Korean J Dermatol.  1996 Apr;34(2):212-218.

Comparison of the Sensitivity of indirect Immunofluorescence and Immunoblot Analysis for the Detection of Autoantibodies in Pemphigus

• Jeong SJ
• Lee CW

Abstract

BACKGROUND: Immunolcgical assays are required for the accurate diagnosis of autoimmune bullous dermatoses including pemphigus vulgaris(PV) and pemphigus foliaceus(PF). In the detection of circulating autoantibodies to pemphigus antigens(desmosomal components), the priority remains controversial between indirect immunofluorescence(IF) and immunoblot(IB) assay.
OBJECTIVE
In the present study we compared the sensitivity of indirect IF and that of IB using amplified alkaline phosphatase staining system in the detection of pemphigus autoantibodies. PATIENTS: We selected eight patients with serum endpoint titer of 1:80 in preliminary study. Among these patients three were PV and five were PF.
METHODS
/RESULTS: The titers of IgG autoantibodies found on indirect IF were confirmed as 1: 80 in all patients, whereas the titers examined by IB assay were much higher, 1: 640 to 1: 2560. In the 3 sera of PV patients, the titers of two cases were 1: 1280 and the third case was 1: 2560. In 5 cases of PF, one was 1:640, two were 1: 1280, and two were 1:2560.
CONCLUSION
This result suggests that the immunoblot examination using amplified alkaline phosphatase staining system demonstrates higher sensitivity compared with indirect IF(p=0.0003 by Mann-Whitney U test) in the detection of pemphigus autoantibodies.

Keyword

Pemphigus vulgaris; Pemphigus foliaceus; Indirect immunofluorescence; Immunoblot; Sensitivity

MeSH Terms

Alkaline Phosphatase
Autoantibodies*
Diagnosis
Fluorescent Antibody Technique, Indirect*
Humans
Immunoglobulin G
Pemphigus*
Skin Diseases, Vesiculobullous
Alkaline Phosphatase
Autoantibodies
Immunoglobulin G