New genetic findings lead the way to a better understanding of fundamental mechanisms of drug hypersensitivity

摘要: Drug hypersensitivity reactions are an important clinical problem for both health care and industry. Recent advances in genetics have identified a number of HLA alleles associated with range these adverse predominantly affecting the skin but also other organs, such as liver. The associations between abacavir HLA-B*57:01 carbamazepine-induced Stevens-Johnson syndrome HLA-B*15:02 been implemented practice. There many different mechanisms proposed pathogenesis drug reactions, including hapten hypothesis, direct binding to T-cell receptors (the pharmacologic interaction hypothesis), peptide-binding displacement. A problem all hypotheses is that they largely based on in vitro findings, little in vivo evidence. Although most studies focused individual mechanisms, it perhaps more consider them being complementary, potentially occurring at same time patient. This might least partly account heterogeneity immune response seen patients. need develop novel methodologies evaluate how relate situation highly consistent genetic findings can be consistently used prediction prevention serious reactions.