CLINICAL MANIFESTATIONS IN 100 JAPANESE BULLOUS PEMPHIGOID CASES IN RELATION TO AUTOANTIGEN PROFILES

The relationship between clinical findings and antigen profiles in 100 bullous pemphigoid (BP) patients has been investigated. The patients were divided into four groups based upon the results of immunoblot ana lysis, namely patients whose sera detected the 230-kDa BP antigen (BP2 30) and the 180-kDa BP antigen (BP180), those recognizing either BP230 or BP180 alone, and those recognizing neither antigen. Analysis by th e chi-squared test showed predominant occurrence of oral (P < 0.05) an d facial lesions (P < 0.005) in patients whose sera detected BP180, an d these patients also tended to have more extensive lesions (P < 0.005 ). Patients that were positive for BP180 alone needed treatment with h igher doses of steroids than the patients positive for BP230 alone (P < 0.05). Furthermore, all five recalcitrant cases, which did not respo nd well to steroid treatment, were shown to possess autoantibodies aga inst BP180 in their sera. Patients with antibodies to BP230 had a tend ency to have a high titre of anti-BMZ antibodies (P < 0.005). These re sults suggest that anti-BP180 antibodies may be more related to the di sease severity than anti-BP230 antibodies.