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Anti–Laminin γ1 Pemphigoid Accompanied by Autoantibodies to Laminin α3 and γ2 Subunits of Laminin-332

Masahiro Kamata, MD, PhD1; Hideki Fujita, MD, PhD1; Taeko Hamanaka, MD1; Koji Takahashi, MD1; Hiroshi Koga, MD2; Takashi Hashimoto, MD2; Shinichi Sato, MD, PhD1
[+] Author Affiliations
1Department of Dermatology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
2Department of Dermatology, Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology, Kurume, Fukuoka, Japan
JAMA Dermatol. 2013;149(12):1437-1439. doi:10.1001/jamadermatol.2013.5358.
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Anti–laminin γ1 pemphigoid (ALG1P) is an autoimmune subepidermal bullous disease characterized by autoantibodies to a 200-kDa acidic noncollagenous glycoprotein of the lower lamina lucida. In contrast, anti–laminin-332 mucous membrane pemphigoid (MMP) is an autoimmune blistering disease characterized by autoantibodies to various subunits of laminin-332 of the basement membrane. We report the first case to our knowledge of ALG1P with IgG autoantibodies for 3 distinct laminins: α3 and γ2 subunits of laminin-332 and laminin γ1.

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Figure 1.
Patient With Anti–Laminin γ1 Pemphigoid Accompanied by Autoantibodies to α3 and γ2 Subunits of Laminin-332

A and B, Clinical presentation of the patient. C and D, Histopathologic findings (hematoxylin-eosin, original magnification ×100 [C] and ×400 [D]); the rectangular area marked in panel C is magnified in panel D. E and F, Indirect immunofluorescence of perilesional skin (E; original magnification ×100) and 1M sodium chloride–split skin (F; original magnification ×200).

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Figure 2.
Immunoblot Results of Anti–Laminin γ1 Pemphigoid Accompanied by Autoantibodies to α3 and γ2 Subunits of Laminin-332

A, With normal human dermal extracts, control epidermolysis bullosa acquisita (EBA) serum reacted with the 290-kDa type VII collagen (lane 1), and control anti–laminin γ1 (p200) pemphigoid serum reacted with the 200-kDa laminin γ1 (lane 2); IgG antibodies from our patient reacted with the laminin γ1 antigen (lane 3, pointer). B, With purified human laminin-332, control anti–laminin-332 type mucous membrane pemphigoid (MMP) serum reacted with the 165-kDa α3, 145-kDa α3, 140-kDa β3, and 105-kDa γ2 subunits (lane 1). A reference normal control serum showed negative results (lane 2). IgG antibodies from this patient reacted with the α3 and γ2 subunits of laminin-332 (lane 3, pointers).

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