T-cell-mediated drug hypersensitivity: immune mechanisms and their clinical relevance
Asia Pacific Allergy
;
(4): 77-89, 2016.
Artigo
em Inglês
| WPRIM
| ID: wpr-750063
ABSTRACT
T-cell-mediated drug hypersensitivity represents a significant proportion of immune mediated drug hypersensitivity reactions. In the recent years, there has been an increase in understanding the immune mechanisms behind T-cell-mediated drug hypersensitivity. According to hapten mechanism, drug specific T-cell response is stimulated by drug-protein conjugate presented on major histocompatibility complex (MHC) as it is presented as a new antigenic determinant. On the other hand, p-i concept suggests that a drug can stimulate T cells via noncovalent direct interaction with T-cell receptor and/or peptide-MHC. The drug binding site is quite variable and this leads to several different mechanisms within p-i concept. Altered peptide repertoire can be regarded as an 'atypical' subset of p-i concept since the mode of the drug binding and the binding site are essentially identical to p-i concept. However, the intracellular binding of abacavir to HLA-B*5701 additionally results in alteration in peptide repertoire. Furthermore the T-cell response to altered peptide repertoire model is only shown for abacavir and HLA-B*5701 and therefore it may not be generalised to other drug hypersensitivity. Danger hypothesis has been postulated to play an important role in drug hypersensitivity by providing signal 2 but its experimental data is lacking at this point in time. Furthermore, the recently described allo-immune response suggests that danger signal may be unnecessary. Finally, in view of these new understanding, the classification and the definition of type B adverse drug reaction should be revised.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Sítios de Ligação
/
Receptores de Antígenos de Linfócitos T
/
Linfócitos T
/
Classificação
/
Hipersensibilidade a Drogas
/
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos
/
Mãos
/
Haptenos
/
Antígenos HLA
/
Complexo Principal de Histocompatibilidade
Tipo de estudo:
Estudo prognóstico
Idioma:
Inglês
Revista:
Asia Pacific Allergy
Ano de publicação:
2016
Tipo de documento:
Artigo
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