BP180 NC16a ELISA Using Bullous Fluid Samples as a Diagnostic Tool for Bullous Pemphigoid

Abstract

Bullous pemphgoid (BP) is an acquired autoimmune subepidermal blistering disease which affects mainly elderly persons. Its target antigens have been proved to be hemidesmosomal cytoplasmic BP230 and transmembrane BP180 proteins. In this study, we investigated the clinical benefit of BP180 NC16a scores measured by enzyme-linked immunosorbent assay (ELISA) using bullous fluid samples and whether the diagnosis of BP might be made without taking lesional biopsies. Seventeen (89.5%) of 19 bullous fluid samples from BP patients were positive, while none of 32 bullous fluid samples from other patients exceeded the cut-off value. Thus, the sensitivity and specificity of BP180 NC16a ELISA using bullous fluid samples, which showed patterns similar to those of serum samples, were 89.5% and 100%, respectively. At the same time, the bullous/serum fluid BP180NC16a ELISA index value ratios were 0.73±0.27 (mean±SD). These findings indicate that BP180NC16a ELISA using bullous fluid samples will be a valuable tool, for diagnosis of patients with BP, because they are similar to serum samples.