2025-08-04 北海道大学
特定のHLAタイプを持つDPP-4阻害薬を内服中の糖尿病患者の一部は、今回新たに発見された自己抗体が生じ、DPP-4阻害薬関連水疱性類天疱瘡を発症する。さらに従来の自己抗体も生じると、より強い治療を必要とする。
<関連情報>
- https://www.hokudai.ac.jp/news/2025/08/post-1993.html
- https://www.hokudai.ac.jp/news/pdf/250804_pr.pdf
- https://www.science.org/doi/10.1126/sciadv.adv9423
DPP-4阻害薬関連水疱性類天疱瘡におけるBP180ドメインスワップタンパクによる新規エピトープ同定 Identification of distinct epitopes in dipeptidyl peptidase-4 inhibitor–associated bullous pemphigoid
Shoko Mai, Yosuke Mai, Inkin Ujiie, Kentaro Izumi, […] , and Hideyuki Ujiie
Science Advances Published:1 Aug 2025
DOI:https://doi.org/10.1126/sciadv.adv9423
Abstract
Bullous pemphigoid (BP) is a common autoimmune skin disorder caused by autoantibodies targeting BP180. Recent evidence shows that dipeptidyl peptidase-4 inhibitors (DPP4i), used in diabetes management, can induce BP (DPP4i-BP). DPP4i-BP differs from typical BP in its genetic, clinical, and immunological features, but methods to specifically detect DPP4i-BP autoantibodies have been unavailable. This study used enzyme-linked immunosorbent assay with “domain-swapped BP180” proteins to identify autoantibodies in DPP4i-BP, which targeted BP180 regions from the seventh noncollagenous domain to the fourth collagenous domain (NC7-Col4). These epitopes were associated with DPP4i-BP–specific human leukocyte antigen class II peptide epitopes. Notably, the duration of DPP4i intake before BP onset was significantly shorter in patients with anti–NC7-Col4 autoantibodies than those without them. Measuring the autoantibodies enabled the early diagnosis of DPP4i-BP before epitope spreading. Furthermore, anti–NC7-Col4 autoantibodies were detected in some patients with diabetes taking DPP4i without BP, suggesting that these assays may offer potential tools for early identification of at-risk individuals.
