| Background:Bullous pemphigoid(BP)is the most common subepidermal autoimmune bullous disorder which usually affected the individuals over 60 years old.Autoantibodies binding to BP180 and BP230 play an important role in the pathogenesis of BP.Circulating Anti-BP180 autoantibody titres have been shown to correlate with the disease activity.Epidemiologic findings of recent years showed BP was associated with neurological diseases(ND),cardiovascular disease,diabetes and some other diseases.ND was most frequently associated with BP.However,this association has not been completely understood.Studies have shown that the neural isoforms of BP180 and BP230 can cross react with those antigens in the skin.Some researches demonstrated anti-BP180 and BP230 autoantibodies might be found in patients with ND.But the results of positive rates of those antibodies were inconsistent in different kinds of ND and different samples.In order to provide more evidences for further study of the relationship between ND and BP,it is needed to expand the sample sizes and further detect whether BP autoantibodies can be found in the sera of patients with ND.Objective:To determine the prevalence of anti-BP180 and BP230 autoantibodies in patients without BP but diagnosed as ND.Methods:Serum samples of ND patients were collected at the departments of neurology and neurosurgery of three hospitals.Serum samples of normal controls were collected at the physical examination center.The anti-BP 180 and BP230 antibodies were tested by enzyme-linked immunosorbent assay(ELISA)while anti-basement membrane zone antibodies were tested by indirect immunofluorescence(IIF).The positive rates of anti-BP180,anti-BP230 and anti-basement membrane antibodies in ND patients were compared with those in neurologically healthy control group.The ND patients were divided into over 60 years old group and under 60 years old group,then the positive rates of the antibodies were compared with matched neurologically healthy control group,respectively.The positive rates of the antibodies in over 60 years old group and under 60 years old group in ND patients were compared with each other,respectively.The ND patients were divided into with stroke group and without stroke group,then the positive rates of the antibodies in the two groups were compared with each other,respectively.Results:1.Totally,131 patients with ND were enrolled in the study.Their mean age was 61.18 years(standard deviation = 13.00,range = 19-89).53(40.5%)patients were women and 78(59.5%)were men.The neurologically healthy control group comprised of 131 subjects(53 women and 78 men)with mean age 58.98 years(standard deviation=12.82,range =26-96).The difference in mean age between individuals with and without ND was not statistically significant(P =0.168).2.In the ELISA assay,the positive rates of anti-BP180 NC16a and anti-BP230 autoantibodies in ND patients were 11.45%(15/131)and 5.34%(7/131),respectively.The positive rates of anti-BP180 NC16a and anti-BP230 autoantibodies in controls were 3.05%(4/131)and 2.29%(3/131),respectively.The difference of the positive rates of anti-BP180 NC16a antibodies in ND group and control group was statistically significant(?2 = 6.866,P =0.009).But the difference of the positive rates of anti-BP230 antibodies in the two groups was not statistically significant(?2 = 1.66,P = 0.20).3.The ND patients were divided into over 60 years old group and under 60 years old group.The positive rates of anti-BP180 NC16a antibodies were 12.5%(9/72)and 10.17%(6/59)in the two groups,respectively.The positive rates of anti-BP230 autoantibodies in the two groups were 8.33%(6/72)and 1.69%(1/59),respectively.The differences of the positive rates of anti-BP180 and BP230 antibodies were not statistically significant in the two groups(?2= 0.174,P = 0.677;?2 = 1.665,P = 0.197,respectively).4.The ND patients and the controls were divided into over 60 years old group and under 60 years old group,respectively.The positive rates of anti-BP180 NC16a and anti-BP230 autoantibodies in the over 60 years old group of ND patients were 12.5%(9/72)and 8.33%(6/72),respectively.The positive rates of anti-BP180 NC16a and anti-BP230 autoantibodies in the under 60 years old group of controls were 1.39%(1/72)and 1.39%(1/72),respectively.The difference of the positive rates of anti-BP180 NC16a antibodies in ND group and control group was statistically significant(?2 = 6.878,P = 0.009).But the difference of the positive rates of anti-BP230 antibodies in the two groups was not statistically significant(?2 = 2.403,P=0.12);The positive rates of anti-BP180 NC16a and anti-BP230 autoantibodies in the under 60 years old group of ND patients were 10.17%(6/59)and 1.69%(1/59),respectively.The positive rates of anti-BP180 NC16a and anti-BP230 autoantibodies in the under 60 years old group of controls were 5.08%(3/59)and 3.39%(2/59),respectively.The difference of the positive rates of anti-BP180 NC16a antibodies in ND group and controls was not statistically significant(?2 = 0.481,P = 0.488).The difference of the positive rates of anti-BP230 antibodies in the two groups was not statistically significant(Fisher's test,P=1).5.The ND patients were divided into stroke group and non-stroke group.The positive rates of anti-BP180 NC16a autoantibodies in the two groups were 11.01%(12/109),13.64%(3/22),respectively.The positive rates of anti-BP230 autoantibodies in the two groups were 6.42%(7/109)and 0.00%(0/22),respectively.The difference of the positive rates of anti-BP180 NC16a antibodies in stroke group and non-stroke group was not statistically significant(?2=0,P = 1).The difference of the positive rates of anti-BP230 antibodies in stroke group and non-stroke group was not statistically significant(Fisher's test,P = 1).6.In the IIF assay,neither the tested ND sera nor the control samples showed any specific immunostaining on the substrates.Conclusions:1.Anti BP180 antibodies may be associated with the correlation between BP and ND.Anti-BP230 antibodies may not be associated with the correlation between BP and ND.2.The correlation between stroke and BP may not be higher than that of other ND and BP.3.Anti-basement membrane zone antibodies may not be related to the correlation between BP and ND. |
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