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Antiplectin autoantibodies in subepidermal blistering diseases.
[epidermolysis bullosa simplex]
Hemidesmosomal
proteins
may
become
targets
of
autoimmunity
in
subepidermal
blistering
diseases
.
Well-known
recognized
autoantigens
are
the
intracellular
plaque
protein
BP
230
,
the
transmembrane
BP
180
and
its
shed
ectodomain
LAD
-
1
.
To
establish
the
prevalence
of
autoimmunity
against
plectin
,
another
intracellular
plaque
protein
,
and
to
investigate
its
antigenic
sites
.
Two
hundred
and
eighty-
two
patients
with
subepidermal
blistering
diseases
,
investigated
by
routine
immunoblot
analysis
for
possible
antiplectin
antibodies
,
were
included
in
the
study
.
Epitope
mapping
was
performed
using
recombinantly
produced
overlapping
plectin
domains
from
the
actin-binding
domain
to
the
rod
domain
.
The
COOH-terminal
region
of
plectin
was
not
included
in
the
study
.
In
11
of
282
(
3
.
9
%
)
patients
an
immunoblot
staining
pattern
identical
to
that
of
antiplectin
monoclonal
antibody
HD
121
was
found
.
Affinity-purified
antibodies
bound
back
to
normal
human
skin
in
a
pattern
typical
for
plectin
,
i
.
e
.
to
the
epidermal
basement
membrane
zone
as
well
as
to
keratinocytes
in
the
epidermis
,
and
to
myocytes
.
No
binding
was
seen
to
plectin
-
deficient
skin
of
a
patient
with
epidermolysis
bullosa
simplex
with
muscular
dystrophy
.
Epitope
mapping
of
the
plectin
molecule
showed
that
the
central
coiled-coil
rod
domain
is
an
immunodominant
hotspot
as
92
%
of
the
sera
with
antiplectin
antibodies
reacted
with
it
.
Most
patients
with
antiplectin
antibodies
also
had
antibodies
to
other
pemphigoid
antigens
.
P
lectin
is
a
minor
pemphigoid
antigen
with
an
immunodominant
epitope
located
on
the
central
rod
domain
.
Diseases
Validation
Diseases presenting
"also had antibodies"
symptom
epidermolysis bullosa simplex
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