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When these pads thin, the cheeks can appear hollow, the nasolabial folds deepen, and the skin around the eyes can look sunken or gaunt

Parental Approach to the Prevention and Management of Fever and Pain Following Childhood Immunizations: A Survey Study

In rare cases, more serious side effects can occur, such as pancreatitis, gallbladder disease, or allergic reactions

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However, neither the innate nor the adaptive immune response is affected by the DPP-4 inhibitors being used clinically (128), and reassuringly, there is no evidence for any increased risk of infections in the pooled safety analyses (119123) or in the CV safety outcome trials (125127), in line with the view that the catalytic activity of DPP-4 is not necessary for the co-stimulatory role of CD26 in T-cell activation