Molecular diagnosis of anti-laminin 332 (epiligrin) mucous membrane pemphigoid

Roxana Chiorean†,
Sorina Danescu†,
Oana Virtic,
Mayson B. Mustafa,
Adrian Baican,
Annette Lischka,
Takashi Hashimoto,
Yoshinobu Kariya,
Manuel Koch and
Cassian SitaruEmail author View ORCID ID profile

†Contributed equally

Orphanet Journal of Rare Diseases201813:111

https://doi.org/10.1186/s13023-018-0855-x

Received: 25 August 2017

Accepted: 26 June 2018

Published: 6 July 2018

Abstract

Background

Mucous membrane pemphigoid is a group of chronic subepithelial autoimmune blistering diseases that mainly affect mucous membranes. Laminin 332-specific autoantibodies are present in approximately 1/3 of the patients, being associated with an increased risk of malignancy. Because of the severe complications, an early recognition of the disease allowing a timely therapy is essential. The gold standard methods for detection of laminin 332-specific autoantibodies, including the immunoprecipitation and immunoblotting are non-quantitative, laborious and restricted to a few specialized laboratories worldwide. In addition, the use of radioimmunoassays, although highly sensitive and specific, are laborious, expensive and tightly regulated. Therefore, there is a stringent need for a quantitative immunoassay for the routine detection of laminin 332-specific autoantibodies more broadly available to diagnostic laboratories. The aim of this study was to compare different antigenic substrates, including native, recombinant laminin 332 and laminin 332-rich keratinocyte extracellular matrix, for development of an ELISA to detect autoantibodies in mucous membrane pemphigoid.

Results

Using a relatively large number of sera from MMP patients with well-characterized autoantibody reactivity we show the suitability of ELISA systems using laminin 332 preparations as adjunct diagnostic tools in MMP. While glycosylation of laminin 332 does not appear to influence its recognition by MMP autoantibodies, ELISA systems using both purified, native and recombinant laminin 332 demonstrated a high sensitivity and good correlation with the detection of autoantibodies by immunoblotting. ELISA systems using different laminin 332 preparations represent a feasible and more accessible alternative for a broad range of laboratories.