engleski

IN VITRO TESTS OF T CELL MEDIATED DRUG HYPERSENSITIVITY AND BASOPHIL ACTIVATION

Pathophysiology of drug hypersensitivity reactions is still not fully understood. Drugs are immunogenic due to their chemical reactivity, but also because of their capability of binding to available T cell receptors (TCRs) and MHC- molecules on antigen presenting cells (APC). The skin is the most frequently involved target organ in drug DTH reactions, which produce clinical manifestations ranging from maculopapular exanthema (MPE), urticaria, generalized exanthematic pustulosis (AGEP), drug rash with eosinophilia and systemic symptoms (DRESS)/drug- induced hypersensitivity syndrome (DIHS), Stevens- Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), Erythema multiforme and fixed drug eruption. Hypersensitivity reactions to drugs represent an important health problem with significant morbidity and mortality. In general, diagnosis of DTH should confirm that symptoms corespond to DTH and identify the causative agent. Diagnosis needs to rely on a combination of medical history and different in vivo and in vitro tests. The sensitivity of in vivo tests is not high, but in some cases is necessary. In vitro diagnostic test are safe and provide better insight into the mechanisms and cells involved in a certain type of DTH reaction. On the other hand basophils and mast cells are primary effector cells for immediate IgE mediated allergic reactions. Several new in vitro tests for basophil activation are also presented.

drug hypersensitivity, DTH, T cell, Basophil, in vitro tests

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