Nina van Beek1, Stine Krüger1, Tarek Fuhrmann1, Susanne Lemcke2, Stephanie Goletz2, Christian Probst3, Lars Komorowski3, Giovanni Di Zenzo4, Marian Dmochowski5, Kossara Drenovska6, Michael Horn7, Hana Jedlickova8, Cezary Kowalewski9, Ljiljana Medenica10, Dedee Murrell11, Aikaterini Patsatsi12, Shamir Geller13, Soner Uzun14, Snejina Vassileva6, Xuejun Zhu15, Kai Fechner3, Detlef Zillikens1, Winfried Stöcker3, Enno Schmidt16, Kristin Rentzsch3. 1. Department of Dermatology, University of Lübeck, Lübeck, Germany. 2. Lübeck Institute of Experimental Dermatology, Lübeck, Germany. 3. Institute of Experimental Immunology, EUROIMMUN AG, Lübeck, Germany. 4. Molecular and Cell Biology Laboratory, IDI-IRCCS, Rome, Italy. 5. Department of Dermatology, Poznan University of Medical Sciences, Poznan, Poland. 6. Department of Dermatology and Venereology, Sofia University of Medicine, Sofia, Bulgaria. 7. University Institute of Clinical Chemistry and Center of Laboratory Medicine, Bern, Switzerland. 8. Department of Dermatology, St. Anna University Hospital, Brno, Czech Republic. 9. Department of Dermatology and Immunodermatology, Medical University of Warsaw, Warsaw, Poland. 10. Department of Dermatology, School of Medicine, University of Belgrade, Belgrade, Serbia. 11. St. George Hospital, University of New South Wales School of Medicine, Sydney, Australia. 12. 2nd Dermatology Department, Aristotle University School of Medicine, Papageorgiou General Hospital, Thessaloniki, Greece. 13. Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. 14. Department of Dermatology, Faculty of Medicine, Akdeniz University, Antalya, Turkey. 15. Department of Dermatology, Beijing University First Hospital, Beijing, China. 16. Department of Dermatology, University of Lübeck, Lübeck, Germany; Lübeck Institute of Experimental Dermatology, Lübeck, Germany. Electronic address: enno.schmidt@uksh.de.
Abstract
BACKGROUND: The current standard in the serologic diagnosis of autoimmune bullous diseases (AIBD) is a multistep procedure sequentially applying different assays. In contrast, the BIOCHIP Mosaic technology combines multiple substrates for parallel analysis by indirect immunofluorescence. METHODS: Sera from 749 consecutive, prospectively recruited patients with direct immunofluorescence-positive AIBD from 13 international study centers were analyzed independently and blinded by using (1) a BIOCHIP Mosaic including primate esophagus, salt-split skin, rat bladder, monkey liver, monkey liver with serosa, recombinant BP180 NC16A, and gliadin GAF3X, as well as HEK293 cells expressing recombinant desmoglein 1, desmoglein 3, type VII collagen, and BP230 C-terminus and (2) the conventional multistep approach of the Department of Dermatology, University of Lübeck. RESULTS: In 731 of 749 sera (97.6%), specific autoantibodies could be detected with the BIOCHIP Mosaic, similar to the conventional procedure (725 cases, 96.8%). The Cohen κ for both serologic approaches ranged from 0.84 to 1.00. In 6.5% of sera, differences between the 2 approaches occurred and were mainly attributed to autoantigen fragments not present on the BIOCHIP Mosaic. LIMITATIONS: Laminin 332 and laminin γ1 are not represented on the BIOCHIP Mosaic. CONCLUSIONS: The BIOCHIP Mosaic is a standardized time- and serum-saving approach that further facilitates the serologic diagnosis of AIBD.
BACKGROUND: The current standard in the serologic diagnosis of autoimmune bullous diseases (AIBD) is a multistep procedure sequentially applying different assays. In contrast, the BIOCHIP Mosaic technology combines multiple substrates for parallel analysis by indirect immunofluorescence. METHODS: Sera from 749 consecutive, prospectively recruited patients with direct immunofluorescence-positive AIBD from 13 international study centers were analyzed independently and blinded by using (1) a BIOCHIP Mosaic including primate esophagus, salt-split skin, rat bladder, monkey liver, monkey liver with serosa, recombinant BP180 NC16A, and gliadin GAF3X, as well as HEK293 cells expressing recombinant desmoglein 1, desmoglein 3, type VII collagen, and BP230 C-terminus and (2) the conventional multistep approach of the Department of Dermatology, University of Lübeck. RESULTS: In 731 of 749 sera (97.6%), specific autoantibodies could be detected with the BIOCHIP Mosaic, similar to the conventional procedure (725 cases, 96.8%). The Cohen κ for both serologic approaches ranged from 0.84 to 1.00. In 6.5% of sera, differences between the 2 approaches occurred and were mainly attributed to autoantigen fragments not present on the BIOCHIP Mosaic. LIMITATIONS: Laminin 332 and laminin γ1 are not represented on the BIOCHIP Mosaic. CONCLUSIONS: The BIOCHIP Mosaic is a standardized time- and serum-saving approach that further facilitates the serologic diagnosis of AIBD.