We read with great interest the report of Wieland et al1 on the prevalence of circulating autoantibodies to bullous pemphigoid (BP) 180 and BP230 antigens in serum samples in unaffected subjects. In that study, the circulating autoantibodies were detected by commercial enzyme-linked immunosorbent assay (ELISA), and further studies were conducted on serum samples with indirect immunofluorescence (IIF). The authors detected the presence of BP180 and/or BP230 in 7.5% of the tested patients (25 of 337). In the 25 patients testing positive by ELISA, IIF was always negative. The records of all of these patients were reviewed, and the presence of previous autoimmune disease was excluded.
Foureur N, Grootenboer-Mignot S, Descamps V. Value of the Detection of Circulating Antibodies Against BP Antigens in Unaffected Subjects. Arch Dermatol. 2010;146(7):801. doi:10.1001/archdermatol.2010.137