Human leukocyte antigen-associated severe cutaneous adverse drug reactions: from bedside to bench and beyond
10.5415/apallergy.2019.9.e20
- Author:
Dinh Van NGUYEN
1
;
Christopher VIDAL
;
Hieu Chi CHU
;
Sheryl VAN NUNEN
Author Information
1. Division of Respiratory, Allergy and Clinical Immunology, Vinmec International Hospital, Times City and VinUni Project, Hanoi, Vietnam. v.dinhnv6@vinmec.com
- Publication Type:Review
- Keywords:
Severe cutaneous adverse drug reactions;
Human leukocyte antigen;
T-cell-mediated reactions
- MeSH:
Alopecia;
Asia;
Autoimmune Diseases;
Cicatrix;
Drug Hypersensitivity Syndrome;
Drug-Related Side Effects and Adverse Reactions;
Eosinophilia;
Exanthema;
Genetic Predisposition to Disease;
Humans;
Hypersensitivity;
Leukocytes;
Major Histocompatibility Complex;
Mass Screening;
Mortality;
Stevens-Johnson Syndrome;
T-Lymphocytes
- From:
Asia Pacific Allergy
2019;9(3):e20-
- CountryRepublic of Korea
- Language:English
-
Abstract:
Despite their being uncommon, severe cutaneous adverse drug reactions (SCARs) result in a very great burden of disease. These reactions not only carry with them a high mortality (10%–50%) and high morbidity (60%) with severe ocular complications, alopecia, oral and dental complications and development of autoimmune diseases, but also create a substantial economic burden for patients' families and society. SCARs are, therefore, an important medical problem needing a solution in many countries, especially in Asia. The clinical spectrum of SCARs comprises Stevens-Johnson syndrome, toxic epidermal necrolysis, DRESS (drug rash with eosinophilia and systemic symptoms) (also known as drug hypersensitivity syndrome or drug-induced hypersensitivity syndrome) and acute generalised exanthematous pustulosis. Recent crucial advances in determining genetic susceptibility and understanding how T cells recognise certain medications or their metabolites via the major histocompatibility complex and the effects of cofactors, have led to the implementation of cost-effective screening programs enabling prevention in a number of countries, and to further understanding of the patho-mechanisms involved in SCARs and their significance. In this review, we document comprehensively the journey of SCARs from bedside to bench and outline future perspectives in SCARs research.
