Direct immunofluorescence in the clinic for pemphigus and pemphigoid diseases.

IF 4 3区医学 Q2 IMMUNOLOGY

Expert Review of Clinical Immunology Pub Date : 2026-08-01 Epub Date: 2026-08-28 DOI:10.1080/1744666X.2026.2724860

Hua Qian, Yuguang Zhao, Mako Mine, Xiaoguang Li, Takashi Hashimoto

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引用次数: 0

Abstract

Introduction: Direct immunofluorescence (DIF) is a cornerstone diagnostic tool for autoimmune bullous diseases (AIBDs), providing critical tissue-based visualization of immune deposits.

Area covered: Literatures were searched using Pubmed with DIF and pemphigus or pemphigoid or AIBD as keywords before 20 December 2025. This review details the role of DIF in the diagnoses of AIBDs, both pemphigus and pemphigoid diseases, highlighting characteristic staining patterns. Pemphigus diseases show IgG/IgA/C3 depositions to keratinocyte cell surfaces, while pemphigoid diseases exhibit linear/granular basement membrane zone depositions of various immunoglobulins and complement components. DIF results are usually consistent with H&E pathological results, intraepidermal blisters for pemphigus diseases and subepidermal blisters for pemphigoid diseases. DIF findings are distinct in some subtypes of AIBDs, guiding differential diagnosis and complementing serological assays, such as indirect immunofluorescence, enzyme-linked immunosorbent assays and immunoblotting.

Expert opinion: DIF remains the diagnostic gold standard for AIBDs, providing indispensable tissue-specific insights, that cannot be fully replaced by serological tests. However, serological tests are more important in monitoring disease activity. Thus, when biopsy is impractical, optimal diagnosis requires synergistic use of both DIF and serological tests.

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直接免疫荧光在天疱疮和类天疱疮疾病的临床应用。

简介：直接免疫荧光（DIF）是自身免疫性大疱性疾病（aibd）的基础诊断工具，提供了关键的基于组织的免疫沉积可视化。覆盖区域：2025年12月20日前，以DIF和天疱疮或类天疱疮或AIBD为关键词，使用Pubmed检索文献。本文综述了DIF在aibd诊断中的作用，包括天疱疮和类天疱疮疾病，并强调了特征性的染色模式。天疱疮疾病表现为IgG/IgA/C3在角质形成细胞表面沉积，而类天疱疮疾病表现为各种免疫球蛋白和补体成分的线状/颗粒状基底膜带沉积。DIF结果通常与H&E病理结果一致，天疱疮疾病为表皮内疱，类天疱疮疾病为表皮下疱。在aibd的某些亚型中，DIF的发现是不同的，可以指导鉴别诊断并补充血清学检测，如间接免疫荧光、酶联免疫吸附试验和免疫印迹。专家意见：DIF仍然是诊断aibd的金标准，提供了不可缺少的组织特异性见解，这是血清学测试无法完全取代的。然而，血清学检测在监测疾病活动方面更为重要。因此，当活检不切实际时，最佳诊断需要DIF和血清学检测的协同使用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Clinical Immunology IMMUNOLOGY-

CiteScore

7.60

自引率

2.30%

发文量

221

审稿时长

6-12 weeks

期刊介绍： Expert Review of Clinical Immunology (ISSN 1744-666X) provides expert analysis and commentary regarding the performance of new therapeutic and diagnostic modalities in clinical immunology. Members of the International Editorial Advisory Panel of Expert Review of Clinical Immunology are the forefront of their area of expertise. This panel works with our dedicated editorial team to identify the most important and topical review themes and the corresponding expert(s) most appropriate to provide commentary and analysis. All articles are subject to rigorous peer-review, and the finished reviews provide an essential contribution to decision-making in clinical immunology. Articles focus on the following key areas: • Therapeutic overviews of specific immunologic disorders highlighting optimal therapy and prospects for new medicines • Performance and benefits of newly approved therapeutic agents • New diagnostic approaches • Screening and patient stratification • Pharmacoeconomic studies • New therapeutic indications for existing therapies • Adverse effects, occurrence and reduction • Prospects for medicines in late-stage trials approaching regulatory approval • Novel treatment strategies • Epidemiological studies • Commentary and comparison of treatment guidelines Topics include infection and immunity, inflammation, host defense mechanisms, congenital and acquired immunodeficiencies, anaphylaxis and allergy, systemic immune diseases, organ-specific inflammatory diseases, transplantation immunology, endocrinology and diabetes, cancer immunology, neuroimmunology and hematological diseases.