Findings shed light on humoral response in gliptin-associated bullous pemphigoid

The humoral response to BP180 and BP230 antigens is weakened in certain patients with gliptin-associated bullous pemphigoid, according to a study.

“Recently, several case-control studies demonstrated an association between gliptins and bullous pemphigoid (BP) occurrence,” Adele Salemme, MSc, of the molecular and cell biology laboratory at Istituto Dermopatico dell'Immacolata, IRCCS, in Rome, Italy, and colleagues wrote. “Data on clinical and immunological features of gliptin-associated bullous pemphigoid (GABP) are controversial.”

Salemme and colleagues clinically and immunologically characterized a cohort of 74 GABP patients in order to understand the pathophysiology of GABP, an emerging drug-induced variant of BP.

Eligible participants in the prospective trial were enrolled from nine centers in Italy between 2013 and 2020.

Results showed that the non-inflammatory phenotype was prevalent. This phenotype is characterized by low amounts of circulating skin. In addition, skin infiltrating eosinophils were common, according to the findings.

Further analysis showed that IgG, IgE and IgA humoral response to BP180 and BP230 antigens was reduced by two parameters — frequency and titers — in comparison with idiopathic BP patients.

Other findings showed that reactivity to IgG has a number of BP180 targets beyond NC16A.

Regarding potential limitations of the analysis, the researchers noted that the control group did not comprise only BP patients with type 2 diabetes.

“GABP patients show peculiar features of anti-BP180 and -BP230 humoral response laying the foundations for diagnostic improvements and to get novel insights into understanding the mechanism of BP onset,” the researchers concluded.

They added that “significant reactivity” to E-1080 and E-1331 may assist in improving diagnosis of this condition.