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Dipeptidyl peptidase-4 (DPP-4, EC 3.4. 14.5) is a member of protease family. DPP-4, also known as adenosine deaminase binding protein (ADBP) or T-cell activation antigen CD26. DPP-4 is a serine exopeptidase, it cleaves dipeptides from the N-termini of oligopeptides and smaller peptides with proline, hydroxyproline, dehydroproline or alanine. The enzyme is found in two forms in blood, free and bound. Due to its ubiquitous distribution and involvement in various physiological processes, a great number of pathological conditions are associated with altered DPP-4 expression or activity. These pathological conditions are: diabetes, psychoneuroendocrine disorders, autoimmune and inflammatory diseases, infectious diseases, haematological malignancies, solid tumors. The altered CD26 / DPP-4 activity or concentrations in plasma are related to various physiological and autoimmune pathological conditions. DPP-4 activity is detected in saliva, cerebrospinal fluid, synovial fluid, follicular fluid, seminal fluid and urine. [ABSTRACT FROM AUTHOR]

For the treatment of T2DM; cure can not be achieved with conventional methods. The degree of increase in the epidemic of diabetes; together with the research of new treatments will provide a better understanding of patophysiology necessitates the development. Preferred drugs in cases that do not respond to metformin; hypoglycemia, can cause weight gain and are undesirable cardiac event. Today; incretin-based therapies have been developed that provide effective glucose level and weight control. Incretins while increasing glucose dependent insulin secretion in the pancreas, suppress glucagon secretion. Glucagon-like peptide-1 receptor agonists, and dipeptidyl peptidase-4 inhibitors, are incretin based treatment. Glucagon-like peptide-1 receptor agonists is the most important treatment can be used with monotherapy or combination therapy. Glucagon-like peptide-1 agonists, besides providing good glycemic control, the low rate of hypoglycemia and weight loss are causing significant advantage. Dipeptidyl peptidase-4 inhibitors; leads to rapid inactivation of incretin hormones such as glucagon-like peptide-1 agonists and glucose dependent insulinotropic polypeptide. Dipeptidyl peptidase-4 inhibitors; they extend the duration of action of glucagon-like peptide-1 by inhibiting the degradation of incretin hormones in circulation. [ABSTRACT FROM AUTHOR]

Sitagliptin is a new generation theurapeutic agent of diabetes mellitus belongs to dipeptidyl peptidase-IV inhibitor class which acts via the incretin hormone system. The advantages are the absence of hypoglycemia when used as monotherapy. Trials that reported the weight effects of sitagliptin found modest increases or decreases. The most common side effects of sitagliptin are headache and pharyngitis, and few serious adverse events were observed during clinical trials. Sitagliptin and metabolites may cause hypersensitivity reactions. Sitagliptin associated cutaneous leukocytoclastic vasculitis has not been described previously in the literature . Here, we report a case of cutaneous leukocytoclastic vasculitis due to probable sitagliptin usage. As sitagliptin is a widely used agent in type 2 diabetes mellitus treatment, physicians should be aware of the possibility of this rare but potentially serious adverse event. [ABSTRACT FROM AUTHOR]