Related Experiment Videos
Does class switching contribute to remission in bullous pemphigoid?
B Modre1, J Allen, F Wojnarowska
1Department of Dermatology, Oxford Radcliffe Hospital, UK.
Acta Dermato-Venereologica
|May 6, 1999
Summary
In bullous pemphigoid, a shift from inflammatory Immunoglobulin G1 (IgG1) to blocking Immunoglobulin G4 (IgG4) autoantibodies correlates with disease remission. This isotype switching may explain disease improvement.
Area of Science:
- Immunology
- Dermatology
- Autoimmune Diseases
Background:
- Demonstrating a correlation between circulating IgG autoantibody titers and bullous pemphigoid (BP) disease activity has been challenging.
- It is hypothesized that a shift in antibody isotype from pro-inflammatory IgG1 to blocking IgG4 may contribute to disease remission in BP.
Purpose of the Study:
- To investigate the correlation between IgG subclass autoantibody titers and clinical disease activity in bullous pemphigoid and other bullous diseases.
- To explore the potential role of isotype switching from IgG1 to IgG4 in disease remission.
Main Methods:
- Studied 16 patients with bullous pemphigoid, 3 with cicatricial pemphigoid, and 2 with epidermolysis bullosa acquisita at various disease stages.
- Measured the titers of IgG subclass and total IgG basement membrane zone autoantibodies.
- Correlated autoantibody titers with clinical disease activity and remission status.
Main Results:
- In bullous pemphigoid patients who achieved remission, IgG1 autoantibody levels decreased, while IgG4 autoantibody levels increased.
- Patients with active disease did not exhibit these specific changes in IgG1 and IgG4 autoantibodies.
- Similar trends were observed in other bullous diseases studied.
Conclusions:
- Isotype switching from IgG1 to IgG4 autoantibodies appears to correlate with clinical improvement in bullous pemphigoid.
- This antibody subclass shift may represent a mechanism contributing to disease remission in bullous pemphigoid and potentially other autoimmune blistering diseases.