Evidence map›Paper›PMID 40375473›Full record

ArticleInternational journal of dermatology2025

Lymphocyte Transformation Tests and Patch Tests to Identify Drugs Potentially Associated With Bullous Pemphigoid Development.

Belen de Nicolas-Ruanes, Carlos Fernandez-Lozano, Patricia Gutierrez-Canales, Asuncion Ballester-Martinez, Natalia Rodriguez-Otero, Javier Martinez-Botas, Belén de la Hoz Caballer, Ana Andres-Martin, Emilio Solano-Solares, Maria Esther Gomez-Salazar Lopez-Silanes and 8 more

Abstract read
In one paragraph

Article in International journal of dermatology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Bridging Rare to Common Diseases: Precision Medicine and the Transforming Landscape of Pediatric Allergy and Immunology.Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology · 2026
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Belen de Nicolas-RuanesDermatology Department, Ramón y Cajal University Hospital, Ramón y Cajal Institute for Health Research, Madrid, Spain.ORCID https://orcid.org/0000-0002-3206-2826
Carlos Fernandez-LozanoBiochemistry-Research Department, Ramón y Cajal University Hospital, Madrid, Spain.
Patricia Gutierrez-CanalesAllergy Department, Ramón y Cajal University Hospital, Ramón y Cajal Institute for Health Research, Madrid, Spain.
Asuncion Ballester-MartinezDermatology Department, Ramón y Cajal University Hospital, Ramón y Cajal Institute for Health Research, Madrid, Spain.
Natalia Rodriguez-OteroAllergy Department, Ramón y Cajal University Hospital, Ramón y Cajal Institute for Health Research, Madrid, Spain.
Javier Martinez-BotasBiochemistry-Research Department, Ramón y Cajal University Hospital, Madrid, Spain.ORCID https://orcid.org/0000-0002-5190-3619
Belén de la Hoz CaballerAllergy Department, Ramón y Cajal University Hospital, Ramón y Cajal Institute for Health Research, Madrid, Spain.
Ana Andres-MartinImmunology Department, Ramón y Cajal University Hospital, Ramón y Cajal Institute for Health Research, Madrid, Spain.
Emilio Solano-SolaresAllergy Department, Ramón y Cajal University Hospital, Ramón y Cajal Institute for Health Research, Madrid, Spain.
Maria Esther Gomez-Salazar Lopez-SilanesPharmacy Department, Ramón y Cajal University Hospital, Ramón y Cajal Institute for Health Research, Madrid, Spain.
Laura Gisella Diaz-MontalvoMicroarrays Unit, Ramón y Cajal Institute for Health Research, Madrid, Spain.
Diana M ArrebolaBiochemistry-Research Department, Ramón y Cajal University Hospital, Madrid, Spain.
Vivian Lizeth Stewart-DelcidImmunology Department, Ramón y Cajal University Hospital, Ramón y Cajal Institute for Health Research, Madrid, Spain.
Emilio Garcia-MouronteDermatology Department, Ramón y Cajal University Hospital, Ramón y Cajal Institute for Health Research, Madrid, Spain.
Carlos Azcarraga-LlobetDermatology Department, Ramón y Cajal University Hospital, Ramón y Cajal Institute for Health Research, Madrid, Spain.ORCID https://orcid.org/0000-0001-8088-4077
Emilio Berna-RicoDermatology Department, Ramón y Cajal University Hospital, Ramón y Cajal Institute for Health Research, Madrid, Spain.
Sonia Ortega-SanchezImmunology Department, Ramón y Cajal University Hospital, Ramón y Cajal Institute for Health Research, Madrid, Spain.
Montserrat Fernandez-GuarinoDermatology Department, Ramón y Cajal University Hospital, Ramón y Cajal Institute for Health Research, Madrid, Spain.

Funding

Ramón y Cajal Institute for Health Research
6 · The paper itself

Abstract

backgroundBullous pemphigoid (BP) is the most common autoimmune blistering disease, with a rising incidence in the elderly. BP is associated with multiple triggering factors, including drug exposure. However, evidence in this respect is limited, and the underlying immune mechanisms remain unknown. Our study aims to identify the role of specific drugs in BP pathogenesis using in vitro lymphocyte transformation tests (LTT) and in vivo patch testing, aiding in the differentiation between truly associated drugs and coincidental associations.

methodsThirty-three patients with suspected BP and no ongoing systemic treatment were enrolled. LTT and patch tests were conducted 3 months after diagnosis. BP disease activity was assessed using the Bullous Pemphigoid Disease Activity Index (BPDAI) at diagnosis and at follow-up visits at 3 and 6 months.

resultsLTT results were positive in 60% of patients for dipeptidyl peptidase 4 inhibitors, loop diuretics, hydrochlorothiazide, levetiracetam, nivolumab, enalapril, and amlodipine. Patients showed a reduction in BPDAI over the study period, regardless of LTT results. Although limited by the low sample size, positive LTT patients showed a trend toward clinical improvement when the implicated drug was discontinued. Patch testing was positive in one patient, who also had a corresponding positive LTT.

conclusionsOur findings demonstrate the existence of a potential role for certain drugs in BP pathogenesis, suggesting that these drugs may trigger the disease in genetically predisposed individuals. Although further studies are needed, LTT may serve as a useful and available tool in the management of BP patients in the future.

Indexed as

Pemphigoid, BullousAgedAged, 80 and overFemaleHumansMaleMiddle AgedPatch TestsSeverity of Illness Indexbullous pemphigoiddipeptidyl peptidase 4 inhibitorsdrug‐associated bullous pemphigoiddrug‐induced bullous pemphigoidlymphocyte transformation testpatch test

Identifiers

PMID40375473
PMCPMC12332248

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.