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Mai S, Izumi K, Mai Y, Natsuga K, Ishii N, Sawamura D, Schauer F, Kiritsi D, Nishie W, Ujiie H. Native autoantigen complex detects pemphigoid autoantibodies. JID INNOVATIONS 2023; 3:100193. [PMID: 36992950 PMCID: PMC10041560 DOI: 10.1016/j.xjidi.2023.100193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 01/18/2023] [Accepted: 01/19/2023] [Indexed: 02/22/2023] Open
Abstract
Pemphigoid diseases are a group of autoimmune disorders characterized by subepidermal blistering in the skin and mucosa. Among them, mucous membrane pemphigoid (MMP) autoantibodies are characterized by targeting multiple molecules in the hemidesmosomes, including collagen XVII, laminin-332, and integrin a6/β4. Traditionally, recombinant proteins of the autoantigens have been employed to identify circulating autoantibodies by immune assays. However, developing an efficient detection system for MMP autoantibodies has been challenging because the autoantibodies have heterogeneous profiles and the antibody titers are typically low. In this study, we introduce an ELISA that takes advantage of a native autoantigen complex rather than simple recombinant proteins. We generated HaCaT keratinocytes with a DDDDK-tag knocked in at the COL17A1 locus by CRISPR/Cas9-mediated gene editing. Immunoprecipitation using the DDDDK-tag isolated a native complex that contained full-length and processed collagen XVII and integrin α6/β4. Then, we used the complex proteins to prepare an ELISA system and enrolled 55 MMP cases to validate its diagnostic performance. The sensitivity and specificity of the ELISA for detecting MMP autoantibodies were 70.9% and 86.7%, respectively, far superior to those of conventional assays. In autoimmune diseases such as MMP, in which autoantibodies target various molecules, isolating the antigen-protein complexes can help establish a diagnostic system.
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Takeuchi S, Takeichi T, Koike Y, Takama H, Tanahashi K, Okuno Y, Ishii N, Muro Y, Ogi T, Suga Y, Akiyama M. Mutations in SAM syndrome and palmoplantar keratoderma patients suggest genotype/phenotype correlations in DSG1 mutations. J Eur Acad Dermatol Venereol 2021; 36:e215-e218. [PMID: 34657339 DOI: 10.1111/jdv.17752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 09/21/2021] [Accepted: 10/13/2021] [Indexed: 11/28/2022]
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Ishii N, Nakajima K, Kakuta T, Noda T, Fujita T, Kusano K. One Indication for an Extravascular Cardiac Resynchronization Therapy Defibrillator: Lessons from a Combination Therapy Case with Epicardial Cardiac Resynchronization Therapy and a Subcutaneous Implantable Cardioverter Defibrillator. Intern Med 2021; 60:1877-1880. [PMID: 33518564 PMCID: PMC8263187 DOI: 10.2169/internalmedicine.6125-20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Extravascular cardiac resynchronization therapy (CRT) defibrillators (CRT-Ds) are ideal for recurrent blood stream infections. Furthermore, CRT is useful for patients intolerant to right ventricular (RV) pacing. The case was a 65-year-old man with a CRT-D who presented with a blood stream infection. Because he was hemodynamically unstable with temporary RV pacing, an epicardial CRT device was re-implanted concomitantly through a surgical procedure. After the operation, a subcutaneous implantable cardioverter defibrillator (S-ICD) was placed. However, not all pacing is eligible for S-ICD screening. Combination therapy with an epicardial CRT device and S-ICD might be an alternate option for cardiac surgery cases.
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Niwa Y, Hayama K, Izaki S, Koga H, Ishii N, Terui T, Fujita H. Mucosa-predominant pemphigus vulgaris with anti-desmocollin 2 and 3 antibody positivity and ocular symptoms. Clin Exp Dermatol 2021; 46:1590-1592. [PMID: 34056753 DOI: 10.1111/ced.14771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2021] [Indexed: 11/28/2022]
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Li X, Qian H, Natsuaki Y, Koga H, Kawakami T, Tateishi C, Tsuruta D, Ishii N, Hashimoto T. Clinical and immunological findings in 55 patients with anti-laminin 332-type mucous membrane pemphigoid. Br J Dermatol 2021; 185:449-451. [PMID: 33811327 DOI: 10.1111/bjd.20099] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 03/30/2021] [Accepted: 03/31/2021] [Indexed: 11/26/2022]
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Janela-Lapert R, Castel M, Ishii N, Courville P, Joly P, Hebert V. Pemphigoïde mixte muco-cutanée : caractéristiques cliniques et immunologiques. Ann Dermatol Venereol 2020. [DOI: 10.1016/j.annder.2020.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Engelman D, Yoshizumi J, Hay R, Osti M, Micali G, Norton S, Walton S, Boralevi F, Bernigaud C, Bowen A, Chang A, Chosidow O, Estrada‐Chavez G, Feldmeier H, Ishii N, Lacarrubba F, Mahé A, Maurer T, Mahdi M, Murdoch M, Pariser D, Nair P, Rehmus W, Romani L, Tilakaratne D, Tuicakau M, Walker S, Wanat K, Whitfeld M, Yotsu R, Steer A, Fuller L. The 2020 International Alliance for the Control of Scabies Consensus Criteria for the Diagnosis of Scabies. Br J Dermatol 2020; 183:808-820. [PMID: 32034956 PMCID: PMC7687112 DOI: 10.1111/bjd.18943] [Citation(s) in RCA: 114] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/07/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Scabies is a common parasitic skin condition that causes considerable morbidity globally. Clinical and epidemiological research for scabies has been limited by a lack of standardization of diagnostic methods. OBJECTIVES To develop consensus criteria for the diagnosis of common scabies that could be implemented in a variety of settings. METHODS Consensus diagnostic criteria were developed through a Delphi study with international experts. Detailed recommendations were collected from the expert panel to define the criteria features and guide their implementation. These comments were then combined with a comprehensive review of the available literature and the opinion of an expanded group of international experts to develop detailed, evidence-based definitions and diagnostic methods. RESULTS The 2020 International Alliance for the Control of Scabies (IACS) Consensus Criteria for the Diagnosis of Scabies include three levels of diagnostic certainty and eight subcategories. Confirmed scabies (level A) requires direct visualization of the mite or its products. Clinical scabies (level B) and suspected scabies (level C) rely on clinical assessment of signs and symptoms. Evidence-based, consensus methods for microscopy, visualization and clinical symptoms and signs were developed, along with a media library. CONCLUSIONS The 2020 IACS Criteria represent a pragmatic yet robust set of diagnostic features and methods. The criteria may be implemented in a range of research, public health and clinical settings by selecting the appropriate diagnostic levels and subcategories. These criteria may provide greater consistency and standardization for scabies diagnosis. Validation studies, development of training materials and development of survey methods are now required. What is already known about this topic? The diagnosis of scabies is limited by the lack of accurate, objective tests. Microscopy of skin scrapings can confirm the diagnosis, but it is insensitive, invasive and often impractical. Diagnosis usually relies on clinical assessment, although visualization using dermoscopy is becoming increasingly common. These diagnostic methods have not been standardized, hampering the interpretation of findings from clinical research and epidemiological surveys, and the development of scabies control strategies. What does this study add? International consensus diagnostic criteria for common scabies were developed through a Delphi study with global experts. The 2020 International Alliance for the Control of Scabies (IACS) Criteria categorize diagnosis at three levels of diagnostic certainty (confirmed, clinical and suspected scabies) and eight subcategories, and can be adapted to a range of research and public health settings. Detailed definitions and figures are included to aid training and implementation. The 2020 IACS Criteria may facilitate the standardization of scabies diagnosis.
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Luo Y, Hara T, Kawashima A, Ishido Y, Suzuki S, Ishii N, Kambara T, Suzuki K. Pathological role of excessive DNA as a trigger of keratinocyte proliferation in psoriasis. Clin Exp Immunol 2020; 202:1-10. [PMID: 32415989 DOI: 10.1111/cei.13455] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 05/06/2020] [Accepted: 05/11/2020] [Indexed: 12/14/2022] Open
Abstract
Psoriasis is characterized by excessive growth and aberrant differentiation of epidermal keratinocytes due to persistent inflammation. However, the underlying mechanism that triggers immune activation in psoriasis is not clear. In this study, we explored excessive DNA as a potential trigger of psoriasis using cultured human keratinocytes and psoriatic skin tissues. We demonstrated that human genomic DNA fragments induced tumour necrosis factor (TNF)-α expression, hyperproliferation and over-expression of heparin-binding epidermal-like growth factor (HB-EGF) and transforming growth factor (TGF)-α, accompanied by defective expression of keratins 1 and 10 in cultured normal human epidermal keratinocytes, which have a similar phenotype to that of keratinocytes in psoriatic skin lesions. In psoriatic lesions, we found high levels of double-stranded (ds)DNA fragments, accompanying keratinocytes expressing Ki-67, HB-EGF and TNF-α. In addition, we showed that 1,25-dihydroxyvitamin D3 inhibited genomic DNA fragment-induced TNFA and interleukin-1β (IFNB) expression in human keratinocytes, and an intact function of cathelicidin anti-microbial peptide (CAMP) was required for this effect. These results suggest that excessive dsDNA fragments probably act as a risk factor for immune activation in psoriasis, and the active form of vitamin D can prevent genomic DNA-mediated skin inflammation via CAMP.
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Slutsky Bank E, Baniel A, Shehadeh W, Gat A, Matz H, Ishii N, Hashimoto T, Sprecher E, Zeeli T. Bullous pemphigoid distributed above the injury level in a paraplegic patient. Clin Exp Dermatol 2020; 45:531-533. [PMID: 31944365 DOI: 10.1111/ced.14162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2019] [Indexed: 11/27/2022]
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Kadokura Y, Fukusaki C, Ishii N. Effects of illuminance on night-time crying in infants. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Takenouchi R, Shibata M, Kishida I, Ishii C, Ishii N, Kawada M. Relation between sleep quality and daily physical activity in chronic schizophrenia patients. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.1037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Hayashi M, Tsunoda T, Sato F, Yaguchi Y, Igarashi M, Izumi K, Nishie W, Ishii N, Okamura K, Suzuki T, Hashimoto T. Clinical and immunological characterization of 14 cases of dipeptidyl peptidase‐4 inhibitor‐associated bullous pemphigoid: a single‐centre study. Br J Dermatol 2019; 182:806-807. [DOI: 10.1111/bjd.18516] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Shibata T, Sata K, Oroguchi T, Ishii N. Development of health management system with recording daily living habits and body compositions. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.394] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
It is difficult for university students to maintain their health. Department of health management was opened at April 2018 in Tokai university, Japan. About two hundred students entered it last year. Health management system was developed to maintain their health through the college life. The system is named THINKss (Tokai Health INtelligence Knowledge Support System). The number of registered students increased about four hundred this year. Every student can record their daily physical and mental conditions, meal photos with the time, body temperature, blood pressure, bone density, body compositions on their smartphone. If they use activity trackers with a wrist-based heart rate sensor (Garmin co. ltd.), their daily activities and sleeping status are corrected through API automatically. The weather information around university is also recorded everyday. Every student can browse own measurements on their smartphones. Because physical status includes cold symptoms (sneeze, throat pain, cough, fatigue, articular pain, muscle pain, chill, and body temperature), the system can recommend visiting a clinic. Because three meal photos are shown alongside, the balance of the meals is known. It may improve their meals. Because the activity tracker records advanced sleeping status (rem, light, deep, and moving), the relationships between mental conditions and sleeping status should be analyzed. Our previous study for common workers showed that mental status related with sleeping status, taking lunch of convenience-store, standard deviation of time of taking lunch, and oversensitivity to noise. Relationships between body composition changes and the lifestyles should be analyzed for university students. Some alert logics for body composition changes and exacerbating mental conditions may be provided based on the evidences from cumulative data of the health management system. These evidence-based alerts will contribute to maintain student’s health through a college life.
Key messages
Health management system was developed to maintain student’s health through the college life. Evidence-based alerts will contribute to maintain student’s health through a college life.
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Riera-Monroig J, Iranzo P, Ishii N, Hashimoto T, Mascaró JM. Persistence of antienvoplakin and antiperiplakin antibodies in a patient with paraneoplastic pemphigus 20 years after remission. Br J Dermatol 2019; 182:797-798. [PMID: 31529517 DOI: 10.1111/bjd.18534] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Taki T, Takeichi T, Kono M, Sugiura K, Sugimura Y, Ishii N, Hashimoto T, Akiyama M. A patient with bullous pemphigoid with mucosal involvement serologically positive for anti‐BP230 autoantibodies only. Br J Dermatol 2019; 182:221-223. [DOI: 10.1111/bjd.18343] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Koga H, Teye K, Ishii N, Nakama T. 047 Pemphigus autoantibodies to desmocollin 3 exclusively recognize calcium-dependent epitope in extracellular domain 2. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.07.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Hasegawa M, Luong V, Utsunomiya A, Chino T, Oyama N, Matsushita T, Obara T, Kuboi Y, Ishii N, Machinaga A, Ogasawara H, Ikeda W, Imai T. LB1141 Anti-mouse CX3CL1 monoclonal antibody therapy in mouse models of systemic sclerosis. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.06.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Matos I, Goyal L, Cleary J, Voss M, Oh D, Bernstam FM, Ng C, Iyer G, Ishii N, Hu Y, Chessex AV, Pokorska-Bocci A, Nicolas V, Kirpicheva Y, Zanna C, Flaherty K, Tabernero J, Hyman D. Debio 1347 in patients with gastrointestinal cancers harboring an FGFR gene fusion: preliminary results. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz157.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Tsushima T, Ishii N, Matsuzaka S, Armitage K, Ohkusu K, Cammack I, Yamada A, Mori Y, Sasaki S, Hayashi K, Serizawa Y. Culture-negative group B streptococcal pericarditis: A case report and literature review of the diagnostic use of polymerase chain reaction. Clin Case Rep 2019; 7:509-514. [PMID: 30899483 PMCID: PMC6406155 DOI: 10.1002/ccr3.2017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 12/12/2018] [Accepted: 01/04/2019] [Indexed: 12/04/2022] Open
Abstract
Although conventional microbiology cultures may be negative, polymerase chain reaction (PCR) can effectively identify both typical and atypical microorganisms. With careful interpretation, PCR could become the gold-standard diagnostic test for culture-negative bacterial pericarditis.
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Koga H, Teye K, Yamashita K, Ishii N, Tsuruta D, Nakama T. Detection of anti-type VII collagen IgE antibodies in epidermolysis bullosa acquisita. Br J Dermatol 2018; 180:1107-1113. [PMID: 30311191 DOI: 10.1111/bjd.17310] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND Epidermolysis bullosa acquisita (EBA) is a rare pemphigoid disease involving autoantibodies to type VII collagen (COL7), a major structural component of anchoring fibrils. IgE autoantibodies to type XVII collagen (BP180) have been identified in bullous pemphigoid (BP), the prototype of pemphigoid diseases. Although the pathogenic relevance of IgG anti-COL7 has been investigated, that of IgE in EBA remains unclear. OBJECTIVES To reveal the presence and pathogenic relevance of IgE anti-COL7 in EBA. METHODS We examined IgE antibodies in 109 patients with EBA by indirect immunofluorescence (IIF) and enzyme-linked immunosorbent assay (ELISA). RESULTS IIF with normal human skin revealed IgE reactivity in the basement membrane zone in 29 (26·6%) cases. To verify whether the IgE antibodies were specific to COL7, we performed IIF with 21 clearly positive cases and the skin of a patient with dystrophic EBA, which does not involve COL7. All cases showed negative results, indicating that IgE antibodies were specific to COL7. In a modified IgG COL7 ELISA for IgE, 16 (14·7%) cases were positive (three and 13 cases were negative and positive on IIF, respectively). We compared anti-COL7 IgG and IgE, and found a weak but significant correlation (r = 0·459, P < 0·001). EBA is clinically divided into a mechanobullous (MB; noninflammatory) type and an inflammatory (INF) type resembling BP. Of the IIF-positive cases, 11 of 30 (37%) had INF and nine of 48 (19%) had MB. CONCLUSIONS This study is the first to demonstrate the presence of circulating anti-COL7 IgE in patients with EBA, which may correlate with the clinical phenotype.
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Tani N, Sugita K, Ishii N, Wakumoto K, Hashimoto T, Yamamoto O. Juvenile pemphigus vulgaris manifesting as vegetating skin lesions. Clin Exp Dermatol 2018; 44:559-561. [PMID: 30288764 DOI: 10.1111/ced.13796] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2018] [Indexed: 11/30/2022]
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Solimani F, Pollmann R, Ishii N, Eming R, Hashimoto T, Schmidt T, Hertl M. Diagnosis of anti-laminin γ-1 pemphigoid by immunoblot analysis. J Eur Acad Dermatol Venereol 2018; 33:735-741. [PMID: 29972879 DOI: 10.1111/jdv.15170] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 06/01/2018] [Indexed: 01/15/2023]
Abstract
BACKGROUND Anti-laminin-γ1 (lam-γ1) pemphigoid, a recently described immunobullous disorder sharing immune serological features of bullous pemphigoid and epidermolysis bullosa acquisita (EBA), is characterized by the detection of serum IgG autoantibodies against the lam-γ1 chain, a 200 kDa heterotrimeric component of the dermal-epidermal junction (DEJ). OBJECTIVE The aim of the study was to develop an easy-to-perform and reliable assay for the serological detection of anti-lam-γ1 IgG autoantibodies. The clinical appearance alone is not sufficient to establish diagnosis of anti-lam-γ1 pemphigoid and rather requires immune serological evidence of (i) IgG reactivity against the dermal portion of salt-split human skin; (ii) exclusion of IgG against other components of the DEJ; and (iii) IgG reactivity with a 200 kDa protein of dermal extracts by immunoblot analysis (IB). METHODS The sera of 55 patients with anti-lam-γ1 pemphigoid were tested by IB with two recombinant heterotrimers, laminin 111 (lam-111) and laminin 421 (lam-421), as well as with a recombinant lam-γ1 chain monomer. Additionally, a total of 41 control sera from patients with EBA (n = 15), psoriasis vulgaris (PV; n = 14), and healthy controls (HC; n = 12) were tested. RESULTS Immunoblot analysis revealed a positive reactivity with lam-111 and/or lam-421 in 46/55 (84%) of anti-lam-γ1 pemphigoid sera. Moreover, 8/9 of the initially non-reactive sera were positive with the lam-γ1 monomer, leading to an overall sensitivity of 98.2%. Analyses of 41 control sera with the three lam-γ1 recombinants led to a specificity of 88%. Specifically, 3/15 EBA sera, 1/14 PV serum and 1/12 HC serum reacted with the lam-γ1 monomer while only the 3 EBA sera reacted with lam-421. CONCLUSIONS Here we show a novel two-step IB assay using the two recombinant laminin trimers and lam-γ1 chain monomer for the detection of anti-lam-γ1 serum IgG with high sensitivity and specificity. This assay will facilitate the diagnosis and further characterization of this disease.
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Ishiura N, Tamura-Nakano M, Okochi H, Tateishi C, Maki M, Shimoda Y, Ishii N, Hashimoto T, Tamaki T. Herpetiform pemphigus with characteristic transmission electron microscopic findings of various-sized ballooning vacuoles in keratinocytes without acantholysis. Br J Dermatol 2018; 180:187-192. [PMID: 29573413 DOI: 10.1111/bjd.16554] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2018] [Indexed: 11/27/2022]
Abstract
We report a unique case of a Japanese woman with herpetiform pemphigus (HP) who had IgG autoantibodies reactive with nondesmosomal sites of keratinocytes and presented characteristic transmission electron microscopic (TEM) findings of various-sized vacuoles in keratinocytes without acantholysis. The patient presented with pruritic annular oedematous erythemas with small blisters lining the margins on the trunk and extremities. Histopathological examinations showed intraepidermal blisters with prominent infiltrations of eosinophils. Direct and indirect immunofluorescence tests revealed the presence of in vivo bound and circulating IgG autoantibodies to the keratinocyte cell surfaces. However, enzyme-linked immunosorbent assays for desmoglein (Dsg) 1, Dsg3 and desmocollins 1-3 showed negative results. Immunoblotting using the full-length human Dsg1 recombinant protein showed a positive band. TEM examination showed various-sized vacuoles squashing the nuclei in many keratinocytes, resulting in rupture of the cells. Immunoelectron microscopic examination revealed IgG deposition over the entire keratinocyte cell surfaces, which spared the desmosomes. IgG antibodies were also present on the inside walls of the vacuoles around the nuclei of keratinocytes and on the cell surfaces of infiltrating eosinophils. This patient also had marked eosinophilia and high levels of thymus and activation-regulated chemokine and interleukin-5 in the serum. These results indicated a novel autoantigen on the nondesmosomal keratinocyte cell surfaces and the pathogenesis of bullous spongiotic change with inflammation in HP.
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Teye K, Koga H, Nagai A, Ohata C, Numata S, Ishii N, Nakama T. 745 Filaggrin gene (FLG) promoter polymorphisms are associated with atopic dermatitis but not ichthyosis vulgaris in Japan. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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