Department of General Internal Medicine 1, Kawasaki Medical School, Okayama, Japan.
Department of Dermatology, Kawasaki Medical School, Okayama, Japan.
Front Immunol. 2022 Mar 3;13:843480. doi: 10.3389/fimmu.2022.843480. eCollection 2022.
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.
大疱性类天疱疮（BP）是一种罕见的自身免疫性水疱病，BP 患者中 2 型糖尿病（T2DM）的患病率相对较高。已知二肽基肽酶-4 抑制剂（DPP-4i），一种抗糖尿病药物，可引起 BP，尽管 DPP-4i 相关 BP 的确切机制尚不清楚。在本报告中，我们展示了一例 DPP-4i 相关 BP 发病后出现各种疾病特异性抗体的病例。此外，DPP-4i 相关 BP 发病和停用 DPP-4i 两年后，各种疾病特异性抗体呈阳性且滴度升高。这些数据表明，DPP-4i 相关 BP 发病后可能会打破免疫耐受，即使 BP 症状改善，检查 DPP-4i 相关 BP 患者的自身抗体也很重要。
