Mucous membrane pemphigoid with antibodies against β3 subunit of laminin-332: First report from India

Kanwar, Amrinder J.; Vinay, Keshavamurthy; Koga, Hiroshi; Hashimoto, Takashi

doi:10.4103/0378-6323.98079

Cited by 7 publications

(12 citation statements)

References 14 publications

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“…Antibodies to β3 subunit are rare; however, they have been revealed in the literature. 16 Gasparini et al, 17 examining Italian MMP patients with IIF BIOCHIP mosaic, demonstrated that only 6% of patients had anti-Ln-332 antibodies, which is compatible with our results. It was proved that the rather low clinical MMP activity is paralleled by a relatively low autoantibody reactivity in patients peripheral blood.…”

Section: Discussionsupporting

confidence: 93%

A Probing of the Issue of Detecting IgG, IgG4 and IgA Antibodies to Laminin 332 Epitopes in Mucous Membrane Pemphigoid: A Clinical-Laboratory Experience of a Single Central European University Dermatology Department

Gornowicz‐Porowska¹,

Jałowska²,

Seraszek‐Jaros³

et al. 2022

CCID

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Purpose Mucous membrane pemphigoid (MMP) is a very rare autoimmune bullous disease, affecting predominantly the mucosae and characterized by autoantibodies to the epithelial basement membrane components. Laminin 332 (Ln-332) is one of the most probable antigens with association with malignancy. The laboratory diagnosis of Ln-332-mediated autoimmunity is troublesome. The aim here was to comparatively examine IgG, IgG4, and IgA autoantibodies specific to α3, β3 or γ2 subunits of Ln-322 in MMP patients using the BIOCHIP mosaic-based indirect immunofluorescence technique (IIF). Patients and Methods Sera from 15 MMP patients were studied. BIOCHIP mosaic-based Ln-332 IIF, direct immunofluorescence, ELISA tests for anti-BP180/BP20 IgG antibodies and statistical analyses were performed. Results Of all the 15 sera examined for IgG4 antibodies, only 1 (6.67%) reacted with the α3 chain, 0 with the β3 chain, and 0 with the γ2 chain. No positive reactivity was seen with the IgG and IgA antibodies. BIOCHIP mosaic-based IIF with Ln-332 showed 100% sensitivity, 8% specificity, 21% positive predictive value, and 100% negative predictive value in relation to the diagnostic gold standard of DIF. The concomitant malignancies were revealed in three cases. Conclusion The detection of antibodies to Ln-332 chains is occasional in Polish MMP sufferers. Still, the evaluation of IgG4 antibodies in MMP can reduce the false-negative results.

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Section: Discussionsupporting

confidence: 93%

A Probing of the Issue of Detecting IgG, IgG4 and IgA Antibodies to Laminin 332 Epitopes in Mucous Membrane Pemphigoid: A Clinical-Laboratory Experience of a Single Central European University Dermatology Department

Gornowicz‐Porowska¹,

Jałowska²,

Seraszek‐Jaros³

et al. 2022

CCID

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“…28 Our patient demonstrated antibodies to both α3 and β3 subunits. The combination of prednisone and dapsone has been reported to be effective in controlling anti-laminin-332 MMP, 29,30 as was also the outcome in our patient.…”

Section: Discussionsupporting

confidence: 56%

Anti–Laminin-332 Mucous Membrane Pemphigoid Developing After a Diphtheria Tetanus Vaccination

et al. 2013

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accine administration is an effective tool to prevent infectious diseases, but its powerful stimulus on the immune system has generated the fear of exacerbating preexisting autoimmune diseases or inducing autoimmune disorders in otherwise healthy individuals.1 Bullous pemphigoid (BP) is the most frequent autoimmune blistering skin disease. It affects predominantly elderly individuals but has also been reported in children. The etiologic characteristics of BP are unknown, but there have been 26 BP cases suspected of having been induced by vaccinations (Table). [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] In all of the postvaccination BP cases in which immunoblotting and/or enzyme-linked immunosorbent assay (ELISA) studies were performed, the target antigens were found to be BP180 and/or BP230. 3,8,12,16,17 We report a unique case of mucous membrane pemphigoid (MMP) that developed acutely in a 29-yearold man 2 days after he received a diphtheria tetanus (DT) vaccination. The results of laboratory studies were compatible with anti-laminin-332 MMP, which to our knowledge has not been previously described following vaccination. Report of a CaseAn otherwise healthy 29-year-old man was admitted to our department as a result of a sudden mucocutaneous eruption of blisters that occurred 2 days after receiving a DT vaccine for a traumatic skin cut. There were no available medical records of previous DT vaccinations, although the pediatric population in Israel is vaccinated regularly several times during childhood. The patient did not have a history of skin diseases or allergies to medications. The superficial cut was 1.5 cm long. It was treated with povidone-iodine solution and closed with adhesive surgical tape strips. There was no wound infection, and the patient did not receive any systemic antibiotics. On physical examination, there were tense blisters along with flaccid blisters and erosions on the face, inguinal area, and lower abdomen ( Figure 1). There were also widespread erosions on the oral mucosa (Figure 1). The Nikolsky sign was absent, and the rest of the physical examination had normal results. Histopathologic analysis of a skin blister revealed a subepidermal blister with complete epidermal-dermal separation and a sparse mononuclear cell infiltrate in the papillary dermis (Figure 2A and B). Immunohistochemical staining demonstrated type IV collagen on the dermal floor of the split ( Figure 2C). Direct immunofluorescence microscopy showed linear deposits of IgG and C3 along the basement membrane zone. An indirect immunofluorescence test on the patient's serum, which was performed on monkey esophagus, revealed linear deposits of IgG along the basement membrane zone with a titer of 1:160. Indirect immunofluorescence microscopy performed on 1M so-IMPORTANCE Bullous pemphigoid (BP) has been previously described to develop after vaccination in 26 patients. Immunoblotting or enzyme-linked immunosorbent assays (ELISAs), which were performed for 7 of these patients, have always shown circ...

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“…With this knowledge we notice cases of patients whom have acute myeloblastic leukemia, rheumatoid arthritis, diabetes mellitus and prostate carcinoma to be linked to AECP with showing attachment to the β3 subunit. The complications that commonly arise from AECP are laryngeal stenosis and symblepheron, which is an adhesion of the palpebral conjunctiva, either partially or completely [2]. If a patient has been already diagnosed with any of these malignancies, they should also be tested for MMP, as blistering can occur and further symptoms of MMP could bring extra pain and suffering or eventually result in death, as already noted in one case [9].…”

Section: Immunohistochemistry and Related Malignancy Of Antilaminin 332mentioning

confidence: 99%

“…Mucous Membrane Pemphigoid (MMP), is reputed as a persistent, heterogenous group of autoimmune blistering disease primarily involving mucous membranes, however, it can be detected on skin periodically [1,2]. The specific immune deposits that are most commonly found in MMP, include immunoglobulins IgG, and IgA, and complement C3 [3].…”

Section: Introductionmentioning

confidence: 99%

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Mucous membrane pemphigoid: A wide-ranging assessment of various cases and corresponding methods of diagnosis and treatment

Sivri¹,

Chandra²

2018

Med-Science

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Mucous Membrane Pemphigoid (MMP) is as an infrequent yet tenacious autoimmune blistering disease involving the mucosae of the oral cavity, as well as the conjunctiva, genitals, nasal cavity, pharynx and occasionally the skin. It is seen most commonly in older adults, although cases have been reported throughout early childhood. This review article will provide a thorough explanation of MMP by discussing common misdiagnosis scenarios, presenting rare case reports, and exploring recent treatment options in hopes of spreading awareness for furthering research on diagnosis techniques. The purpose this article is to bring light to the dental community, medical professionals and autoimmune disease researchers, the importance of an early and authentic diagnosis and corresponding methods of recent treatments.

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Mucous membrane pemphigoid with antibodies against β3 subunit of laminin-332: First report from India

Cited by 7 publications

References 14 publications

A Probing of the Issue of Detecting IgG, IgG4 and IgA Antibodies to Laminin 332 Epitopes in Mucous Membrane Pemphigoid: A Clinical-Laboratory Experience of a Single Central European University Dermatology Department

A Probing of the Issue of Detecting IgG, IgG4 and IgA Antibodies to Laminin 332 Epitopes in Mucous Membrane Pemphigoid: A Clinical-Laboratory Experience of a Single Central European University Dermatology Department

Anti–Laminin-332 Mucous Membrane Pemphigoid Developing After a Diphtheria Tetanus Vaccination

Mucous membrane pemphigoid: A wide-ranging assessment of various cases and corresponding methods of diagnosis and treatment

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