From Diabetes to Dermatology: The Role of Teneligliptin in Bullous Pemphigoid Development

Bullous pemphigoid (BP) is an autoimmune blistering disease that especially presents in elderly patients, but recently, its incidence has increased in patients treated with inhibitors of dipeptidyl peptidase-4 (DPP-4), among which teneligliptin is widely prescribed as an antidiabetic drug for the treatment of type 2 diabetes mellitus (T2DM). Recent studies describe the association of teneligliptin with the onset of BP, hypothesizing that DPP-4 inhibition could induce immune dysregulation able to trigger autoimmune responses against skin antigens BP180 and BP230. This mini-review discusses the immunomodulatory effects of teneligliptin, immune responses, and chronic inflammation associated with diabetes that predispose patients to BP. It also discusses the clinical implications, such as monitoring for BP in T2DM patients on teneligliptin therapy. Elucidation of this relationship may help in optimizing management strategies by highlighting discontinuation or alternative therapies in the case of a high risk of development of BP.