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Anatomy · General anatomy and histology: cell junctions
Sample itemA 78-year-old woman has tense, itchy blisters on the flexures. Biopsy shows a subepidermal split, and immunofluorescence shows linear IgG along the basement membrane directed against BP180 (collagen XVII). Which cell junction links the basal keratinocyte to the basement membrane and is targeted here?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
D. Hemidesmosome
Hemidesmosomes anchor the basal surface of basal keratinocytes to the basement membrane through integrin alpha6 beta4 and BP180 and BP230, attached to keratin filaments. Their autoimmune attack in bullous pemphigoid causes a subepidermal split. Desmosomal attack in pemphigus gives an intra-epidermal split instead.
Option by option
A. Tight junction
Tight junctions seal the apical region between cells and are not the anchor to the basement membrane.
B. Gap junction
Gap junctions are channels for ion and small-molecule exchange between cells and do not provide attachment to the basement membrane.
C. Desmosome
Desmosomes join adjacent keratinocytes and are the target in pemphigus, giving an intra-epidermal split.
D. Hemidesmosome (correct)
Correct. Hemidesmosomes bind the basal cell to the basement membrane and carry BP180.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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