Journal of the American Academy of Dermatology · 2026
LABD97 IgG ELISA increases sensitivity of ELISA serologic testing for the diagnosis of bullous pemphigoid.
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Snook Jeremy P, Khalighi Mazdak A, Cocks Margaret M, Zone John J
Аннотация
BACKGROUND: Commercially available, antigen-specific serologic testing for bullous pemphigoid (BP) fails to identify approximately 1 in 4 patients with circulating IgG autoantibodies to the epidermal side of human split skin substrate by indirect immunofluorescence (IIF).
OBJECTIVE: Determine the utility of LABD97, a proteolyzed fragment of the shed ectodomain of BP180, as an antigenic target in an IgG ELISA assay to confirm BP diagnosis.
METHODS: Retrospective study of 100 consecutive serum specimens submitted to the Immunodermatology Laboratory at the University of Utah for suspected (initial diagnosis) BP with epidermal pattern IgG/IgG4 on human split skin substrate by IIF.
RESULTS: Within 100 consecutive BP sera, LABD97 IgG ELISA was the most sensitive antigenic target (87%) compared to the commercial-BP180 (NC16A) IgG ELISA (66%) and BP230 IgG ELISA (52%). Additionally, 83% of BP patients that were double negative for commercially available NC16A/BP230 ELISAs were LABD97 positive.
LIMITATIONS: Single-center study, limited clinical data and patient follow up.
CONCLUSION: LABD97 is a more complete and diagnostically relevant portion of BP180 compared to the NC16A BP180 fragment. Utilizing LABD97 ELISA testing significantly increases the sensitivity of serologic BP diagnosis.
OBJECTIVE: Determine the utility of LABD97, a proteolyzed fragment of the shed ectodomain of BP180, as an antigenic target in an IgG ELISA assay to confirm BP diagnosis.
METHODS: Retrospective study of 100 consecutive serum specimens submitted to the Immunodermatology Laboratory at the University of Utah for suspected (initial diagnosis) BP with epidermal pattern IgG/IgG4 on human split skin substrate by IIF.
RESULTS: Within 100 consecutive BP sera, LABD97 IgG ELISA was the most sensitive antigenic target (87%) compared to the commercial-BP180 (NC16A) IgG ELISA (66%) and BP230 IgG ELISA (52%). Additionally, 83% of BP patients that were double negative for commercially available NC16A/BP230 ELISAs were LABD97 positive.
LIMITATIONS: Single-center study, limited clinical data and patient follow up.
CONCLUSION: LABD97 is a more complete and diagnostically relevant portion of BP180 compared to the NC16A BP180 fragment. Utilizing LABD97 ELISA testing significantly increases the sensitivity of serologic BP diagnosis.