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Immunology and Allergy Overview / Directory

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Purpose of the test

The identification of autoantibodies in the immunobullous disorders by indirect immunofluorescence (IIF) plays a major part in the diagnosis of these disorders.

Pemphigus has several variants whose autoantibodies target in particular members of the cadherin superfamily desmoglein 1 and desmoglein 3. The pattern seen in IIF is that of intercellular staining within stratified squamous epithelium (this does not differentiate between desmogleins 1 and 3, antigen specific assays are required for such differentiation). Approximately 90% of pemphigus vulgaris patients have autoantibody detectable by IIF.

Some 70% of bullous pemphigoid patients have circulating autoantibodies to a hemidesmosomal component, BP 230 (BPAG1) and a collagen XVII domain known as BP180 (BPAG2). In IIF the pattern is seen as staining at the dermo-epidermal junction (basement membrane zone).

Other immunobullous disorders can be usefully investigated with IIF. Please contact as below for further advice.

It is strongly advised that biopsy examination by direct immunofluorescence and light microscopy be undertake as part of the investigation of the above disorders.

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Sample Requirements

2 ml freshly separated serum

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Storage and Transport

Serum stored at 4°C should be sent by first class post

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Turnaround Time

6 working days

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Time Limit for Extra Tests

Five days

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Factors affecting results or interpretation

All tests are compromised by prolonged transit times. For this reason, date of bleed and date of postage must be provided with each request.

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Price

Price available on application - please contact adrianturner1@nhs.net. Discounts could be available for significant workloads.

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Contacts

Dr Ted Davies, Consultant Clinical Scientist

T 020 3299 9000 Ex 8752

E edward.davies1@nhs.net

John Cazabon or Rosemary Ebling, Lead Biomedical Scientists

T 020 3299 1559

E john.cazabon@nhs.net

E rosemary.ebling@nhs.net

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