Abstract: Bullous pemphigoid (BP) antigens are of molecular heterogeneity. To find out the relationship between the antigenic molecular heterogeneity and clinical features, treatment and prognosis in BP, 122 sera of BP patients were tested with immunoblotting technique. The results showed that 94 sera reacted with BP antigens extracted from normal human epidermis. Among them, 54 sera (57.4%) had BP 230kD antibody and 83 sera (88.3%) had 180kD antibody. Based on the results of immunoblotting assay, these 94 BP patients who had the positive antibodies were divided into three groups, including group I patients with 230kD protein antibody only,group Ⅱ patients with 180kD protein antibody and other minor protein antibodies, and group Ⅲ patients with both 230kD and 180kD antibodies. The pattern of clinical presentations (mucosal involvement, scarring and milia), disease severity, the largest dose of prednisone per day and duration of hospitalization were compared in these three groups. The results of comparison showed that there was no statistically significant difference among three groups in above mentioned items, except the difference of the largest dose of prednisone between the group Ⅰ and group Ⅱ (t=2.22,P<0.05). The dose of group Ⅰ was by far smaller than that of group Ⅱ, which indicated that the severity of patients with 180kD antigen was similar to that with 230kD antigen, perhaps more inportant in the pathogenesis of BP and patient's manifestations. The 180kD protein antigen can not be regarded as so-called"minor BP antigen".

Key words: Pemphigoid,bullous, Antigens, Heterogeneity, Skin manifestations