Epidermolysis bullosa acquisita associated with epidermal-binding circulating antibodies.

Epidermolysis bullosa acquisita (EBA) is a rare, immunobullous disease, characterized by circulating and tissue-bound antibodies against type VII collagen (C7) of anchoring fibrils in the cutaneous basement membrane zone. These antibodies localize to the dermal aspect of salt-split skin on indirect...

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Main Authors: Wakelin, S, Bhogal, B, Black, M, Allen, J, Wojnarowska, F, Hashimoto, T, Farr, P, Swain, A
Format: Journal article
Language:English
Published: 1997
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author Wakelin, S
Bhogal, B
Black, M
Allen, J
Wojnarowska, F
Hashimoto, T
Farr, P
Swain, A
author_facet Wakelin, S
Bhogal, B
Black, M
Allen, J
Wojnarowska, F
Hashimoto, T
Farr, P
Swain, A
author_sort Wakelin, S
collection OXFORD
description Epidermolysis bullosa acquisita (EBA) is a rare, immunobullous disease, characterized by circulating and tissue-bound antibodies against type VII collagen (C7) of anchoring fibrils in the cutaneous basement membrane zone. These antibodies localize to the dermal aspect of salt-split skin on indirect and direct immunofluorescence (IMF). We report two patients with clinical features of EBA, in whom circulating IgG antibodies bound to the epidermal aspect of salt-split skin. In both patients direct IMF of salt-split perilesional skin revealed dermal IgG deposits, and direct immunogold immunoelectron microscopy showed antibody deposits in the region of anchoring fibrils. Their serum failed to react with epidermal or dermal extracts on Western immunoblotting. Epidermal-binding antibodies have not been reported previously in association with EBA, and the IMF findings in these cases suggest the development of autoantibodies to additional epidermal-associated antigens. Target antigen heterogeneity has been reported in most other immunobullous diseases, and may be a hitherto unrecognized feature of EBA.
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spelling oxford-uuid:dbf210aa-5cc9-4578-8ebf-dc36bd32b73b2022-03-27T09:14:15ZEpidermolysis bullosa acquisita associated with epidermal-binding circulating antibodies.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:dbf210aa-5cc9-4578-8ebf-dc36bd32b73bEnglishSymplectic Elements at Oxford1997Wakelin, SBhogal, BBlack, MAllen, JWojnarowska, FHashimoto, TFarr, PSwain, AEpidermolysis bullosa acquisita (EBA) is a rare, immunobullous disease, characterized by circulating and tissue-bound antibodies against type VII collagen (C7) of anchoring fibrils in the cutaneous basement membrane zone. These antibodies localize to the dermal aspect of salt-split skin on indirect and direct immunofluorescence (IMF). We report two patients with clinical features of EBA, in whom circulating IgG antibodies bound to the epidermal aspect of salt-split skin. In both patients direct IMF of salt-split perilesional skin revealed dermal IgG deposits, and direct immunogold immunoelectron microscopy showed antibody deposits in the region of anchoring fibrils. Their serum failed to react with epidermal or dermal extracts on Western immunoblotting. Epidermal-binding antibodies have not been reported previously in association with EBA, and the IMF findings in these cases suggest the development of autoantibodies to additional epidermal-associated antigens. Target antigen heterogeneity has been reported in most other immunobullous diseases, and may be a hitherto unrecognized feature of EBA.
spellingShingle Wakelin, S
Bhogal, B
Black, M
Allen, J
Wojnarowska, F
Hashimoto, T
Farr, P
Swain, A
Epidermolysis bullosa acquisita associated with epidermal-binding circulating antibodies.
title Epidermolysis bullosa acquisita associated with epidermal-binding circulating antibodies.
title_full Epidermolysis bullosa acquisita associated with epidermal-binding circulating antibodies.
title_fullStr Epidermolysis bullosa acquisita associated with epidermal-binding circulating antibodies.
title_full_unstemmed Epidermolysis bullosa acquisita associated with epidermal-binding circulating antibodies.
title_short Epidermolysis bullosa acquisita associated with epidermal-binding circulating antibodies.
title_sort epidermolysis bullosa acquisita associated with epidermal binding circulating antibodies
work_keys_str_mv AT wakelins epidermolysisbullosaacquisitaassociatedwithepidermalbindingcirculatingantibodies
AT bhogalb epidermolysisbullosaacquisitaassociatedwithepidermalbindingcirculatingantibodies
AT blackm epidermolysisbullosaacquisitaassociatedwithepidermalbindingcirculatingantibodies
AT allenj epidermolysisbullosaacquisitaassociatedwithepidermalbindingcirculatingantibodies
AT wojnarowskaf epidermolysisbullosaacquisitaassociatedwithepidermalbindingcirculatingantibodies
AT hashimotot epidermolysisbullosaacquisitaassociatedwithepidermalbindingcirculatingantibodies
AT farrp epidermolysisbullosaacquisitaassociatedwithepidermalbindingcirculatingantibodies
AT swaina epidermolysisbullosaacquisitaassociatedwithepidermalbindingcirculatingantibodies