Association of Autoantibodies to BP180 with Disease Activity in Greek Patients with Bullous Pemphigoid

Abstract

39 bullous pemphigoid (BP) patients were studied to assess the clinical significance of anti-BP180 and anti-BP230 circulating autoantibodies of BP and correlate their titers with the clinical scores of the BP Disease Area Index (BPDAI) and the Autoimmune Bullous Skin Disorder Intensity Score (ABSIS) as well as with the intensity of pruritus measured by the BPDAI pruritus component. All parameters were evaluated by the time of diagnosis (baseline), month 3, and month 6. Titers of anti-BP180 autoantibodies were strongly correlated with BPDAI (r = 0.557, P value < 0.0001) and ABSIS (r = 0.570, P value < 0.0001) values, as well as with BPDAI component for the intensity of pruritus (rho = 0.530, P value = 0.001) at baseline. At month 3, titers of anti-BP180 autoantibodies were strongly correlated with BPDAI (rho = 0.626, P value = 0.000) and ABSIS (rho = 0.625, P value = 0.000) values, as well as with the BPDAI component for the intensity of pruritus (rho = 0.625, P value = 0.000). At month 6, titers of anti-BP180 autoantibodies were strongly correlated with BPDAI (rho = 0.527, P value = 0.001) and ABSIS (rho = 0.526, P value = 0.001) values, as well as with the BPDAI component for the intensity of pruritus (rho = 0.525, P value = 0.001). There was no statistically significant correlation between titers of anti-BP230 autoantibodies and the BPDAI, ABSIS, and BPDAI component for the intensity of pruritus at the same time points.

Assessment of Bullous Pemphigoid Disease Area Index during Treatment: A Prospective Study of 30 Patients

“…At baseline, BPDAI mean scores were similar in both studies, and anti-BP180 and anti-BP230 ELISA values were consistent with previous reports [10,22,27,28,29]. Likewise, at baseline, we did not find a correlation between BPDAI and anti-BP230 ELISA values, which is consistent with the results obtained by Patsatsi et al [16]. Collectively, these results were in accordance with previous studies, which showed that titres of anti-BP180 autoantibodies were correlated with disease activity assessed by the number of daily new blisters, pruritus intensity or disease duration [10,27,30,31].…”

“…In a previous study, anti-BP180 and anti-BP230 autoantibodies were detected by ELISA at baseline, and then at months 3 and 6, and correlated both with BPDAI score and Autoimmune Bullous Skin Disorder Intensity Score [16]. At baseline, BPDAI mean scores were similar in both studies, and anti-BP180 and anti-BP230 ELISA values were consistent with previous reports [10,22,27,28,29].…”

“…Conversely, anti-BP230 autoantibodies were correlated neither with outcome nor with severity of BP [10,23,27,28,30,31]. Finally, we observed a smaller drop in BPDAI mean score at day 90 in our study compared to Patsatsi et al [16] (77 vs. 97%). This is likely due to the use of superpotent topical steroids for the treatment of the majority of our patients, instead of systemic prednisolone in the series of Patsatsi et al [16].…”

“…Finally, we observed a smaller drop in BPDAI mean score at day 90 in our study compared to Patsatsi et al [16] (77 vs. 97%). This is likely due to the use of superpotent topical steroids for the treatment of the majority of our patients, instead of systemic prednisolone in the series of Patsatsi et al [16]. However, superpotent topical corticosteroids alone were clinically effective, as illustrated by the control of the disease of all BP patients at day 30, in accordance with previous studies [18,19,29].…”

“…In 2011, an international panel of experts proposed a disease extent score, the Bullous Pemphigoid Disease Area Index (BPDAI) to assist in the development of consistent reporting of outcome in future BP reports and studies [15]. Since then, only one study used the BPDAI in practice, aiming to correlate this score with the titres of circulating autoantibodies in a series of BP patients (anti-BP180, anti-BP230) [16]. This prompted us to perform a prospective study on a series of consecutive BP patients to compare BPDAI with other clinical parameters of disease activity at baseline, including the number of daily new blisters, the total lesion area (TLA) and pruritus, and to describe the variations of BPDAI, especially during the initial phase of treatment (first 3 months).…”