Anti-p200
pemphigoid has been characterized by
autoantibodies to an unidentified 200-kDa
protein (p200) of the dermal-epidermal junction. The objective of this study was to identify p200. We performed 2D gel electrophoresis of dermal extracts and immunoblotting with patients' sera, followed by MS analysis of a unique
protein band. The
protein band corresponded to
laminin gamma1. Anti-
laminin gamma1 mAb reacted with the anti-p200 immunoprecipitates by immunoblotting. Sera from 32 patients with anti-p200
pemphigoid showed 90% reactivity to the recombinant products of
laminin gamma1. None of the healthy control sera reacted with
laminin gamma1. By immunoblotting, reactivity of a patient's serum with p200 was competitively inhibited by adding anti-
laminin gamma1 C-terminus mAb. Purified anti-p200
IgG also inhibited the reactivity of this mAb to dermal
laminin gamma1. Most
laminin gamma1-positive sera showed reactivity with recombinant
laminin gamma1 C-terminal E8 fragment. Reactivity of patients' sera and purified
IgG to dermal
laminin gamma1 was higher than reactivity to blood vessel
laminin gamma1 under reducing conditions. These results suggest that
laminin gamma1 is the
autoantigen for patients with anti-p200
pemphigoid. The
autoantibodies may specifically recognize dermal
laminin gamma1 with unique posttranslational modifications. The
epitope is localized to the 246 C-terminal
amino acids within the coiled-coil domain. The 9 C-terminal residues are known to be critically involved in
laminin recognition by
integrins.