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Journal Articles Journal of the European Academy of Dermatology and Venereology Year : 2023

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

Nadège Cordel
Jasmine Flament
  • Function : Author
Fabienne Jouen
  • Function : Author
Vannina Seta
  • Function : Author
Emmanuelle Tancrède-Bohin
  • Function : Author
Catherine Picard Dahan
  • Function : Author
Maria‐polina Konstantinou
Olivier Dereure
Gaëlle Quéreux
  • Function : Author
Catherine Prost
  • Function : Author
Christophe Bedane
  • Function : Author
Sébastien Debarbieux
  • Function : Author
Jean‐philippe Lacour
  • Function : Author
Anne Dompmartin
  • Function : Author
Ewa Wierzbicka-Hainaut
  • Function : Author
Isabelle Bourgault Villada
  • Function : Author
Pierre Vabres
  • Function : Author
Marie‐aleth Richard
  • Function : Author
Anne Pham-Ledard
Marie‐thérèse Leccia
  • Function : Author
Noémie Litrowski
  • Function : Author
Catherine Michel
  • Function : Author
Brigitte Lagrange
  • Function : Author
Claire Abasq
  • Function : Author
Sophie Duvert-Lehembre
  • Function : Author
Isabelle Alcaraz
  • Function : Author
Anne‐laure Breton-Guitarian
  • Function : Author
Florian Lombart
  • Function : Author
Eric Estève
  • Function : Author
Laurent Machet
Pascal del Giudice
  • Function : Author
Marion Fenot
  • Function : Author
Thibaut Belmondo
  • Function : Author
Florence Morin
  • Function : Author
Olivia Guérin
  • Function : Author
Jacques Benichou
  • Function : Author
Pascal Joly

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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Dermatology
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hal-04099670 , version 1 (30-05-2024)

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Nadège Cordel, Jasmine Flament, Fabienne Jouen, Vannina Seta, Emmanuelle Tancrède-Bohin, et al.. Anti‐BP180 IgG antibody ELISA values correlate with adverse pregnancy outcomes in pemphigoid gestationis. Journal of the European Academy of Dermatology and Venereology, 2023, 37 (6), pp.1207-1214. ⟨10.1111/jdv.18973⟩. ⟨hal-04099670⟩
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