What’s new in bullous pemphigoid
Article first published online: 26 FEB 2010
© 2010 Japanese Dermatological Association
The Journal of Dermatology
Special Issue: Blistering Diseases (pages 193-239)
Volume 37, Issue 3, pages 194–204, March 2010
How to Cite
UJIIE, H., SHIBAKI, A., NISHIE, W. and SHIMIZU, H. (2010), What’s new in bullous pemphigoid. The Journal of Dermatology, 37: 194–204. doi: 10.1111/j.1346-8138.2009.00792.x
- Issue published online: 26 FEB 2010
- Article first published online: 26 FEB 2010
- Received 14 October 2009; accepted 25 October 2009.
- animal model;
- immunoglobulin E autoantibody;
- passive transfer;
- type XVII collagen (COL17)
Bullous pemphigoid (BP) is the most common autoimmune blistering disease. BP patients have autoantibodies against type XVII collagen (COL17, also called BP180 or BPAG2), a type II transmembrane protein that spans the lamina lucida and projects into the lamina densa of the epidermal basement membrane. The non-collagenous 16A domain of COL17 is considered to contain pathogenic epitopes of BP. The transfer of immunoglobulin (Ig)G from BP patients fails to cause blisters on mouse skin probably due to differences between humans and mice in the amino acid sequence of NC16A pathogenic epitope of COL17. Passive transfer of rabbit IgG antibodies against the murine homolog of human COL17 NC16A triggers immune reactions to COL17 in mice, including complement activation, mast cell degranulation and neutrophilic infiltration, resulting in dermal–epidermal separation. Recent studies using COL17-humanized mice that express human COL17 but lack murine COL17 were the first to demonstrate the pathogenicity of anti-COL17 human BP IgG autoantibodies in vivo. These new findings provide a greater understanding of BP pathomechanisms and facilitate the development of novel specific and efficient therapeutic strategies for BP.