中国麻风皮肤病杂志 ›› 2025, Vol. 41 ›› Issue (6): 395-399.doi: 10.12144/zgmfskin202506395

• 论著 • 上一篇    下一篇

马赛克间接免疫荧光技术在大疱性类天疱疮诊断中的应用

周生儒1,蔡阳2,王晶莹3,张雪彤1,李敏1,潘萌3   

  1. 1 苏州大学附属第四医院（苏州市独墅湖医院）皮肤科，江苏苏州，215000；2苏州大学附属第四医院（苏州市独墅湖医院）临床检测中心，江苏苏州，215000；3 上海交通大学医学院附属瑞金医院皮肤科，上海，200025
  • 出版日期:2025-06-15 发布日期:2025-05-21

Application of mosaic indirect immunofluorescence technique in the diagnosis of bullous pemphigoid

ZHOU Shengru1, CAI Yang2, WANG Jingying3, ZHANG Xuetong1, LI Min1, PAN Meng3   

  1. 1 Department of Dermatology, The Fourth Affiliated Hospital of Soochow University (Suzhou Dushu Lake Hospital), Suzhou 215000, China; 2 Center of Clinical Laboratory, The Fourth Affiliated Hospital of Soochow University (Suzhou Dushu Lake Hospital), Suzhou 215000, China; 3 Department of Dermatology, Ruiin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
  • Online:2025-06-15 Published:2025-05-21

PDF (PC)

8

摘要： 目的：检测含盐裂猴皮肤、猴食管双底物的马赛克间接免疫荧光技术（IIF）在大疱性类天疱疮（BP）诊断中的敏感性与特异性，以评价其应用价值。方法：对2021年6月至2023年4月就诊的51例血清样本，包括30例BP患者，21例对照（5例湿疹，3例天疱疮，2例线状IgA大疱性皮病，1例抗p200类天疱疮以及10例正常对照），行马赛克IIF检测，观察荧光沉积情况。结果：以盐裂猴皮肤为底物进行IIF检测，30例BP中28例检测结果为阳性，敏感性为93.33%，其中IgG线状沉积于表皮侧27例，沉积于双侧1例，2例阴性；对照血清样本中抗p200类天疱疮IgG阳性线状沉积于真皮侧，1例湿疹IgG线状沉积于表皮侧，其余为阴性，特异性为95.24%。以猴食管为底物进行IIF检测，22例BP IgG线状沉积于基底膜带，敏感性为73.33%；对照血清样本中3例天疱疮均见棘细胞间IgG荧光沉积，其余未见荧光沉积，特异性为100%。盐裂猴皮肤、猴食管底物IIF对BP诊断的敏感性与特异性差异无统计学意义（P＞0.05）。结论：马赛克IIF猴食管和盐裂猴皮肤两种底物诊断BP敏感性高，特异性强。阳性结果可以互相印证，此外猴食管底物可鉴别天疱疮，盐裂猴皮肤可以鉴别抗p200类天疱疮。

关键词: 盐裂皮肤, 间接免疫荧光, 猴食管, 大疱性类天疱疮, 自身免疫性大疱病

Abstract: Objective: To detect the sensitivity and specificity of the mosaic indirect immunofluorescence (IIF) with salt-split monkey skin and monkey esophagus as dual substrates in the diagnosis of bullous pemphigoid (BP), so as to evaluate its application value. Methods: Serum samples of 51 patients from June 2021 to April 2023, including 30 BP patients and 21 controls (5 eczema patients, 3 pemphigus patients, 2 linear IgA bullous dermatosis patients, 1 anti-p200 pemphigoid patient and 10 normal controls), were detected by Mosaic IIF detection and fluorescence deposition was observed. Results: When using salt-split monkey skin as substrate for IIF detection, 28 out of 30 BP serum samples were positive, with a sensitivity of 93.33%. And 27 cases were positive with IgG epidermal localization, 1 case showed deposits both in dermis and epidermis, and 2 cases were negative. Among the controls, the anti-p200 pemphigoid case showed linear IgG deposition binding to the dermal side, the eczema case showed IgG linear deposits on the epidermal side, and other controls were negative, with a specificity of 95.24%. When IIF was performed using monkey esophagus as the substrate, 22 BP cases showed IgG linear deposits at the basement membrane zone, with a sensitivity of 73.33%. In the control group, 3 pemphigus patients showed intercellular IgG deposits in the spinous layer, while no deposits was observed in other controls, with a specificity of 100%. There was no statistically significant difference in the sensitivity and specificity between IIF with salt-split monkey skin and monkey esophagus substrates for BP diagnosis (P＞0.05). Conclusion: Mosaic IIF demonstrates high sensitivity and strong specificity in the serological diagnosis of BP patients. The positive results of mosaic IIF with monkey esophagus and salt-split monkey skin substrates can corroborate each other in the diagnosis of BP. Moreover, monkey esophagus substrate can differentiate pemphigus, while salt-split monkey skin can differentiate anti-p200 pemphigoid.

Key words: salt-split skin, indirect immunofluorescence, monkey esophagus, bullous pemphigoid, autoimmune bullous diseases