiscriteriasuggestedbysummaryof133cases AT huaqian thesecondstudyofclinicalandimmunologicalfindingsinantilaminin332typemucousmembranepemphigoidexaminedatkurumeuniversitydiagnosiscriteriasuggestedbysummaryof133cases AT yoheinatsuaki thesecondstudyofclinicalandimmunologicalfindingsinantilaminin332typemucousmembranepemphigoidexaminedatkurumeuniversitydiagnosiscriteriasuggestedbysummaryof133cases AT hiroshikoga thesecondstudyofclinicalandimmunologicalfindingsinantilaminin332typemucousmembranepemphigoidexaminedatkurumeuniversitydiagnosiscriteriasuggestedbysummaryof133cases AT tamihirokawakami thesecondstudyofclinicalandimmunologicalfindingsinantilaminin332typemucousmembranepemphigoidexaminedatkurumeuniversitydiagnosiscriteriasuggestedbysummaryof133cases AT chiharutateishi thesecondstudyofclinicalandimmunologicalfindingsinantilaminin332typemucousmembranepemphigoidexaminedatkurumeuniversitydiagnosiscriteriasuggestedbysummaryof133cases AT daisuketsuruta thesecondstudyofclinicalandimmunologicalfindingsinantilaminin332typemucousmembranepemphigoidexaminedatkurumeuniversitydiagnosiscriteriasuggestedbysummaryof133cases AT daisuketsuruta thesecondstudyofclinicalandimmunologicalfindingsinantilaminin332typemucousmembranepemphigoidexaminedatkurumeuniversitydiagnosiscriteriasuggestedbysummaryof133cases AT noritoishii thesecondstudyofclinicalandimmunologicalfindingsinantilaminin332typemucousmembranepemphigoidexaminedatkurumeuniversitydiagnosiscriteriasuggestedbysummaryof133cases AT xiaoguangli thesecondstudyofclinicalandimmunologicalfindingsinantilaminin332typemucousmembranepemphigoidexaminedatkurumeuniversitydiagnosiscriteriasuggestedbysummaryof133cases AT xiaoguangli thesecondstudyofclinicalandimmunologicalfindingsinantilaminin332typemucousmembranepemphigoidexaminedatkurumeuniversitydiagnosiscriteriasuggestedbysummaryof133cases AT takashihashimoto thesecondstudyofclinicalandimmunologicalfindingsinantilaminin332typemucousmembranepemphigoidexaminedatkurumeuniversitydiagnosiscriteriasuggestedbysummaryof133cases AT takashihashimoto thesecondstudyofclinicalandimmunologicalfindingsinantilaminin332typemucousmembranepemphigoidexaminedatkurumeuniversitydiagnosiscriteriasuggestedbysummaryof133cases AT huaqian secondstudyofclinicalandimmunologicalfindingsinantilaminin332typemucousmembranepemphigoidexaminedatkurumeuniversitydiagnosiscriteriasuggestedbysummaryof133cases AT huaqian secondstudyofclinicalandimmunologicalfindingsinantilaminin332typemucousmembranepemphigoidexaminedatkurumeuniversitydiagnosiscriteriasuggestedbysummaryof133cases AT yoheinatsuaki secondstudyofclinicalandimmunologicalfindingsinantilaminin332typemucousmembranepemphigoidexaminedatkurumeuniversitydiagnosiscriteriasuggestedbysummaryof133cases AT hiroshikoga secondstudyofclinicalandimmunologicalfindingsinantilaminin332typemucousmembranepemphigoidexaminedatkurumeuniversitydiagnosiscriteriasuggestedbysummaryof133cases AT tamihirokawakami secondstudyofclinicalandimmunologicalfindingsinantilaminin332typemucousmembranepemphigoidexaminedatkurumeuniversitydiagnosiscriteriasuggestedbysummaryof133cases AT chiharutateishi secondstudyofclinicalandimmunologicalfindingsinantilaminin332typemucousmembranepemphigoidexaminedatkurumeuniversitydiagnosiscriteriasuggestedbysummaryof133cases AT daisuketsuruta secondstudyofclinicalandimmunologicalfindingsinantilaminin332typemucousmembranepemphigoidexaminedatkurumeuniversitydiagnosiscriteriasuggestedbysummaryof133cases AT daisuketsuruta secondstudyofclinicalandimmunologicalfindingsinantilaminin332typemucousmembranepemphigoidexaminedatkurumeuniversitydiagnosiscriteriasuggestedbysummaryof133cases AT noritoishii secondstudyofclinicalandimmunologicalfindingsinantilaminin332typemucousmembranepemphigoidexaminedatkurumeuniversitydiagnosiscriteriasuggestedbysummaryof133cases AT xiaoguangli secondstudyofclinicalandimmunologicalfindingsinantilaminin332typemucousmembranepemphigoidexaminedatkurumeuniversitydiagnosiscriteriasuggestedbysummaryof133cases AT xiaoguangli secondstudyofclinicalandimmunologicalfindingsinantilaminin332typemucousmembranepemphigoidexaminedatkurumeuniversitydiagnosiscriteriasuggestedbysummaryof133cases AT takashihashimoto secondstudyofclinicalandimmunologicalfindingsinantilaminin332typemucousmembranepemphigoidexaminedatkurumeuniversitydiagnosiscriteriasuggestedbysummaryof133cases AT takashihashimoto secondstudyofclinicalandimmunologicalfindingsinantilaminin332typemucousmembranepemphigoidexaminedatkurumeuniversitydiagnosiscriteriasuggestedbysummaryof133cases
_version_	1718405787729002496

The Second Study of Clinical and Immunological Findings in Anti-laminin 332-Type Mucous Membrane Pemphigoid Examined at Kurume University—Diagnosis Criteria Suggested by Summary of 133 Cases

Ejemplares similares