Roy Ayan, Sahoo Jayaprakash, Narayanan Niya, Merugu Chandhana, Kamalanathan Sadishkumar, Naik Dukhabandhu
Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, Jodhpur 342005, India.
Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry 605006, India.
World J Diabetes. 2021 Sep 15;12(9):1426-1441. doi: 10.4239/wjd.v12.i9.1426.
Dipeptidyl peptidase-4 inhibitors (DPP-4i) have an important place in the management of type 2 diabetes. The DPP-4 enzyme is ubiquitously distributed throughout the human body and has multiple substrates through which it regulates several important physiological functions. DPP-4 regulates several immune functions, including T-cell activation, macrophage function, and secretion of cytokines. Studies have reported an increase in autoimmune diseases like bullous pemphigoid, inflammatory bowel disease, and arthritis with DPP-4i use. The relationship of DPP-4i and autoimmune diseases is a complex one and warrants further research into the effect of DPP-4 inhibition on the immune system to understand the pathogenesis more clearly. Whether a particular cluster of autoimmune diseases is associated with DPP-4i use remains an important contentious issue. Nevertheless, a heightened awareness from the clinicians is required to identify and treat any such diseases. Through this review, we explore the clinical and pathophysiological characteristics of this association in light of recent evidence.
二肽基肽酶-4抑制剂（DPP-4i）在2型糖尿病的管理中占有重要地位。DPP-4酶在人体中广泛分布，有多种底物，通过这些底物调节多种重要的生理功能。DPP-4调节多种免疫功能，包括T细胞活化、巨噬细胞功能和细胞因子分泌。研究报告称，使用DPP-4i会导致自身免疫性疾病如大疱性类天疱疮、炎症性肠病和关节炎增加。DPP-4i与自身免疫性疾病的关系很复杂，需要进一步研究DPP-4抑制对免疫系统的影响，以更清楚地了解发病机制。特定的自身免疫性疾病群是否与使用DPP-4i有关仍是一个重要的有争议的问题。然而，临床医生需要提高认识，以识别和治疗任何此类疾病。通过本综述，我们根据最新证据探讨这种关联的临床和病理生理特征。
