Comparative Analysis of BIOCHIP Mosaic Based Indirect Immunofluorescence with Direct Immunofluorescence in Diagnosis of Autoimmune Bullous Skin Diseases

Arunprasath, P (2020) Comparative Analysis of BIOCHIP Mosaic Based Indirect Immunofluorescence with Direct Immunofluorescence in Diagnosis of Autoimmune Bullous Skin Diseases. Masters thesis, PSG Institute of Medical Sciences and Research, Coimbatore.


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BACKGROUND: Autoimmune bullous skin diseases (AIBD) are a heterogeneous group of diseases characterized by autoantibodies against desmosomal proteins in pemphigus group of disorders and adhesion molecules of the dermal-epidermal junction in pemphigoid group of diseases. DIF establishes diagnosis of AIBD by demonstrating intercellular deposits of IgG and C3 in case of pemphigus vulgaris (PV) and linear deposits of IgG and C3 along the basement membrane zone (BMZ) in bullous pemphigoid (BP). BIOCHIP mosaic, a novel diagnostic approach employs detection of characteristic staining pattern and target antigens in a single miniature incubation field. AIM OF THE STUDY: To compare the BIOCHIP mosaic based IIF with DIF in the diagnosis of AIBD. OBJECTIVE: To determine the sensitivity and specificity of BIOCHIP method in diagnosing AIBD by comparing it with the gold standard DIF test. MATERIALS AND METHODS: A total of 40 patients of AIBD in active phase of the disease were included in the study. Skin biopsy was done in these patients for DIF study and serum was subjected to BIOCHIP mosaic based IIF assay. The results were then compared. RESULTS: DIF revealed a diagnosis of PV in 18 patients and BP in 22 patients. BIOCHIP confirmed the diagnosis of PV in 18 patients. But in 22 patients diagnosed as BP by DIF, BIOCHIP revealed a diagnosis of BP in 18 patients and floor pattern staining in 4 patients which could be attributed to any of the floor pattern staining subepidermal blistering disease like epidermolysis bullousa Acquisita, Anti P200 Pemphigoid and Anti Laminin 332 Pemphigoid. Using the BIOCHIP mosaic, sensitivities of the desmoglein 1 and desmoglein 3 specific substrates were 83.3% and 88.8% respectively. And that of BP 180 and BP 230 specific substrates were 77.3% and 68.2% respectively. CONCLUSION: This study concludes that the BIOCHIP method has a high degree of sensitivity and specificity in the diagnosis of AIBD and its diagnostic accuracy is comparable with the DIF. The advantages of the BIOCHIP includes simultaneous, multiparametric analysis of all relevant target antigens and characteristic staining pattern in a single field, avoids invasive technique as in biopsy and provides faster results. BIOCHIP could be used as cost-effective and first line screening tool in diagnosis of AIBD replacing biopsy and DIF.

Item Type: Thesis (Masters)
Additional Information: 201830351
Uncontrolled Keywords: Autoimmune bullous skin diseases (AIBD), BIOCHIP dermatology mosaic, Direct Immunofluorescence, Indirect Immunofluorescence.
Subjects: MEDICAL > Dermatology Venereology and Leprosy
Depositing User: Subramani R
Date Deposited: 05 Feb 2021 15:51
Last Modified: 05 Feb 2021 15:51

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