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

Recently, several case-control studies demonstrated an association between gliptins and bullous pemphigoid (BP) occurrence. However, data on the clinical and immunologic features of gliptin-associated bullous pemphigoid (GABP) are controversial. This study aimed to clinically and immunologically cha...

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Published in:Journal of the American Academy of Dermatology 2022-07, Vol.87 (1), p.56-63
Main Authors: Salemme, Adele, Fania, Luca, Scarabello, Alessandra, Caproni, Marzia, Marzano, Angelo Valerio, Cozzani, Emanuele, Feliciani, Claudio, De Simone, Clara, Papini, Manuela, Satta, Rosanna Rita, Parodi, Aurora, Mariotti, Feliciana, Lechiancole, Stefania, Genovese, Giovanni, Passarelli, Francesca, Festa, Francesca, Bellei, Barbara, Provini, Alessia, Sordi, Donatella, Pallotta, Sabatino, Abeni, Damiano, Mazzanti, Cinzia, Didona, Biagio, Di Zenzo, Giovanni
Format: Article
Language:English
Subjects:
autoantibody
BP180
bullous pemphigoid
epitope
gliptin
humoral response
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Summary:Recently, several case-control studies demonstrated an association between gliptins and bullous pemphigoid (BP) occurrence. However, data on the clinical and immunologic features of gliptin-associated bullous pemphigoid (GABP) are controversial. This study aimed to clinically and immunologically characterize a large cohort of GABP patients to get an insight into the pathophysiology of this emerging drug-induced variant of BP. Seventy-four GABP patients were prospectively enrolled and characterized from 9 different Italian dermatology units between 2013 and 2020. Our findings demonstrated the following in the GABP patients: (1) a noninflammatory phenotype, which is characterized by low amounts of circulating and skin-infiltrating eosinophils, is frequently found; (2) immunoglobulin (Ig)G, IgE, and IgA humoral responses to BP180 and BP230 antigens are reduced in frequency and titers compared with those in patients with idiopathic BP; (3) IgG reactivity targets multiple BP180 epitopes other than noncollagenous region 16A. A limitation of the study is that the control group did not comprise only type 2 diabetes mellitus patients with BP. GABP patients show peculiar features of anti-BP180 and -BP230 humoral responses, laying the foundation for diagnostic improvements and getting novel insights into understanding the mechanism of BP onset.
ISSN:0190-9622
1097-6787
DOI:10.1016/j.jaad.2022.02.036