An Updated Review of the Molecular Mechanisms in Drug Hypersensitivity
Drug hypersensitivity may manifest ranging from milder skin reactions (e.g., maculopapular exanthema and urticaria) to severe systemic reactions, such as anaphylaxis, drug reactions with eosinophilia and systemic symptoms (DRESS)/drug-induced hypersensitivity syndrome (DIHS), or Stevens–Johnson synd...
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| Format: | Article |
| Language: | English |
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Wiley
2018-01-01
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| Series: | Journal of Immunology Research |
| Online Access: | http://dx.doi.org/10.1155/2018/6431694 |
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| author | Chun-Bing Chen Riichiro Abe Ren-You Pan Chuang-Wei Wang Shuen-Iu Hung Yi-Giien Tsai Wen-Hung Chung |
| author_facet | Chun-Bing Chen Riichiro Abe Ren-You Pan Chuang-Wei Wang Shuen-Iu Hung Yi-Giien Tsai Wen-Hung Chung |
| author_sort | Chun-Bing Chen |
| collection | DOAJ |
| description | Drug hypersensitivity may manifest ranging from milder skin reactions (e.g., maculopapular exanthema and urticaria) to severe systemic reactions, such as anaphylaxis, drug reactions with eosinophilia and systemic symptoms (DRESS)/drug-induced hypersensitivity syndrome (DIHS), or Stevens–Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN). Current pharmacogenomic studies have made important strides in the prevention of some drug hypersensitivity through the identification of relevant genetic variants, particularly for genes encoding drug-metabolizing enzymes and human leukocyte antigens (HLAs). The associations identified by these studies are usually drug, phenotype, and ethnic specific. The drug presentation models that explain how small drug antigens might interact with HLA and T cell receptor (TCR) molecules in drug hypersensitivity include the hapten theory, the p-i concept, the altered peptide repertoire model, and the altered TCR repertoire model. The broad spectrum of clinical manifestations of drug hypersensitivity involving different drugs, as well as the various pathomechanisms involved, makes the diagnosis and management of it more challenging. This review highlights recent advances in our understanding of the predisposing factors, immune mechanisms, pathogenesis, diagnostic tools, and therapeutic approaches for drug hypersensitivity. |
| format | Article |
| id | doaj-art-3fc64c4caaec44b29d464d6cc069aac0 |
| institution | Kabale University |
| issn | 2314-8861 2314-7156 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Immunology Research |
| spelling | doaj-art-3fc64c4caaec44b29d464d6cc069aac02025-02-03T05:54:41ZengWileyJournal of Immunology Research2314-88612314-71562018-01-01201810.1155/2018/64316946431694An Updated Review of the Molecular Mechanisms in Drug HypersensitivityChun-Bing Chen0Riichiro Abe1Ren-You Pan2Chuang-Wei Wang3Shuen-Iu Hung4Yi-Giien Tsai5Wen-Hung Chung6Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Taipei, Linkou, Keelung, TaiwanDivision of Dermatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, JapanDepartment of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Taipei, Linkou, Keelung, TaiwanDepartment of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Taipei, Linkou, Keelung, TaiwanDepartment and Institute of Pharmacology, School of Medicine, Infection and Immunity Research Center, National Yang-Ming University, Taipei, TaiwanDivision of Pediatric Allergy and Immunology, Changhua Christian Hospital, Changhua City, TaiwanDepartment of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Taipei, Linkou, Keelung, TaiwanDrug hypersensitivity may manifest ranging from milder skin reactions (e.g., maculopapular exanthema and urticaria) to severe systemic reactions, such as anaphylaxis, drug reactions with eosinophilia and systemic symptoms (DRESS)/drug-induced hypersensitivity syndrome (DIHS), or Stevens–Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN). Current pharmacogenomic studies have made important strides in the prevention of some drug hypersensitivity through the identification of relevant genetic variants, particularly for genes encoding drug-metabolizing enzymes and human leukocyte antigens (HLAs). The associations identified by these studies are usually drug, phenotype, and ethnic specific. The drug presentation models that explain how small drug antigens might interact with HLA and T cell receptor (TCR) molecules in drug hypersensitivity include the hapten theory, the p-i concept, the altered peptide repertoire model, and the altered TCR repertoire model. The broad spectrum of clinical manifestations of drug hypersensitivity involving different drugs, as well as the various pathomechanisms involved, makes the diagnosis and management of it more challenging. This review highlights recent advances in our understanding of the predisposing factors, immune mechanisms, pathogenesis, diagnostic tools, and therapeutic approaches for drug hypersensitivity.http://dx.doi.org/10.1155/2018/6431694 |
| spellingShingle | Chun-Bing Chen Riichiro Abe Ren-You Pan Chuang-Wei Wang Shuen-Iu Hung Yi-Giien Tsai Wen-Hung Chung An Updated Review of the Molecular Mechanisms in Drug Hypersensitivity Journal of Immunology Research |
| title | An Updated Review of the Molecular Mechanisms in Drug Hypersensitivity |
| title_full | An Updated Review of the Molecular Mechanisms in Drug Hypersensitivity |
| title_fullStr | An Updated Review of the Molecular Mechanisms in Drug Hypersensitivity |
| title_full_unstemmed | An Updated Review of the Molecular Mechanisms in Drug Hypersensitivity |
| title_short | An Updated Review of the Molecular Mechanisms in Drug Hypersensitivity |
| title_sort | updated review of the molecular mechanisms in drug hypersensitivity |
| url | http://dx.doi.org/10.1155/2018/6431694 |
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