Prevalence of pemphigus and pemphigoid autoantibodies in the general population

Wiebke Prüßmann, Jasper Prüßmann, Hiroshi Koga, Andreas Recke, Hiroaki Iwata, David Juhl, Siegfried Görg, Reinhard Henschler, Takashi Hashimoto, Enno Schmidt, Detlef Zillikens, Saleh M. Ibrahim, Ralf J. Ludwig

Research output: Contribution to journalArticlepeer-review

45 Scopus citations


Background: Mucocutaneous blistering is characteristic of autoimmune bullous dermatoses (AIBD). Blisters are caused by autoantibodies directed against structural components of the skin. Hence, detection of specific autoantibodies has become a hallmark for AIBD diagnosis. Studies on prevalence of AIBD autoantibodies in healthy individuals yielded contradictory results. Methods: To clarify this, samples from 7063 blood donors were tested for presence of anti-BP180-NC16A, anti-BP230 and anti-Dsg1/3 IgG by indirect immunofluorescence (IF) microscopy using a biochip. Results: Cumulative prevalence of these autoantibodies was 0.9 % (CI: 0.7-1.1 %), with anti-BP180-NC16A IgG being most prevalent. Validation of IF findings using ELISA confirmed presence of autoantibodies in 7/15 (anti-Dsg1), 6/7 (anti-Dsg3), 35/37 (anti-BP180-NC16A) and 2/3 (anti-BP230) cases. Moreover, in 16 samples, anti-BP180-NC16A autoantibody concentrations exceeded the cut-off for the diagnosis of bullous pemphigoid. Interestingly, these anti-BP180-NC16A autoantibodies from healthy individuals formed immune complexes with recombinant antigen and dose-dependently activated neutrophils in vitro. However, fine-epitope mapping within NC16A showed a different binding pattern of anti-BP180-NC16A autoantibodies from healthy individuals compared to bullous pemphigoid patients, while IgG subclasses were identical. Conclusions: Collectively, we here report a low prevalence of AIBD autoantibodies in a large cohort of healthy individuals. Furthermore, functional analysis shows differences between autoantibodies from healthy donors and AIBD patients.

Original languageBritish English
Article number63
JournalOrphanet Journal of Rare Diseases
Issue number1
StatePublished - 15 May 2015


  • Autoimmunity
  • BP180
  • Desmoglein
  • Pemphigoid
  • Pemphigus
  • Skin
  • Type XVII collagen


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