Immunoreactivity of bullous pemphigoid (BP) autoantibodies against the NC16A and C-terminal domains of the 180 kDa BP antigen (BP180): immunoblot analysis and enzyme-linked immunosorbent assay using BP180 recombinant proteins.

The 180 kDa bullous pemphigoid (BP) antigen (BP180) is known to be recognized by sera from patients with BP, herpes gestationis (HG) and cicatricial pemphigoid (CP). A series of previous studies using BP180 recombinant proteins has shown that most sera from patients with BP and HG react with the NC16A domain of BP180, an extracellular non-collagenous region just adjacent to the plasma membrane. In contrast, the C-terminal region of BP180 has been reported to be one of the epitopes of CP. In the present study, we examined the immunoreactivity of 110 BP sera against the NC16A and C-terminal domains of BP180 using immunoblot analysis and enzyme-linked immunosorbent assay (ELISA). Immunoblot analysis revealed that 100 (91%) and 26 (23.5%) of the 110 BP sera recognized the NC16A and C-terminal domains, respectively. The results of the ELISA were correlated with those of immunoblotting. There were no specific or significant clinical features such as severe involvement of mucous membranes and scarring in BP patients whose sera reacted with the C-terminal region. These findings suggest that some BP sera react with the C-terminal region of BP180 without any association with the characteristic clinical features of CP.