Riassunto
Premesse
La diagnosi di pemfigoide bolloso (PB) si basa sulla presenza di criteri clinici e di laboratorio che comprendono la ricerca di autoanticorpi diretti contro proteine della giunzione dermo-epidermica. Recentemente sono stati sviluppati metodi immunoenzimatici che utilizzano peptidi umani ricombinanti e ricercano autoanticorpi specifici di malattia. In questo studio abbiamo valutato se esiste un’associazione tra i livelli di autoanticorpi anti-BP180 e anti-BP230 e l’attività di malattia e la remissione clinica in pazienti affetti da PB.
Metodi
Da gennaio 2008 a gennaio 2010 sono stati arruolati 52 pazienti affetti da PB, 25 dei quali hanno avuto un follow-up di 12 mesi. Gli autoanticorpi anti-BP180 e anti-BP230 sono stati ricercati con metodo immunoenzimatico nel campione basale e nel follow-up.
Risultati
Al momento dell’arruolamento 43 pazienti erano positivi agli autoanticorpi anti-BP180 (83%) e 19 pazienti agli autoanticorpi anti-BP230 (36%). Complessivamente, 44/52 pazienti (85%) erano positivi ad almeno un autoanticorpo. In un modello di regressione multipla, il dosaggio degli autoanticorpi anti-BP180 ha mostrato la più forte associazione con l’attività di malattia. La positività agli autoanticorpi anti-BP230 ha invece riportato il più alto valore di Odds Ratio nel predire la mancata remissione di malattia.
Conclusioni
Gli autoanticorpi anti-BP180 e anti-BP230 non sono marcatori predittivi equivalenti di severità di malattia e remissione clinica, pertanto l’utilizzo di entrambi sembra giustificato non solo nella fase diagnostica, ma anche nel follow-up clinico dei pazienti affetti da PB.
Summary
Background
The diagnosis of bullous pemphigoid (BP) is based on the presence of clinical and laboratory criteria, including the search for autoantibodies directed against proteins of the dermoepidermal junction. Human recombinant BP180 and BP230 peptides have been used to develop new quantitative enzyme immunoassays for the detection of specific antibodies. The aim of our study was to evaluate the association of anti-BP180 and anti-BP230 autoantibody levels with disease activity and clinical remission in patients with PB.
Methods
From January 2008 to January 2010, 52 patients with PB were enrolled; 25 patients completed a follow-up of 12 months. Autoantibodies anti-BP180 and anti-BP230 were investigated by enzyme immunoassay.
Results
Of the 52 patients, 43 (83%) were positive for anti-BP180 autoantibodies, 19 (36%) for autoantibodies to BP230, and 44 (85%) for at least one of the two autoantibodies. In a multivariate analysis, anti-BP180 levels showed the strongest association with disease activity. The positivity for anti-BP230 autoantibodies had the highest Odds Ratio for predicting the failure of disease remission.
Conclusions
Autoantibodies against BP230 and BP180 are not equivalent predictive markers of disease severity and clinical remission; hence, the use of both is justified, not only in the diagnostic phase, but also in the clinical follow-up of patients with PB.
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Tampoia, M., Zucano, A., Bizzaro, N. et al. Gli autoanticorpi anti-BP180 e anti-BP230 sono marcatori predittivi ma non equivalenti di severità di malattia e di remissione clinica nel pemfigoide bolloso. Riv Ital Med Lab 7, 42–48 (2011). https://doi.org/10.1007/s13631-011-0007-y
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DOI: https://doi.org/10.1007/s13631-011-0007-y
Parole chiave
- Pemfigoide bolloso
- Autoanticorpi anti-BP180
- Autoanticorpi anti-BP230
- Marcatori predittivi
- Severità di malattia