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. 2023 Jun;37(6):1207-1214.
doi: 10.1111/jdv.18973. Epub 2023 Mar 6.

Anti-BP180 IgG antibody ELISA values correlate with adverse pregnancy outcomes in pemphigoid gestationis

Nadège Cordel  1   2 , Jasmine Flament  3 , Fabienne Jouen  2   4 , Vannina Seta  5 , Emmanuelle Tancrède-Bohin  6 , Catherine Picard Dahan  7 , Maria-Polina Konstantinou  8 , Olivier Dereure  9 , Gaëlle Quéreux  10 , Catherine Prost  11 , Christophe Bedane  12 , Sébastien Debarbieux  13 , Jean-Philippe Lacour  14 , Anne Dompmartin  15 , Ewa Wierzbicka-Hainaut  16 , Isabelle Bourgault Villada  17 , Saskia Ingen Housz Oro  18 , Pierre Vabres  19 , Marie-Aleth Richard  20 , Emmanuel Delaporte  21 , Anne Pham-Ledard  22 , Marie-Thérèse Leccia  23 , Noémie Litrowski  24 , Catherine Michel  25 , Brigitte Lagrange  26 , Michel D'Incan  27 , Claire Abasq  28 , Sophie Duvert-Lehembre  29 , Alain Dupuy  30 , Isabelle Alcaraz  31 , Anne-Laure Breton-Guitarian  32 , Florian Lombart  33 , Eric Estève  34 , Laurent Machet  35 , Pascal Del Giudice  36 , Marion Fenot  37 , Thibaut Belmondo  38 , Florence Morin  39 , Olivia Guérin  40 , Jacques Benichou  40   41 , Benoît Tressières  42 , Pascal Joly  2   3 ; French study Group on autoimmune bullous skin diseases
Affiliations

Anti-BP180 IgG antibody ELISA values correlate with adverse pregnancy outcomes in pemphigoid gestationis

Nadège Cordel et al. J Eur Acad Dermatol Venereol. 2023 Jun.

Abstract

Background: Adverse pregnancy outcomes (APO) occur in 35% of patients with pemphigoid gestationis (PG). No biological predictor of APO has been established yet.

Objectives: To assess a potential relationship between the occurrence of APO and the serum value of anti-BP180 antibodies at the time of PG diagnosis.

Methods: Multicentre retrospective study conducted from January 2009 to December 2019 in 35 secondary and tertiary care centres.

Inclusion criteria: (i) diagnosis of PG according to clinical, histological and immunological criteria, (ii) ELISA measurement of anti-BP180 IgG antibodies determined at the time of PG diagnosis with the same commercial kit and (iii) obstetrical data available.

Results: Of the 95 patients with PG included, 42 had one or more APO, which mainly corresponded to preterm birth (n = 26), intrauterine growth restriction (IUGR) (n = 18) and small weight for gestational age at birth (n = 16). From a ROC curve, we identified a threshold of 150 IU ELISA value as the most discriminating to differentiate between patients with or without IUGR, with 78% sensitivity, 55% specificity, 30% positive and 91% negative predictive value. The threshold >150 IU was confirmed using a cross-validation based on bootstrap resampling, which showed that the median threshold was 159 IU. Upon adjusting for oral corticosteroid intake and main clinical predictors of APO, an ELISA value of >150 IU was associated with the occurrence of IUGR (OR = 5.11; 95% CI: 1.48-22.30; p = 0.016) but not with any other APO. The combination of blisters and ELISA values higher than 150 IU led to a 2.4-fold higher risk of all-cause APO (OR: 10.90; 95% CI: 2.33-82.3) relative to patients with blisters but lower values of anti-BP180 antibodies (OR of 4.54; 95% CI 0.92-34.2).

Conclusion: These findings suggest that anti-BP180 antibody ELISA value in combination with clinical markers is helpful in managing the risk of APO, in particular IUGR, in patients with PG.

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References

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