Autoimmune blistering diseases: characterization of target antigens

The development of techniques for identification of antigens has had broad application and success in the field of immunodermatology. During the past 10 years, a variety of skin autoantigens, including those found within the epidermis such as in pemphigus and those defined as extracellular matrix proteins such as in EBA, have been identified as the specific targets for autoantibody binding. The intrinsic function of all the autoantigens identified to date is adhesion, either cell-to-cell or cell-to-substrate. The binding of autoantibodies to these adhesion proteins abrogates this critical function via mechanisms not yet clearly understood. Further investigations will focus not only on the characterization of additional autoantigenic targets, but also on identifying mechanisms for the origin and pathogenesis of autoantibodies in blistering skin diseases.