Boch K, Hammers CM, Goletz S, Kamaguchi M, Ludwig RJ, Schneider SW, Zillikens D, Hadaschik E, Schmidt E. Immunoglobulin M pemphigoid.
J Am Acad Dermatol 2021;
85:1486-1492. [PMID:
33453342 DOI:
10.1016/j.jaad.2021.01.017]
[Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 12/14/2020] [Accepted: 01/01/2021] [Indexed: 01/20/2023]
Abstract
BACKGROUND
Pemphigoid diseases are a heterogeneous group of autoimmune blistering disorders characterized by predominant deposition of immunoglobulin G or immunoglobulin A autoantibodies against structural proteins of the dermoepidermal junction (DEJ). Sole linear immunoglobulin M (IgM) deposits at the DEJ in pemphigoid diseases have been observed; however, IgM-specific target antigens have not been identified.
OBJECTIVE
Characterization of patients with IgM pemphigoid.
METHODS
Skin biopsy specimens and sera from IgM-positive patients were assessed using histopathology, direct and indirect immunofluorescence microscopy, enzyme-linked immunosorbent assays, immunoblotting, cryosection assay, complement fixation test, and internalization assays.
RESULTS
Tissue-bound linear IgM deposits along the DEJ and circulating IgM autoantibodies against type XVII collagen (Col17) were detected. These circulating IgM autoantibodies showed no complement activating or blister inducing capacity, but the ability of Col17 internalization ex vivo.
LIMITATIONS
Limited number of patients.
CONCLUSION
This study provides further evidence for the role of IgM autoantibodies in pemphigoid disease and highlights Col17 as a target antigen in IgM pemphigoid.
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