AUTHOR=Mee John B. 

TITLE=Diagnostic Techniques in Autoimmune Blistering Diseases

JOURNAL=British Journal of Biomedical Science

VOLUME=Volume 80 - 2023

YEAR=2023

URL=https://www.frontierspartnerships.org/journals/british-journal-of-biomedical-science/articles/10.3389/bjbs.2023.11809

DOI=10.3389/bjbs.2023.11809

ISSN=2474-0896

ABSTRACT=Autoimmune blistering diseases (AIBD) comprise a heterogeneous group of uncommon disorders of the skin and mucous membranes, characterised by anFbodies targeFng structural proteins within epithelial Fssue and the underlying basement membrane. There can be significant overlap in clinical presentaFon of these diseases and accurate diagnosis relies on the detecFon and characterisaFon of relevant autoanFbodies.Immunofluorescence provides the gold-standard diagnosFc tool for these diseases, idenFfying both Fssue-bound autoanFbodies in biopsy material using direct immunofluorescence and circulaFng anFbodies in serum through indirect immunofluorescence. Following advances in the idenFficaFon and subsequent characterisaFon of numerous anFgenic targets in these diseases, the development of anFgen-specific tests, in parFcular, enzyme-linked immunosorbent assays on serum specimens, has provided a third key tool to not only idenFfy, but also quanFfy AIBD autoanFbodies. This quanFficaFon has proven parFcularly useful in monitoring disease acFvity and informing clinical management decisions. Accurate diagnosis of these diseases is important since opFmal treatment strategies differ between them and, prognosFcally, some diagnoses are associated with an increased risk of malignancy. This review outlines the molecular pathology underlying the major AIBD and describes how the three principal techniques can be used in combinaFon, to provide best pracFce for diagnosis and treatment monitoring.