Evaluation of bullous pemphigoid 180 ELISA in the diagnosis of bullous pemphigoid patients

Background Bullous pemphigoid (BP) is an acquired autoimmune blistering skin disease that targets the dermoepidermal adhesion molecules – BP180 and BP230. BP180 is considered the immunodominant epitope of BP. Bullous pemphigoid disease area index (BPDAI) is a scoring system developed by the international autoimmune bullous disease committee to assess the disease severity of BP patients. Objective The aim of the study was to evaluate the usefulness of BP180 enzyme-linked immunosorbent assay (ELISA) in the diagnosis of a sample of Egyptian BP patients in a hospital-based study. Patients and methods Fifteen patients who fulfilled the clinical and pathological criteria of BP and 15 agematched and sex-matched volunteers participated in this study. The disease severity was assessed by BPDAI. Skin biopsies were obtained from 15 patients and tested using direct immunofluorescence (DIF). Serum samples were obtained from all 30 participants and tested using BP180 ELISA. Follow-up of the disease time course of three patients was performed every month for 6 months. Results All patients were positive by DIF and showed linear immunoglobulin G deposits along the dermoepidermal junction. Of the 15 patients, six were positive using BP180 ELISA, whereas nine were negative. The baseline BP180 ELISA index of patients ranged from 0.5 to 146. The median ELISA index was 24. All controls were negative using ELISA. The baseline BPDAI of patients ranged from 3 to 30. The median BPDAI was 5. The baseline BPDAI positively correlated with the baseline BP180 ELISA index of patients. The correlation coefficient was 0.790, P value was 0.0005. Conclusion BP180 ELISA can be useful in the diagnosis and follow-up of some BP patients; however, DIF remains the standard method for diagnosis of this disease.