Prospective studies on the routine use of a novel multivariant enzyme-linked immunosorbent assay for the diagnosis of autoimmune bullous diseases.
Journal article

Prospective studies on the routine use of a novel multivariant enzyme-linked immunosorbent assay for the diagnosis of autoimmune bullous diseases.

  • van Beek N Department of Dermatology, University of Lübeck, Lübeck, Germany.
  • Dähnrich C Institute of Experimental Immunology, Euroimmun, Lübeck, Germany.
  • Johannsen N Institute of Experimental Immunology, Euroimmun, Lübeck, Germany.
  • Lemcke S Department of Dermatology, University of Lübeck, Lübeck, Germany; Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany; Human Immunophenotyping Laboratory, University of Lübeck, Lübeck, Germany.
  • Goletz S Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany.
  • Hübner F Department of Dermatology, University of Lübeck, Lübeck, Germany.
  • Di Zenzo G Molecular and Cell Biology Laboratory, Rome, Italy.
  • Dmochowski M Autoimmune Blistering Dermatoses Section, Department of Dermatology, Poznan University of Medical Sciences, Poznan, Poland.
  • Drenovska K Department of Dermatology and Venereology, Medical Faculty of Medicine, Sofia, Bulgaria.
  • Geller S Dermatology Department Tel Aviv, Sourasky Medical Center, Tel Aviv, Israel.
  • Horn M University Institute of Clinical Chemistry and Center of Laboratory Medicine, Inselspital, Bern, Switzerland.
  • Kowalewski C Dermatology and Immunodermatology, Medical University of Warsaw, Warsaw, Poland.
  • Medenica L Department of Dermatology, University of Belgrade, School of Medicine Pasterova 2, Belgrade, Serbia.
  • Murrell DF Department of Dermatology St George Hospital, University of New South Wales School of Medicine, Sydney, Australia.
  • Patsatsi A Second University Dermatology Department, Aristotle University School of Medicine, Papageorgiou General Hospital, Thessaloniki, Greece.
  • Uzun S Akdeniz University Faculty of Medicine Department of Dermatology, Antalya, Turkey.
  • Vassileva S Department of Dermatology and Venereology, Medical Faculty of Medicine, Sofia, Bulgaria.
  • Zillikens D Department of Dermatology, University of Lübeck, Lübeck, Germany; Human Immunophenotyping Laboratory, University of Lübeck, Lübeck, Germany.
  • Schlumberger W Institute of Experimental Immunology, Euroimmun, Lübeck, Germany.
  • Schmidt E Department of Dermatology, University of Lübeck, Lübeck, Germany; Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany. Electronic address: enno.schmidt@uksh.de.
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  • 2017-01-01
Published in:
  • Journal of the American Academy of Dermatology. - 2017
English BACKGROUND
Serologic diagnosis of autoimmune blistering disease (AIBD) usually follows a sophisticated multistep algorithm.


OBJECTIVE
We sought validation of a multivariant enzyme-linked immunosorbent assay (ELISA) in the routine diagnosis of AIBD.


METHODS
The multivariant ELISA comprising 6 recombinant immunodominant forms of major AIBD target antigens, ie, desmoglein 1, desmoglein 3, envoplakin, BP180, BP230, and type VII collagen was applied in: (1) a cohort of well-characterized AIBD (n = 173) and control sera (n = 130), (2) a prospective multicenter study with 204 sera from patients with newly diagnosed AIBD with positive direct immunofluorescence microscopy, and (3) a prospective monocenter study with 292 consecutive sera from patients with clinical suspicion of AIBD in comparison with the conventional multistep diagnostic algorithm.


RESULTS
Concordant results in the multivariant ELISA compared with direct immunofluorescence microscopy were seen in 94% of patients with pemphigus and 71% of patients with pemphigoid (Cohen κ value, 0.95 and 0.66) and with the conventional multistep diagnostic approach in 91% of patients with pemphigus and 88% of patients with bullous pemphigoid and 93% of autoantibody-negative sera (Cohen κ, 0.95, 0.84, and 0.78).


LIMITATIONS
IgA autoantibodies and less common target antigens were not analyzed.


CONCLUSIONS
The multivariant ELISA is a practical, highly standardized, and widely available novel diagnostic tool for the routine diagnosis of AIBD.
Language
  • English
Open access status
closed
Identifiers
Persistent URL
https://sonar.ch/global/documents/45064
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