S. Delmonte et al., Rat bladder epithelium: A sensitive substrate for indirect immunofluorescence of bullous pemphigoid, ACT DER-VEN, 80(3), 2000, pp. 175-178
Serological diagnosis of bullous pemphigoid is based on immunoblotting or i
ndirect immunofluorescence on normal human salt-split skin. These methods a
re expensive or time-consuming and not available as a routine test in all l
aboratories. We used rat bladder epithelium as substrate for indirect immun
ofluorescence and compared it with other substrates and with immunoblotting
, Twenty-nine bullous pemphigoid sera were studied on rat bladder epitheliu
m, monkey oesophagus, salt-split skin and with immunoblotting on human kera
tinocyte cultures. Indirect immunofluorescence on rat bladder epithelium pr
oved to be more sensitive (72%) than on monkey oesophagus alone (45%) and l
ess sensitive than on salt-split skin (97%). Rat bladder epithelium, when t
ested on 41 sera of a control group, showed a very high specificity: 2/41 (
95%), In combination with immunoblotting on keratinocyte extracts, indirect
immunofluorescence on rat bladder epithelium allowed 93% of sera to be rec
ognized, a value close to the salt-split skin alone, Rat bladder epithelium
appears to be a more sensitive substrate than monkey oesophagus for the di
agnosis of bullous pemphigoid and, although less specific, it is easier and
faster than using salt-split skin, which remains indispensable to distingu
ish bullous pemphigoid from epidermolysis bullosa acquisita.