{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T20:49:58Z","timestamp":1760042998641},"reference-count":37,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2013,3,6]],"date-time":"2013-03-06T00:00:00Z","timestamp":1362528000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Italian Ministry of Health"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2014,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Epidermolysis bullosa acquisita (<jats:styled-content style=\"fixed-case\">EBA<\/jats:styled-content>) is an autoimmune blistering disease characterized by tissue\u2010bound and circulating autoantibodies to the dermal\u2010epidermal junction. The autoantibody target is type <jats:styled-content style=\"fixed-case\">VII<\/jats:styled-content> collagen (Col <jats:styled-content style=\"fixed-case\">VII<\/jats:styled-content>) which is involved in dermal\u2010epidermal adhesion. Diagnosis is made by clinical and histopathological findings, linear deposition of autoantibodies at the dermal\u2010epidermal junction detected by direct immunofluorescence, and binding to the dermal side of salt\u2010split skin by indirect immunofluorescence (<jats:styled-content style=\"fixed-case\">IIF<\/jats:styled-content>). However, the detection of specific anti\u2010Col <jats:styled-content style=\"fixed-case\">VII<\/jats:styled-content> reactivity has an important confirmatory value.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The humoral immune response in <jats:styled-content style=\"fixed-case\">EBA<\/jats:styled-content> sera was analysed by (i) <jats:styled-content style=\"fixed-case\">IIF<\/jats:styled-content> on human skin, (ii) a commercial Col <jats:styled-content style=\"fixed-case\">VII ELISA<\/jats:styled-content>, and (iii) immunoblotting on Col <jats:styled-content style=\"fixed-case\">VII<\/jats:styled-content> produced by an epithelial cell line.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>The aim of this study was to compare the sensitivity of different approaches for the serological diagnosis of <jats:styled-content style=\"fixed-case\">EBA<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The vast majority of <jats:styled-content style=\"fixed-case\">EBA<\/jats:styled-content> sera (79.2%) bound to the Col <jats:styled-content style=\"fixed-case\">VII<\/jats:styled-content> non\u2010collagenous domains by a commercial <jats:styled-content style=\"fixed-case\">ELISA<\/jats:styled-content>, while a small proportion of patients (12.5%) exclusively reacted to the collagenous domain by immunoblotting. Of note, the autoantibodies reactivity to Col <jats:styled-content style=\"fixed-case\">VII<\/jats:styled-content> was more frequently detected by <jats:styled-content style=\"fixed-case\">IB<\/jats:styled-content> (91.7%) than by <jats:styled-content style=\"fixed-case\">IIF<\/jats:styled-content> (83.3%) and <jats:styled-content style=\"fixed-case\">ELISA<\/jats:styled-content> (79.2%). Interestingly, 2 out of 24 sera recognized Col <jats:styled-content style=\"fixed-case\">VII<\/jats:styled-content> epitopes undetectable in the native secreted protein but present in the context of extracellular matrix proteins, as assessed by immunomapping on Col <jats:styled-content style=\"fixed-case\">VII<\/jats:styled-content>\u2010deficient skin.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our findings show that the use of multiple assays allows to improve diagnostic performance. An algorithm for efficient serological diagnosis of <jats:styled-content style=\"fixed-case\">EBA<\/jats:styled-content> is proposed.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jdv.12129","type":"journal-article","created":{"date-parts":[[2013,3,6]],"date-time":"2013-03-06T09:29:51Z","timestamp":1362562191000},"page":"483-490","source":"Crossref","is-referenced-by-count":10,"title":["Sensitivity of different assays for the serological diagnosis of epidermolysis bullosa acquisita: analysis of a cohort of 24 Italian patients"],"prefix":"10.1111","volume":"28","author":[{"given":"V.","family":"Calabresi","sequence":"first","affiliation":[{"name":"Molecular and Cell Biology Laboratory Istituto Dermopatico dell'Immacolata IDI\u2010IRCCS Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Sinistro","sequence":"additional","affiliation":[{"name":"Molecular and Cell Biology Laboratory Istituto Dermopatico dell'Immacolata IDI\u2010IRCCS Rome 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