类天疱疮样扁平苔藓的免疫学研究

The Study of Immunofluorescence and Immunoblotting in 4 Patients with Lichen Planus Pemphigoides

为了探讨类天疱疮样扁平苔藓(LPP)与类天疱疮(BP)的联系,以及LPP抗原是否属于BP的经典抗原,对临床或病理中发现有水疱的4例扁平苔藓(LP)患者血清用DIF、IIF、免疫印迹检查,发现在基底膜IgG呈线状沉积者3例、C3呈颗粒状沉积者4例、纤维蛋白呈线状沉积者3例。其中2例经IIF检查发现血清中存在循环抗BMZ IgG抗体,其抗体滴度分别是1:80和1:320。盐裂的皮肤切片中抗体结合在表皮侧。通过免疫印迹检测这4例患者均出现与表皮抗原反应的阳性条带,其中有2例出现200000这一与BP经典抗原不同的抗原,结合文献分析表明LPP不是LP与BP重叠的疾病。

In order to investigate the relationship between lichen planus pemphigoides (LPP) and bullous pemphigoid (BP) and to determine whether the LPP antigen is the classical BP antigen. Four LP patients who were found to have blisters or subepidermal bullae by clinical and histopathological findings were investigated using DIF, IIF, immunoblotting methods. The results showed that there were linear deposition of IgG along the BMZ in three cases, C3 granular deposition in four cases, and linear fibrin deposition in 3 cases. Two out of these patients showed circulating IgG anti-BMZ antibody with titers 1:80 and 1:320, and lmol/L NaCl split section showed that the antibody was bound to the epidermal side, as did control BP antisera. Western blotting of the epidermal extracts using the sera of these 4 patients showed that all 4 patients'sera reacted with the epidermal antigen, and the sera of 2 patients reacted with 200kD antigen which is different from classical bullous pemphigoid antigen. With a review of literature we suggest that LPP is not the overlapping of BP and LP.