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논문 기본 정보

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학술저널
저자정보
Klaewsongkram Jettanong (Division of Allergy and Clinical Immunology Department of Medicine Faculty of Medicine The Skin and) Buranapraditkun Supranee (Division of Allergy and Clinical Immunology Department of Medicine Faculty of Medicine The Skin and) Thantiworasit Pattarawat (Division of Allergy and Clinical Immunology Department of Medicine Faculty of Medicine The Skin and) Rerknimitr Pawinee (King Chulalongkorn Memorial Hospital Thai Red Cross Society Bangkok Thailand.Division of Dermatolog) Tuchinda Papapit (Department of Dermatology Faculty of Medicine Siriraj Hospital Mahidol University Bangkok Thailand.) Chularojanamontri Leena (Department of Dermatology Faculty of Medicine Siriraj Hospital Mahidol University Bangkok Thailand.) Rerkpattanapipat Ticha (Allergy Immunology and Rheumatology Division Department of Medicine Faculty of Medicine Ramathibodi) Chanprapaph Kumutnart (Division of Dermatology Department of Medicine Faculty of Medicine Ramathibodi Hospital Mahidol Uni) Disphanurat Wareeporn (Division of Dermatology Department of Medicine Faculty of Medicine Thammasat University Pathumthani) Chakkavittumrong Panlop (Division of Dermatology Department of Medicine Faculty of Medicine Thammasat University Pathumthani) Tovanabutra Napatra (Dermatologic Division Department of Internal Medicine Chiang Mai University Chiang Mai Thailand.) Srisuttiyakorn Chutika (Division of Dermatology Department of Medicine Phramongkutklao Hospital Phramongkutklao College of) Srinoulprasert Yuttana (Department of Immunology Faculty of Medicine Siriraj Hospital Mahidol University Bangkok Thailand.) Sukasem Chonlaphat (Division of Pharmacogenomics and Personalized Medicine Department of Pathology Faculty of Medicine) Chongpison Yuda (Center for Excellence in Biostatistics Faculty of Medicine The Skin and Allergy Research Unit Chula)
저널정보
대한천식알레르기학회(구 대한알레르기학회) Allergy, Asthma & Immunology Research Allergy, Asthma & Immunology Research Vol.13 No.6
발행연도
2021.11
수록면
896 - 907 (12page)
DOI
10.4168/aair.2021.13.6.896

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Propose: The purpose of this study was to investigate panels of enzyme-linked immunospot assays (ELISpot) to detect drug-specific mediator releasing cells for confirming culprit drugs in severe cutaneous adverse reactions (SCARs). Methods: Frequencies of drug-induced interleukin-22 (IL-22)-, interferon-gamma (IFN-γ)-, and granzyme-B (GrB)-releasing cells were measured by incubating peripheral blood mononuclear cells (PBMCs) from SCAR patients with the culprit drugs. Potential immunoadjuvants were supplemented to enhance drug-induced mediator responses. Results: Twenty-seven patients, including 9 acute generalized exanthematous pustulosis (AGEP), 10 drug reactions with eosinophilia and systemic symptoms, and 8 Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) were recruited. The average frequencies of drug-induced IL-22-, IFN-γ-, and GrB-releasing cells were 35.5±16.3, 33.0±7.1, and 164.8±43.1 cells/million PBMCs, respectively. The sensitivity of combined IFN-γ/IL-22/GrB ELISpot was higher than that of IFN-γ ELISpot alone for culprit drug detection in all SCAR subjects (77.8% vs 51.9%, P < 0.01). The measurement of drug-induced IL-22- and IFN-γ releasing cells confirmed the culprit drugs in 77.8% of AGEP. The measurement of druginduced IFN-γ- and GrB-releasing cells confirmed the culprit drugs in 62.5% of SJS/TEN. Alpha-galactosylceramide supplementation significantly increased the frequencies of druginduced IFN-γ releasing cells. Conclusion: The measurement of drug-induced IFN-γ-releasing cells is the key for identifying culprit drugs. The additional measurement of drug-induced IL-22-releasing cells enhances ELISpot sensitivity to identify drug-induced AGEP, while the measurement of drug-induced GrB-releasing cells could have a role in SJS/TEN. ELISpot sensitivity might be improved by supplementary alpha-galactosylceramide.
#Drug allergy #diagnosis #in vitro #T cell #cytokine #IFN-γ

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참고문헌 (35)

참고문헌 신청
Co Minh HB / 2006 / Systemic reactions during skin tests with beta-lactams : a risk factor analysis / J Allergy Clin Immunol 117:466~468 google schola Liccardi G / 2006 / Systemic reactions from skin testing : literature review / J Investig Allergol Clin Immunol 16:75~78 google schola Haw WY / 2016 / In vitro rapid diagnostic tests for severe drug hypersensitivity reactions in children / Ann Allergy Asthma Immunol 117:61~66 google schola Suthumchai N / 2018 / The measurement of drug-induced interferon γ-releasing cells and lymphocyte proliferation in severe cutaneous adverse reactions / J Eur Acad Dermatol Venereol 32:992~998 google schola Copaescu A / 2021 / An updated review of the diagnostic methods in delayed drug hypersensitivity / Front Pharmacol 11:573573 google schola

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