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Title: An Updated Review of the Diagnostic Methods in Delayed Drug Hypersensitivity.
Austin Authors: Copaescu, Ana ;Gibson, Andrew;Li, Yueran;Trubiano, Jason ;Phillips, Elizabeth J
Affiliation: Clinical Immunology and Allergy, McGill University Health Center, Montréal, Canada
Department of Infectious Diseases, Vanderbilt University Medical Center, Nashville, TN, United States
The National Center for Infections in Cancer, Peter MacCallum Cancer Center, Melbourne, VIC, Australia
Immunology and Infectious Diseases, Murdoch University, Murdoch, WA, Australia
Institute for Immunology and Infectious Diseases, Murdoch University, Murdoch, WA, Australia
Infectious Diseases
Department of Oncology, Sir Peter MacCallum Cancer Center, The University of Melbourne, Parkville, VIC, Australia
Medicine (University of Melbourne)
Centre for Antibiotic Allergy and Research
Issue Date: 12-Jan-2020
Date: 2021
Publication information: Frontiers in Pharmacology 2020; 11: 573573
Abstract: Delayed drug hypersensitivity reactions are clinically diverse reactions that vary from isolated benign skin conditions that remit quickly with no or symptomatic treatment, drug discontinuation or even continued drug treatment, to the other extreme of severe cutaneous adverse reactions (SCARs) that are associated with presumed life-long memory T-cell responses, significant acute and long-term morbidity and mortality. Diagnostic "in clinic" approaches to delayed hypersensitivity reactions have included patch testing (PT), delayed intradermal testing (IDT) and drug challenges for milder reactions. Patch and IDT are, in general, performed no sooner than 4-6 weeks after resolution of the acute reaction at the maximum non-irritating concentrations. Functional in vitro and ex vivo assays have largely remained the province of research laboratories and include lymphocyte transformation test (LTT) and cytokine release enzyme linked ImmunoSpot (ELISpot) assay, an emerging diagnostic tool which uses cytokine release, typically IFN-γ, after the patient's peripheral blood mononuclear cells are stimulated with the suspected drug(s). Genetic markers such as human leukocyte antigen have shown recent promise for both pre-prescription screening as well as pre-emptive and diagnostic testing strategies.
DOI: 10.3389/fphar.2020.573573
Journal: Frontiers in Pharmacology
PubMed URL: 33597867
ISSN: 1663-9812
Type: Journal Article
Subjects: HLA
T cells
delayed hypersensitivity reaction
drug allergy
enzyme linked ImmunoSpot (ELISpot)
lymphocyte transformation test (LTT)
severe cutaneous adverse reactions
skin testing
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