Case Report: Appearance of Various Disease-Specific Antibodies After the Onset of Dipeptidyl Peptidase-4 Inhibitor-Associated Bullous Pemphigoid

• DOI: 10.3389/fimmu.2022.843480
• Publication Date: 2022-03-03T04:43:53Z
• Authors: Yuichiro Iwamoto; Takatoshi Anno; Katsumasa Koyama; Fumiko Kawasaki; Kohei Kaku; Koichi Tomoda; Seiko Sugiyama; Yumi Aoyama; Hideaki Kaneto
• Keywords: bullous pemphigoid; 0303 health sciences; 03 medical and health sciences; dipeptidyl peptidase-4 inhibitor; autoantibodies; type 2 diabetes mellitus; Immunology; dipeptidyl peptidase-4 inhibitor-associated bullous pemphigoid; Immunologic diseases. Allergy; RC581-607; 3. Good health

Bullous pemphigoid (BP) is a rare autoimmune blistering disease, and the prevalence of type 2 diabetes mellitus (T2DM) is relatively high in subjects with BP. It is known that dipeptidyl peptidase-4 inhibitor (DPP-4i), one kind of antidiabetic drugs, can cause BP, although precise mechanism of DPP-4i-related BP remains unclear. In this report, we showed a case with appearance of various disease-specific antibodies after the onset of DPP-4i-related BP. Furthermore, various disease-specific antibodies became positive and showed high titers two years after the onset of DPP-4i-related BP and discontinuation of DPP-4i. These data showed that it is possible for immune tolerance to be broken after the onset of DPP-4i-related BP, and it may be important to check autoimmune antibodies in DPP-4i-related BP subjects even when BP symptoms are improved.