| Bullous pemphigoid is an acquired autoimmune disease, which mostly happen to the elderly. In clinical work, we found that some BP patients were accompanied with neurological diseases. Literature review showed that BP can happen to many neurological diseases, including dementia, multiple sclerosis, Pakinsin's disease, cerebral stroke, etc.The pathogenic relationship between the two identities is still not clear. Immunological cross-reactions may play a role in the association of these two diseases.We collected the data of the BP cases that were diagnosed in Peking Union Medical College Hospital during a 4-year period (2001-2005). A retrospective study was made to those that were associated with neurological disorders. By RT-PCR, we found that BPAg1 neuro type (BPAg1-a) can be expressed in the mouse brain, spinal cord, skin, liver and renal tissue; the muscle type (BPAg1-b) can be expressed in the mouse brain, spinal cord, heart muscle, skin, liver and renal tissue; while the skin type (BPAg1-e) can only be expressed in the skin tissue. None of the three types of BPAg1 can be expressed in the spleen tissue. By immunoblot assay, we found that some BP patients' sera recognized the 280kd, 230kd, 180kd and 165kd antigens from mouse brain extracts. The bands incidence of those BP patients who associated with neurological diseases is much higher than that in those who didn't. The sera of three cerebral stroke patients can recognize the 230kd antigen of human skin and mouse brain at the same time. This phenomenon suggest that skin and brain have some antigens in common. It is possible that the nervous system alterations in human in the course of neurological diseases could expose the neuronal isoform of BPAg1, thus triggering an immune reaction that, along with the immunological cross-reactions, determines cutaneous damages.
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