Orf-induced pemphigoid with antilaminin-332 antibodies

Bos, R.R. van den; Middelburg, Tom A.; Biezen, Paula van; Eijk, Annemiek A. van der; Pas, Hendrikus; Diercks, Gilles F.H.

doi:10.1111/j.1365-2133.2012.11005.x

Cited by 8 publications

(8 citation statements)

References 8 publications

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“…The patient had a blistering eruption 4 weeks after the finger lesion, which is within the usual time frame reported in autoimmune bullous diseases secondary to orf infection (2 weeks to 1 month). [4][5][6][7][8][9] The efficacy of topical steroids and the absence of relapse of bullous lesions were in favour of orf-induced epidermolysis bullosa acquisita.…”

Section: Discussionmentioning

confidence: 99%

“…Eleven cases of autoimmune bullous diseases have been previously described following orf virus infection (Table 1): nine cases of bullous pemphigoid with or without mucosal involvement, 4-7 one case of mucous membrane pemphigoid without detected autoantibodies 8 and one case of mucous membrane pemphigoid with antilaminin-332 antibodies. 9 The first 10 reported cases displayed the following characteristics: (i) linear deposition of C3, IgG and/or IgA along the basement membrane zone using direct immunofluorescence; (ii) negativity of indirect immunofluorescence analysis, except in two cases showing antibasement membrane IgG that bound the dermal side of salt-split skin; and (iii) negativity of ELISA assays against target antigens of bullous pemphigoid, mucous membrane pemphigoid or epidermolysis bullosa acquisita (anticollagen VII performed in three of 10 cases).…”

Section: Discussionmentioning

confidence: 99%

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Human orf complicated by epidermolysis bullosa acquisita

et al. 2017

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Orf is a DNA parapoxvirus transmitted to humans by contact with infected goats and sheep. Many complications have been reported after orf infection, including erythema multiforme. A few cases of autoimmune bullous dermatosis complicating orf disease have been reported to date. They are usually characterized by tense blister eruptions with or without mucosal involvement; linear deposition of C3, IgG and/or IgA along the basement membrane; and negativity of indirect immunofluorescence analysis and enzyme-linked immunosorbent assay (ELISA) (performed in four of 11 reported cases). These analyses have targeted antigens of bullous pemphigoid, mucous membrane pemphigoid or epidermolysis bullosa acquisita, except one case of mucosal pemphigoid with antilaminin-332 antibodies. We describe the case of a patient who presented with an ulceration on his finger 10 days after direct contact with a lamb during Eid al-Adha. Four weeks later he developed a severe tense blistering eruption associated with mucous membrane erosions. Indirect immunofluorescence analysis using the patient's serum revealed circulating antibasement membrane IgG that bound the dermal side of salt-split skin. ELISA was positive for recombinant immunodominant NC1 domain of type VII collagen. We finally diagnosed epidermolysis bullosa acquisita complicating probable human orf infection.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Human orf complicated by epidermolysis bullosa acquisita

et al. 2017

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“…The virus produces multiple immunomodulatory virulence factors, which interfere with the host's inflammatory and immune response [1]. Among these is a homologue of mammalian vascular endothelial growth factor, the human form of which has been demonstrated to be substantially upregulated in lesional epidermis of bullous pemphigoid and EM [30]. In one case of orf-induced pemphigoid, autoantibodies to the basement membrane protein, laminin-322, were identified.…”

Section: Discussionmentioning

confidence: 99%

Erythema multiforme after orf virus infection: a report of two cases and literature review

et al. 2014

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SUMMARYOrf virus has a worldwide distribution among sheep and goats. The hypersensitivity reaction erythema multiforme (EM) is a known complication of orf infection in humans; however, its occurrence is poorly understood and has not been extensively reviewed. We present two unrelated cases of orf-associated EM, and a review of the literature, highlighting important clinical, epidemiological and immunological aspects of this condition. Orf and its associated complications can occur in rural areas, as well as urban settings, where it is less well-known, through religious or cultural practices involving animal slaughter. Obtaining a history of animal exposures from patients with lesions suspicious for orf and secondary skin eruptions can guide diagnosis and identification of the inciting immune stimulus. Determining the pathophysiology and relative contribution of host and viral factors contributing to EM and other orf-associated hypersensitivity reactions could facilitate the identification of risk factors and inform treatment decisions.

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“…Direct immunofluorescence (IF) of perilesional biopsies and indirect IF microscopy on normal human skin split with a 1-molar sodium chloride solution (1 M NaCl) were performed as described previously . Indirect IF was performed using skin lacking laminin 332 or type VII collagen (Col7) derived from patients with junctional and dystrophic epidermolysis bullosa deficient of laminin 332 and Col7, respectively . For the detection of serum anti–laminin 332 reactivity, a recently developed indirect IF test based on the recombinant expression of laminin 332 (Euroimmun) and immunoblotting with extracellular matrix of cultured human keratinocytes were used (eMethods in the Supplement).…”

Section: Methodsmentioning

confidence: 99%

“…While orf can lead to severe complications in animals, it is deemed to follow a benign course with spontaneous resolution in humans. However, human orf has recently generated considerable interest owing to increasing evidence of its role in inducing autoimmune bullous diseases (AIBDs) . Previously reported cases of orf-induced AIBDs have all been characterized as subepidermal blistering disorders.…”

Section: Introductionmentioning

confidence: 99%

Clinical and Serological Characterization of Orf-Induced Immunobullous Disease

et al. 2022

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IMPORTANCE Ecthyma contagiosum, or orf, is a viral zoonotic infection caused by Poxviridae. Although human orf infection is considered to follow a self-limited course, various immunological reactions may be triggered, including immunobullous diseases. In the majority of the latter cases, the antigenic target remained enigmatic.OBJECTIVE To characterize the predominant autoantigen in orf-induced immunobullous disease and further describe this clinical entity. DESIGN, SETTING, AND PARTICIPANTSThis multicenter case series sought to provide detailed clinical, histopathological and immunological characteristics of a patient with orf-induced pemphigoid. Based on this index patient, serological analyses were conducted of 4 additional patients with previously reported orf-induced immunobullous disease. Immunoblotting with extracellular matrix and a recently established indirect immunofluorescence assay for detection of serum anti-laminin 332 IgG were performed.EXPOSURES The disease course and clinical characteristics of orf-induced immunobullous disease were observed. MAIN OUTCOMES AND MEASURESOrf-induced immunobullous disease is primarily characterized by anti-laminin 332 autoantibodies, predominant skin involvement, and a self-limiting course. The study provides further details on epidemiological, clinical, immunopathological, diagnostic, and therapeutic aspects of orf-induced immunobullous disease. RESULTSIn all 5 patients, IgG1 and/or IgG3 autoantibodies against laminin 332 were identified. The α3, β3, and γ2 chains were recognized in 2, 4, and 1 patient(s), respectively. CONCLUSIONS AND RELEVANCEIn this case series, laminin 332, a well-known target antigen in mucous membrane pemphigoid, was a major autoantigen in orf-induced immunobullous disease, even though predominant mucosal lesions were lacking in this autoimmune blistering disease. Orf-induced anti-laminin 332 pemphigoid is proposed as distinct clinical entity.

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Orf-induced pemphigoid with antilaminin-332 antibodies

Cited by 8 publications

References 8 publications

Human orf complicated by epidermolysis bullosa acquisita

Human orf complicated by epidermolysis bullosa acquisita

Erythema multiforme after orf virus infection: a report of two cases and literature review

Clinical and Serological Characterization of Orf-Induced Immunobullous Disease

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