{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T05:16:03Z","timestamp":1790486163127,"version":"4.1.0"},"reference-count":44,"publisher":"Elsevier BV","issue":"11","license":[{"start":{"date-parts":[[2011,11,1]],"date-time":"2011-11-01T00:00:00Z","timestamp":1320105600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2011,11,1]],"date-time":"2011-11-01T00:00:00Z","timestamp":1320105600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2015,12,2]],"date-time":"2015-12-02T00:00:00Z","timestamp":1449014400000},"content-version":"vor","delay-in-days":1492,"URL":"http:\/\/www.elsevier.com\/open-access\/userlicense\/1.0\/"}],"funder":[{"DOI":"10.13039\/100008672","name":"Wilhelm Sander-Stiftung","doi-asserted-by":"publisher","award":["2004.120.1"],"award-info":[{"award-number":["2004.120.1"]}],"id":[{"id":"10.13039\/100008672","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000780","name":"European Commission","doi-asserted-by":"publisher","award":["QLG1-CT-2001-02007"],"award-info":[{"award-number":["QLG1-CT-2001-02007"]}],"id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["HE1602\/8-1"],"award-info":[{"award-number":["HE1602\/8-1"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["SFB850-TPB6"],"award-info":[{"award-number":["SFB850-TPB6"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001711","name":"Schweizerischer Nationalfonds zur F\u00f6rderung der Wissenschaftlichen Forschung","doi-asserted-by":"publisher","award":["3100A-109811\/1"],"award-info":[{"award-number":["3100A-109811\/1"]}],"id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003196","name":"Ministero della Salute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["jidonline.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Journal of Investigative Dermatology"],"published-print":{"date-parts":[[2011,11]]},"DOI":"10.1038\/jid.2011.180","type":"journal-article","created":{"date-parts":[[2011,6,23]],"date-time":"2011-06-23T04:49:00Z","timestamp":1308804540000},"page":"2271-2280","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":145,"title":["Demonstration of Epitope-Spreading Phenomena in Bullous Pemphigoid: Results of a Prospective Multicenter Study"],"prefix":"10.1016","volume":"131","author":[{"given":"Giovanni","family":"Di Zenzo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sybille","family":"Thoma-Uszynski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Calabresi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lionel","family":"Fontao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silke C","family":"Hofmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Philippe","family":"Lacour","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Sera","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leena","family":"Bruckner-Tuderman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanna","family":"Zambruno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Borradori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Hertl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1038\/jid.2011.180_bb0010","doi-asserted-by":"crossref","first-page":"1526","DOI":"10.1056\/NEJMoa021933","article-title":"Development of autoantibodies before the clinical onset of systemic lupus erythematosus","volume":"349","author":"Arbuckle","year":"2003","journal-title":"N Engl J Med"},{"key":"10.1038\/jid.2011.180_bb0015","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1006\/excr.1997.3923","article-title":"Role of the bullous pemphigoid antigen 180 (BP180) in the assembly of hemidesmosomes and cell adhesion-reexpression of BP180 in generalized atrophic benign epidermolysis bullosa keratinocytes","volume":"239","author":"Borradori","year":"1998","journal-title":"Exp Cell Res"},{"key":"10.1038\/jid.2011.180_bb0020","doi-asserted-by":"crossref","first-page":"5265","DOI":"10.4049\/jimmunol.166.8.5265","article-title":"Intermolecular antigen spreading occurs during the preclinical period of human type 1 diabetes","volume":"166","author":"Brooks-Worrell","year":"2001","journal-title":"J Immunol"},{"key":"10.1038\/jid.2011.180_bb0025","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1046\/j.1523-1747.1998.00107.x","article-title":"Epitope spreading: lessons from autoimmune skin diseases","volume":"110","author":"Chan","year":"1998","journal-title":"J Invest Dermatol"},{"key":"10.1038\/jid.2011.180_bb0030","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1001\/archdermatol.2011.23","article-title":"Usefulness of BP230 and BP180-NC16a enzyme-linked immunosorbent assays in the initial diagnosis and course in patients with bullous pemphigoid: a retrospective study of 138 patients","volume":"147","author":"Charneux","year":"2011","journal-title":"Arch Dermatol"},{"key":"10.1038\/jid.2011.180_bb0035","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/j.1365-2249.2006.03244.x","article-title":"Translational mini-review series on type 1 diabetes: systematic analysis of T cell epitopes in autoimmune diabetes","volume":"148","author":"Di Lorenzo","year":"2007","journal-title":"Clin Exp Immunol"},{"key":"10.1038\/jid.2011.180_bb0040","doi-asserted-by":"crossref","first-page":"864","DOI":"10.1038\/sj.jid.5700594","article-title":"The intracellular and extracellular domains of BP180 antigen comprise novel epitopes targeted by pemphigoid gestationis autoantibodies","volume":"127","author":"Di Zenzo","year":"2007","journal-title":"J Invest Dermatol"},{"key":"10.1038\/jid.2011.180_bb0045","doi-asserted-by":"crossref","first-page":"1040","DOI":"10.1038\/jid.2009.309","article-title":"Sequential intramolecular epitope spreading of humoral responses to human BPAG2 in a transgenic model","volume":"130","author":"Di Zenzo","year":"2010","journal-title":"J Invest Dermatol"},{"key":"10.1038\/jid.2011.180_bb0050","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1046\/j.0022-202X.2003.22126.x","article-title":"Characterization of the anti-BP180 autoantibody reactivity profile and epitope mapping in bullous pemphigoid patients","volume":"122","author":"Di Zenzo","year":"2004","journal-title":"J Invest Dermatol"},{"key":"10.1038\/jid.2011.180_bb0055","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1016\/j.clim.2008.04.012","article-title":"Multicenter prospective study of the humoral autoimmune response in bullous pemphigoid","volume":"128","author":"Di Zenzo","year":"2008","journal-title":"Clin Immunol"},{"key":"10.1038\/jid.2011.180_bb0060","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1111\/1523-1747.ep12616580","article-title":"Cloning and primary structural analysis of the bullous pemphigoid autoantigen BP180","volume":"99","author":"Giudice","year":"1992","journal-title":"J Invest Dermatol"},{"key":"10.1038\/jid.2011.180_bb0065","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/S0141-8130(05)80004-2","article-title":"Comparative structural analysis of desmoplakin, bullous pemphigoid antigen and plectin: members of a new gene family involved in organization of intermediate filaments","volume":"14","author":"Green","year":"1992","journal-title":"Int J Biol Macromol"},{"key":"10.1038\/jid.2011.180_bb0070","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1016\/j.autrev.2008.04.013","article-title":"Is the generation of neo-antigenic determinants by free radicals central to the development of autoimmune rheumatoid disease?","volume":"7","author":"Griffiths","year":"2008","journal-title":"Autoimmun Rev"},{"key":"10.1038\/jid.2011.180_bb0075","first-page":"282","article-title":"Detection of IgG autoantibodies in the sera of patients with bullous and gestational pemphigoid: ELISA studies utilizing a baculovirus-encoded form of bullous pemphigoid antigen 2","volume":"110","author":"Haase","year":"1998","journal-title":"J Invest Dermatol"},{"key":"10.1038\/jid.2011.180_bb0080","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1111\/1523-1747.ep12358276","article-title":"Rabbits immunized with a peptide encoded for by the 230-kD bullous pemphigoid antigen cDNA develop an enhanced inflammatory response to UVB irradiation: a potential animal model for bullous pemphigoid","volume":"101","author":"Hall","year":"1993","journal-title":"J Invest Dermatol"},{"key":"10.1038\/jid.2011.180_bb0085","doi-asserted-by":"crossref","first-page":"13739","DOI":"10.1074\/jbc.271.23.13739","article-title":"Demonstration of the molecular shape of BP180, a 180-kDa bullous pemphigoid antigen and its potential for trimer formation","volume":"271","author":"Hirako","year":"1996","journal-title":"J Biol Chem"},{"key":"10.1038\/jid.2011.180_bb0090","doi-asserted-by":"crossref","first-page":"1065","DOI":"10.1046\/j.1523-1747.2002.19529.x","article-title":"Severity and phenotype of bullous pemphigoid relate to autoantibody profile against the NH2- and COOH-terminal regions of the BP180 ectodomain","volume":"119","author":"Hofmann","year":"2002","journal-title":"J Invest Dermatol"},{"key":"10.1038\/jid.2011.180_bb0095","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jaut.2004.09.007","article-title":"Experimental bullous pemphigoid generated in mice with an antigenic epitope of the human hemidesmosomal protein BP230","volume":"24","author":"Kiss","year":"2005","journal-title":"J Autoimmun"},{"key":"10.1038\/jid.2011.180_bb0100","doi-asserted-by":"crossref","first-page":"1231","DOI":"10.4049\/jimmunol.136.4.1231","article-title":"Molecular heterogeneity of the bullous pemphigoid antigens as detected by immunoblotting","volume":"136","author":"Labib","year":"1986","journal-title":"J Immunol"},{"key":"10.1038\/jid.2011.180_bb0105","doi-asserted-by":"crossref","first-page":"2480","DOI":"10.1172\/JCI116856","article-title":"A passive transfer model of the organ-specific autoimmune disease, bullous pemphigoid, using antibodies generated against the hemidesmosomal antigen, BP180","volume":"92","author":"Liu","year":"1993","journal-title":"J Clin Invest"},{"key":"10.1038\/jid.2011.180_bb0110","doi-asserted-by":"crossref","first-page":"1004","DOI":"10.1111\/j.1365-2133.2004.06245.x","article-title":"Development of a novel ELISA system for detection of anti-BP180 IgG and characterization of autoantibody profile in bullous pemphigoid patients","volume":"151","author":"Mariotti","year":"2004","journal-title":"Br J Dermatol"},{"key":"10.1038\/jid.2011.180_bb0115","doi-asserted-by":"crossref","first-page":"43","DOI":"10.2353\/ajpath.2007.060544","article-title":"B-cell epitope spreading is a critical step for the switch from C-protein-induced myocarditis to dilated cardiomyopathy","volume":"170","author":"Matsumoto","year":"2007","journal-title":"Am J Pathol"},{"key":"10.1038\/jid.2011.180_bb0120","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/S0923-1811(97)00067-4","article-title":"Analysis of antigens targeted by circulating IgG and IgA autoantibodies in 50 patients with cicatricial pemphigoid","volume":"17","author":"Murakami","year":"1998","journal-title":"J Dermatol Sci"},{"key":"10.1038\/jid.2011.180_bb0125","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1016\/j.jaad.2008.01.012","article-title":"Consensus statement on definitions of disease, end points, and therapeutic response for pemphigus","volume":"58","author":"Murrell","year":"2008","journal-title":"J Am Acad Dermatol"},{"key":"10.1038\/jid.2011.180_bb0130","doi-asserted-by":"crossref","first-page":"6963","DOI":"10.4049\/jimmunol.161.12.6963","article-title":"Early development and spreading of autoantibodies to epitopes of IA-2 and their association with progression to type 1 diabetes","volume":"161","author":"Naserke","year":"1998","journal-title":"J Immunol"},{"key":"10.1038\/jid.2011.180_bb0135","doi-asserted-by":"crossref","first-page":"4938","DOI":"10.4049\/jimmunol.1001524","article-title":"Ectodomain shedding generates neoepitopes on collagen XVII, the major autoantigen for bullous pemphigoid","volume":"185","author":"Nishie","year":"2010","journal-title":"J Immunol"},{"key":"10.1038\/jid.2011.180_bb0140","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1038\/nm1496","article-title":"Humanization of autoantigen","volume":"13","author":"Nishie","year":"2007","journal-title":"Nat Med"},{"key":"10.1038\/jid.2011.180_bb0145","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1046\/j.1523-1747.1999.00497.x","article-title":"IgG autoantibodies from bullous pemphigoid (BP) patients bind antigenic sites on both the extracellular and the intracellular domains of the BP antigen 180","volume":"112","author":"Perriard","year":"1999","journal-title":"J Invest Dermatol"},{"key":"10.1038\/jid.2011.180_bb0150","doi-asserted-by":"crossref","first-page":"1260","DOI":"10.1002\/eji.200839129","article-title":"Clonal dissection of the human memory B-cell repertoire following infection and vaccination","volume":"39","author":"Pinna","year":"2009","journal-title":"Eur J Immunl"},{"key":"10.1038\/jid.2011.180_bb0155","doi-asserted-by":"crossref","first-page":"848","DOI":"10.1002\/art.24306","article-title":"Early targets of nuclear RNP humoral autoimmunity in human systemic lupus erythematosus","volume":"60","author":"Poole","year":"2009","journal-title":"Arthritis Rheum"},{"key":"10.1038\/jid.2011.180_bb0160","doi-asserted-by":"crossref","first-page":"1881","DOI":"10.2174\/1381612033454379","article-title":"Antibody penetration into living cells: pathogenic, preventive and immuno-therapeutic implications","volume":"9","author":"Ruiz-Arg\u00fcelles","year":"2003","journal-title":"Curr Pharm Des"},{"key":"10.1038\/jid.2011.180_bb0165","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1001\/archderm.136.2.174","article-title":"Serum levels of autoantibodies to BP180 correlate with disease activity in patients with bullous pemphigoid","volume":"136","author":"Schmidt","year":"2000","journal-title":"Arch Dermatol"},{"key":"10.1038\/jid.2011.180_bb0170","doi-asserted-by":"crossref","first-page":"998","DOI":"10.1046\/j.1523-1747.2000.00893.x","article-title":"IgG autoantibodies from bullous pemphigoid patients recognize multiple antigenic reactive sites located predominantly within the B and C subdomains of the COOH-terminus of BP230","volume":"114","author":"Skaria","year":"2000","journal-title":"J Invest Dermatol"},{"key":"10.1038\/jid.2011.180_bb0175","doi-asserted-by":"crossref","first-page":"1864","DOI":"10.1172\/JCI113803","article-title":"Isolation of complementary DNA for bullous pemphigoid antigen by use of patients\u2019 autoantibodies","volume":"82","author":"Stanley","year":"1988","journal-title":"J Clin Invest"},{"key":"10.1038\/jid.2011.180_bb0180","series-title":"Stata Statistical Software: Release 9","author":"StataCorp","year":"2005"},{"key":"10.1038\/jid.2011.180_bb0185","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1111\/1523-1747.ep12484223","article-title":"Characterization of bullous pemphigoid antibodies by use of recombinant bullous pemphigoid antigen proteins","volume":"97","author":"Tanaka","year":"1991","journal-title":"J Invest Dermatol"},{"key":"10.1038\/jid.2011.180_bb0190","doi-asserted-by":"crossref","first-page":"1413","DOI":"10.1111\/j.0022-202X.2004.22603.x","article-title":"BP230- and BP180-specific auto-antibodies in bullous pemphigoid","volume":"122","author":"Thoma-Uszynski","year":"2004","journal-title":"J Invest Dermatol"},{"key":"10.1038\/jid.2011.180_bb0195","doi-asserted-by":"crossref","first-page":"2015","DOI":"10.4049\/jimmunol.176.3.2015","article-title":"Autoreactive T and B cells from bullous pemphigoid (BP) patients recognize epitopes clustered in distinct regions of BP180 and BP230","volume":"176","author":"Thoma-Uszynski","year":"2006","journal-title":"J Immunol"},{"key":"10.1038\/jid.2011.180_bb0200","doi-asserted-by":"crossref","first-page":"2166","DOI":"10.4049\/jimmunol.0903101","article-title":"A novel active mouse model for bullous pemphigoid targeting humanized pathogenic antigen","volume":"184","author":"Ujiie","year":"2010","journal-title":"J Immunol"},{"key":"10.1038\/jid.2011.180_bb0205","doi-asserted-by":"crossref","first-page":"1729","DOI":"10.1053\/gast.2002.33606","article-title":"The gluten response in children with celiac disease is directed toward multiple gliadin and glutenin peptides","volume":"122","author":"Vader","year":"2002","journal-title":"Gastroenterology"},{"key":"10.1038\/jid.2011.180_bb0210","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1038\/nri724","article-title":"Epitope spreading in immune-mediated diseases: implications for immunotherapy","volume":"2","author":"Vanderlugt","year":"2002","journal-title":"Nat Rev Immunol"},{"key":"10.1038\/jid.2011.180_bb0215","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1046\/j.0022-202x.2001.01683.x","article-title":"Cloning of hamster type XVII collagen cDNA, and pathogenesis of anti-type XVII collagen antibody and complement in hamster bullous pemphigoid","volume":"118","author":"Yamamoto","year":"2002","journal-title":"J Invest Dermatol"},{"key":"10.1038\/jid.2011.180_bb0220","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/j.jdermsci.2005.11.002","article-title":"Enzyme-linked immunosorbent assay using bacterial recombinant proteins of human BP230 as a diagnostic tool for bullous pemphigoid","volume":"41","author":"Yoshida","year":"2006","journal-title":"J Dermatol Sci"},{"key":"10.1038\/jid.2011.180_bb0225","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1111\/1523-1747.ep12338088","article-title":"A highly sensitive enzyme-linked immunosorbent assay for the detection of circulating anti-BP180 autoantibodies in patients with bullous pemphigoid","volume":"109","author":"Zillikens","year":"1997","journal-title":"J Invest Dermatol"}],"container-title":["Journal of Investigative Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0022202X15350752?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0022202X15350752?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,4,6]],"date-time":"2025-04-06T07:55:26Z","timestamp":1743926126000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0022202X15350752"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,11]]},"references-count":44,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2011,11]]}},"alternative-id":["S0022202X15350752"],"URL":"https:\/\/doi.org\/10.1038\/jid.2011.180","relation":{},"ISSN":["0022-202X"],"issn-type":[{"value":"0022-202X","type":"print"}],"subject":[],"published":{"date-parts":[[2011,11]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Demonstration of Epitope-Spreading Phenomena in Bullous Pemphigoid: Results of a Prospective Multicenter Study","name":"articletitle","label":"Article Title"},{"value":"Journal of Investigative Dermatology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1038\/jid.2011.180","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"Copyright \u00a9 2011 The Society for Investigative Dermatology, Inc. Published by Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}]}}