1. ¹Department of Dermatology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
2. ²Dermatology Branch, DCS, NCI, NIH, Bethesda, Maryland, USA
3. ³Department of Dermatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan

Correspondence: Kim B. Yancey, Department of Dermatology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, Texas 75390-9069, USA. E-mail: kim.yancey@utsouthwestern.edu

⁴Current address: Department of Dermatology, Gacheon University of Medicine and Science, Gil Medical Center, #1198 Guwol-Dong, Namdong-Gu, Incheon 405-760 Korea

Received 1 March 2007; Revised 8 May 2007; Accepted 22 May 2007; Published online 26 July 2007.

Abstract

Bullous pemphigoid antigen 2 (BPAG2) is targeted by autoantibodies in patients with bullous pemphigoid (BP), and absent in patients with one type of epidermolysis bullosa (OMIM #226650). A keratin 14 promoter construct was used to produce transgenic (Tg) mice appropriately expressing human BPAG2 (hBPAG2) in murine epidermal basement membrane (BM). Grafts of Tg skin placed on gender-matched, syngeneic wild type (Wt) or major histocompatibility complex I (MHC I)-/- mice elicited IgG that bound human epidermal BM and BPAG2. Production of such IgG in grafted mice was prompt (detectable within 162 days), robust (titer 1,280), durable (present 380 days), and correlated with the involution and loss of Tg skin grafts. MHC II-/- mice grafted with Tg skin did not develop anti-hBPAG2 IgG or graft loss indicating that MHC II:CD4+ T cell interactions were crucial for these responses. Tg skin grafts on Wt mice developed neutrophil-rich infiltrates, dermal edema, subepidermal blisters, and deposits of immunoreactants in epidermal BM. This model shows fidelity to alterations seen in patients with BP, has relevance to immune responses that may arise in patients with epidermolysis bullosa following BPAG2 gene replacement, and can be used to identify interventions that may block production of IgG against proteins in epidermal BM.