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Clinical and Translational Allergy
Published in: Clinical and Translational Allergy 1/2015

Open Access 01-12-2015 | Review

Pathogenesis and diagnosis of delayed-type drug hypersensitivity reactions, from bedside to bench and back

Authors: Rik Schrijvers, Liesbeth Gilissen, Anca Mirela Chiriac, Pascal Demoly

Published in: Clinical and Translational Allergy | Issue 1/2015

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Abstract

Drug hypersensitivity reactions (DHR) have been present since the advent of drugs. In particular T-cell mediated delayed-type hypersensitivity reactions represent a heterogeneous clinical entity with a diverse pathogenesis and result in a considerable burden of morbidity and mortality not only driven by the reactions themselves but also by the use of alternatives which are sometimes less effective or even more dangerous. Diagnostic procedures rely on clinical history, skin testing and potential provocation testing, whereas validated in vitro diagnostic procedures are still lacking for most of them. Recent work in the field of pharmacogenomics combined with basic scientific research has provided insights in the pathogenesis of abacavir and carbamazepine hypersensitivities linked with certain human leucocyte antigen risk alleles. Nevertheless, important scientific questions on how other DHR arise and how host-drug interactions occur, remain unanswered. Recent work indicates an intricate relation between host, drug and pathogens in severe cutaneous and systemic reactions and provides more insights in the role of regulatory T-cells and viral reactivation in these reactions. In this review we focus on type IV delayed-type DHR, and address recent advances in the pathogenesis, pharmacogenomics, and diagnosis of these reactions with an emphasis on the understandings arising from basic research.
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Metadata
Title
Pathogenesis and diagnosis of delayed-type drug hypersensitivity reactions, from bedside to bench and back
Authors
Rik Schrijvers
Liesbeth Gilissen
Anca Mirela Chiriac
Pascal Demoly
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Clinical and Translational Allergy / Issue 1/2015
Electronic ISSN: 2045-7022
DOI
https://doi.org/10.1186/s13601-015-0073-8

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