Gliptin-associated bullous pemphigoid shows peculiar features of anti-BP180 and -BP230 humoral response: Results of a multicenter study

Dipeptidyl Peptidase 4 Inhibitor‒Associated Bullous Pemphigoid Is Characterized by an Altered Expression of Cytokines in the Skin

“…It remains to be investigated whether the correlations between cytokines and auto-antibody levels as well as severity among DPP4i users have any mechanistical significance. Moreover, the possible relationship between cytokine expression and DPP4i-BP linked anti-BP180 antibodies targeting non-NC16A epitopes (Lindgren et al 2019;Mai et al 2019;Salemme et al 2022) will be an interesting topic for future research.…”

Comments on “Bullous pemphigoid: Three main clusters defining 3 outcome profiles”

“…Recent studies have demonstrated that antihyperglycemic drugs, dipeptidyl peptidase 4 (DPP4) inhibitors, may be a risk of developing BP. 2,3 DPP4 inhibitoreassociated BP has peculiar presentations. Patients with DPP4 inhibitoreassociated BP usually show a noninflammatory phenotype, which means a lower amount of circulating and infiltrating eosinophils, 2 but can have a more severe presentation of blisters and erosions.…”

“…2,3 DPP4 inhibitoreassociated BP has peculiar presentations. Patients with DPP4 inhibitoreassociated BP usually show a noninflammatory phenotype, which means a lower amount of circulating and infiltrating eosinophils, 2 but can have a more severe presentation of blisters and erosions. 3 The frequency and titers of immunoglobulin G autoantibodies to BP180 and BP230 are usually lower in these patients with DPP4 inhibitoreassociated BP than in other patients with BP.…”

“…3 The frequency and titers of immunoglobulin G autoantibodies to BP180 and BP230 are usually lower in these patients with DPP4 inhibitoreassociated BP than in other patients with BP. 2,3 In addition, the autoantibodies in patients with DPP4 inhibitoreassociated BP may target different epitopes of BP180 other than noncollagenous region 16A. 2,3 These features highlight the characteristics of these patients with DPP4 inhibitoreassociated BP and differentiate these patients from other patients with BP.…”

“…2,3 In addition, the autoantibodies in patients with DPP4 inhibitoreassociated BP may target different epitopes of BP180 other than noncollagenous region 16A. 2,3 These features highlight the characteristics of these patients with DPP4 inhibitoreassociated BP and differentiate these patients from other patients with BP. However, it seems that Guerrois et al 1 did not include the use of DPP4 inhibitors in their analysis.…”