{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T22:42:36Z","timestamp":1774737756565,"version":"3.50.1"},"reference-count":43,"publisher":"Termedia Sp. z.o.o.","issue":"2","license":[{"start":{"date-parts":[[2021,6,15]],"date-time":"2021-06-15T00:00:00Z","timestamp":1623715200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0\/"},{"start":{"date-parts":[[2021,6,15]],"date-time":"2021-06-15T00:00:00Z","timestamp":1623715200000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0\/"},{"start":{"date-parts":[[2021,6,15]],"date-time":"2021-06-15T00:00:00Z","timestamp":1623715200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cent Eur J Immunol"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Autoimmune bullous diseases (ABDs) are potentially life-threatening mucocutaneous illnesses that require diagnosis with direct immunofluorescence (DIF). In this study we compared the diagnostic accuracy of traditional DIF (DIFt; separate immunoglobulin (Ig) G, IgG1, IgG4, IgA, IgM and C3 deposits detection) and modified DIF (DIFm; simultaneous IgG + IgG4 deposits detection instead of separate IgG and IgG4 deposits detection) in routine diagnostics of ABDs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and methods<\/jats:title>\n                    <jats:p>Eighteen patients with ABDs (7 with pemphigus dermatoses and 11 with subepithelial ABDs) were evaluated with DIFt and DIFm.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The agreement of detectability of IgG immunoreactants was obtained in 16 ABD cases (88.89%), as positive results in both DIFt and DIFm were obtained in 13 cases and negative results in both DIFt and DIFm were obtained in 3 cases. One ABD case (Brunsting-Perry pemphigoid) (5.56%) was negative in DIFm with a\u00a0positive DIFt result (IgG1 deposits). One ABD case (bullous pemphigoid) (5.56%) had only C3 deposits in DIFt with a\u00a0positive DIFm reading (IgG + IgG4 deposits). A\u00a0statistically significant relationship (p = 0.0186) between DIFm and DIFt results was revealed using Fisher\u2019s exact test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Both DIFt and DIFm are useful methods to detect deposition of IgG immunoreactants, but it seems that the innovative DIFm method slightly increases the detectability of IgG\/IgG4 immunoreactants in relation to DIFt. The introduction of DIFm into routine laboratory diagnostics of ABDs seems to be justified, as it enables the abandonment of separate FITC conjugates for IgG and IgG4, which is important for cost-effectiveness.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.5114\/ceji.2021.107028","type":"journal-article","created":{"date-parts":[[2021,9,16]],"date-time":"2021-09-16T04:42:22Z","timestamp":1631767342000},"page":"183-190","source":"Crossref","is-referenced-by-count":7,"title":["Conceptualization and validation of an innovative direct immunofluorescence technique utilizing fluorescein conjugate\nagainst IgG + IgG4 for routinely diagnosing\nautoimmune bullous dermatoses"],"prefix":"10.5114","volume":"46","author":[{"given":"Magdalena","family":"Danuta Ja\u0142owska","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justyna","family":"Gornowicz-Porowska","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Agnieszka","family":"Seraszek-Jaros","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monika","family":"Bowszyc-Dmochowska","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"El\u017cbieta","family":"Kaczmarek","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marian","family":"Dmochowski","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3061","published-online":{"date-parts":[[2021,6,15]]},"reference":[{"key":"ref-1541202","doi-asserted-by":"crossref","first-page":"1974","DOI":"10.3389\/fimmu.2019.01974","article-title":"Serological diagnosis of autoimmune bullous skin diseases","volume":"20","author":"Saschenbrecker S","year":"2019","unstructured":"Saschenbrecker S, Karl I, Komorowski L (2019): Serological diagnosis of autoimmune bullous skin diseases. Front Immunol 20: 1974.","journal-title":"Front Immunol"},{"key":"ref-1541203","first-page":"179","article-title":"Pemphigus vegetans\u2013immunopathological findings in a rare variant of pemphigus vulgaris","volume":"8","author":"Monshi B","year":"2010","unstructured":"Monshi B, Marker M, Feichtinger H, et al. (2010): Pemphigus vegetans\u2013immunopathological findings in a rare variant of pemphigus vulgaris. J Dtsch Dermatol Ges 8: 179-183.","journal-title":"J Dtsch Dermatol Ges"},{"key":"ref-1541204","doi-asserted-by":"crossref","first-page":"371","DOI":"10.3390\/genes11040371","article-title":"A comparative analysis of CD32A and CD16A polymorphisms in relation to autoimmune responses in pemphigus diseases and subepithelial autoimmune blistering disorders","volume":"11","author":"Gornowicz-Porowska J","year":"2020","unstructured":"Gornowicz-Porowska J, Kowalczyk MJ, Seraszek-Jaros A, et al. (2020): A comparative analysis of CD32A and CD16A polymorphisms in relation to autoimmune responses in pemphigus diseases and subepithelial autoimmune blistering disorders. Genes (Basel) 11: 371.","journal-title":"Genes (Basel)"},{"key":"ref-1541205","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1016\/j.autrev.2010.08.007","article-title":"Modern diagnosis of autoimmune blistering skin diseases","volume":"10","author":"Schmidt E","year":"2010","unstructured":"Schmidt E, Zillikens D (2010): Modern diagnosis of autoimmune blistering skin diseases. Autoimmun Rev 10: 84-89.","journal-title":"Autoimmun Rev"},{"key":"ref-1541206","doi-asserted-by":"crossref","first-page":"21","DOI":"10.5114\/ada.2017.65617","article-title":"Accuracy of molecular diagnostics in pemphigus and bullous pemphigoid: comparison of commercial and modified mosaic indirect immunofluorescence tests as well as enzyme-linked immunosorbent assays","volume":"24","author":"Gornowicz-Porowska J","year":"2017","unstructured":"Gornowicz-Porowska J, Seraszek-Jaros A, Bowszyc-Dmochowska M, et al. (2017): Accuracy of molecular diagnostics in pemphigus and bullous pemphigoid: comparison of commercial and modified mosaic indirect immunofluorescence tests as well as enzyme-linked immunosorbent assays. Adv Dermatol Allergol 24: 21-27.","journal-title":"Adv Dermatol Allergol"},{"key":"ref-1541207","doi-asserted-by":"crossref","first-page":"885","DOI":"10.1590\/abd1806-4841.20143221","article-title":"Immunofluorescence testing in the diagnosis of autoimmune blistering diseases: overview of 10-year experience","volume":"89","author":"Arbache ST","year":"2014","unstructured":"Arbache ST, Nogueira TG, Delgado L, et al. (2014): Immunofluorescence testing in the diagnosis of autoimmune blistering diseases: overview of 10-year experience. An Bras Dermatol 89: 885-889.","journal-title":"An Bras Dermatol"},{"key":"ref-1541208","first-page":"1077","article-title":"Diagnosis of autoimmune bullous diseases","volume":"16","author":"van Beek N","year":"2018","unstructured":"van Beek N, Zilliken D, Schmidt E (2018): Diagnosis of autoimmune bullous diseases. 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J Dermatol Sci 26: 55-61.","journal-title":"J Dermatol Sci"},{"key":"ref-1541214","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1111\/apm.12643","article-title":"Can immunohistochemistry replace immunofluorescence in diagnosis of skin bullous diseases?","volume":"125","author":"Al-Shenawy HA","year":"2017","unstructured":"Al-Shenawy HA (2017): Can immunohistochemistry replace immunofluorescence in diagnosis of skin bullous diseases? APMIS 125: 114-121.","journal-title":"APMIS"},{"key":"ref-1541215","doi-asserted-by":"crossref","first-page":"1369","DOI":"10.1038\/nbt1207-1369","article-title":"Isotype selection in antibody engineering","volume":"25","author":"Salfeld JG","year":"2007","unstructured":"Salfeld JG (2007): Isotype selection in antibody engineering. Nat Biotechnol 25: 1369-1372.","journal-title":"Nat Biotechnol"},{"key":"ref-1541216","first-page":"469","article-title":"Immunoglobulin G4: an odd antibody Clin Exp Allergy","volume":"39","author":"Aalberse RC","year":"2009","unstructured":"Aalberse RC, Stapel SO, Schuurman J, et al. (2009): Immunoglobulin G4: an odd antibody Clin Exp Allergy 39: 469-477."},{"key":"ref-1541217","doi-asserted-by":"crossref","first-page":"80","DOI":"10.5114\/ceji.2013.34362","article-title":"Immunoglobulin G4 is prevailing over immunoglobulin G1 in autoimmunity of pemphigus and bullous pemphigoid: analysis of tissue-bound antibodies in active diseases","volume":"38","author":"Gornowicz-Porowska J","year":"2013","unstructured":"Gornowicz-Porowska J, Pietkiewicz P, Bowszyc-Dmochowska M, et al. (2013): Immunoglobulin G4 is prevailing over immunoglobulin G1 in autoimmunity of pemphigus and bullous pemphigoid: analysis of tissue-bound antibodies in active diseases. 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(2007): IgG4 autoantibodies induce dermal-epidermal separation. J Cell Mol Med 11: 1117-1128."},{"key":"ref-1541220","first-page":"189","article-title":"Immediate hypersensitivity phenomena in bullous pemphigoid: critical concepts","volume":"33","author":"Bowszyc-Dmochowska M","year":"2002","unstructured":"Bowszyc-Dmochowska M, Dmochowski M (2002): Immediate hypersensitivity phenomena in bullous pemphigoid: critical concepts. J Med 33: 189-198.","journal-title":"J Med"},{"key":"ref-1541221","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1007\/BF00372587","article-title":"The analysis of IgG subclasses of anti-intercellular antibodies in pemphigus by an immunoblot technique","volume":"284","author":"Dmochowski M","year":"1992","unstructured":"Dmochowski M, Hashimoto T, Nishikawa T (1992): The analysis of IgG subclasses of anti-intercellular antibodies in pemphigus by an immunoblot technique. Arch Dermatol Res 284: 309-311.","journal-title":"Arch Dermatol Res"},{"key":"ref-1541222","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/S0923-1811(99)00012-2","article-title":"Human desmocollin 1a transiently expressed in COS-7 cells and NIH 3T3-3 cells is reacted by IgG4 antibodies in a pemphigus foliaceus serum","volume":"21","author":"Dmochowski M","year":"1999","unstructured":"Dmochowski M, Nie Z, Kiyokawa C, et al. (1999): Human desmocollin 1a transiently expressed in COS-7 cells and NIH 3T3-3 cells is reacted by IgG4 antibodies in a pemphigus foliaceus serum. J Dermatol Sci 21: 42-48.","journal-title":"J Dermatol Sci"},{"key":"ref-1541223","first-page":"520","article-title":"Oznaczanie przeciwcia\u0142 IgG4 w surowicy u chorych na IgG-mediowane autoimmunizacyjne podnask\u00f3rkowe dermatozy p\u0119cherzowe zwi\u0119ksza wykrywanie autoimmunizacji\/Determination of serum IgG4 antibodies in patients with IgG-mediated autoimmune subepidermal bullous dermatoses increases the detection of autoimmunity. XXX Congress of the Polish Dermatological Society, Cracow, September 19-22, 2012","volume":"99","author":"Pietkiewicz P","year":"2012","unstructured":"Pietkiewicz P, Gornowicz-Porowska J, Dmochowski M, Bowszyc-Dmochowska M (2012): Oznaczanie przeciwcia\u0142 IgG4 w surowicy u chorych na IgG-mediowane autoimmunizacyjne podnask\u00f3rkowe dermatozy p\u0119cherzowe zwi\u0119ksza wykrywanie autoimmunizacji\/Determination of serum IgG4 antibodies in patients with IgG-mediated autoimmune subepidermal bullous dermatoses increases the detection of autoimmunity. XXX Congress of the Polish Dermatological Society, Cracow, September 19-22, 2012. Dermatol Rev\/Przegl Dermatol 99: 520.","journal-title":"Dermatol Rev\/Przegl Dermatol"},{"key":"ref-1541224","first-page":"s42","article-title":"Nabyte p\u0119cherzowe oddzielanie si\u0119 nask\u00f3rka jako schorzenie wielonarz\u0105dowe\/Epidermolysis bullosa acquisita as a multiorgan disease. 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Br J Dermatol 180: 149-156.","journal-title":"Br J Dermatol"},{"key":"ref-1541226","doi-asserted-by":"crossref","first-page":"1735","DOI":"10.1002\/jemt.23339","article-title":"Blue light-emitting diode technology-operated microscopy is preferable to both short arc mercury lamp-operated microscopy and laser scanning confocal microscopy for direct immunofluorescence images evaluation in routinely diagnosing subepidermal autoimmune blistering diseases","volume":"82","author":"Gornowicz-Porowska J","year":"2019","unstructured":"Gornowicz-Porowska J, Bowszyc-Dmochowska M, Raptis-Bolwach, et al. (2019): Blue light-emitting diode technology-operated microscopy is preferable to both short arc mercury lamp-operated microscopy and laser scanning confocal microscopy for direct immunofluorescence images evaluation in routinely diagnosing subepidermal autoimmune blistering diseases. Microsc Res Tech 82: 1735-1740.","journal-title":"Microsc Res Tech"},{"key":"ref-1541227","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1097\/DAD.0000000000001516","article-title":"Practical direct immunofluorescence","volume":"42","author":"Kim RH","year":"2020","unstructured":"Kim RH, Brinster NK (2020): Practical direct immunofluorescence. Am J Dermatopathol 42: 75-85.","journal-title":"Am J Dermatopathol"},{"key":"ref-1541228","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s00403-007-0734-0","article-title":"The relevance of the IgG subclass of autoantibodies for blister induction in autoimmune bullous skin diseases","volume":"299","author":"Sitaru C","year":"2007","unstructured":"Sitaru C, Mihai S, Zillikens D (2007): The relevance of the IgG subclass of autoantibodies for blister induction in autoimmune bullous skin diseases. 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(2017): Pemphigoid gestationis: clinical and histologic features of twenty-three patients. Int J Womens Dermatol 3: 86-90.","journal-title":"Int J Womens Dermatol"},{"key":"ref-1541237","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1016\/j.jdermsci.2017.07.012","article-title":"IgG4, complement, and the mechanisms of blister formation in pemphigus and bullous pemphigoid","volume":"88","author":"Dainichi T","year":"2017","unstructured":"Dainichi T, Chow Z, Kabashima K (2017): IgG4, complement, and the mechanisms of blister formation in pemphigus and bullous pemphigoid. J Dermatol Sci 88: 265-270.","journal-title":"J Dermatol Sci"},{"key":"ref-1541238","doi-asserted-by":"crossref","first-page":"1477","DOI":"10.3389\/fimmu.2019.01477","article-title":"Complement activation in autoimmune bullous dermatoses: a comprehensive review","volume":"10","author":"Edwards G","year":"2019","unstructured":"Edwards G, Diercks FH, Seelen MAJ, et al. 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