Abstract

REGATEIRO, Frederico  and  FARIA, Emília. Immunopathological mechanisms of drug hypersensitivity reactions. Rev Port Imunoalergologia [online]. 2016, vol.24, n.2, pp.62-78. ISSN 0871-9721.

Immune-mediateddrug hypersensitivity (HS) reactions involve lymphocyte activation and present the hallmark characteristics of adaptive responses: specificity and immunological memory. Lymphocyte activation requires specific recognition of the drug by lymphocyte receptors (signal 1) and co-stimulation (signal 2) by the antigen presenting cell (APC). The type of inflammatory reaction is determined by the cytokine microenvironment during activation (signal 3). The origin of these stimulatory signals in drug HS is controversial. Small drug recognition by lymphocytes occurs by haptenization, pro-haptenization and “p-I concept” mechanisms. Co-stimulatory signals might be induced on the APC by the drug itself or originate from the microenvironment surrounding the APC. Cytokines polarize the effector response of lymphocytes and give rise to different types of HS with distinct clinical manifestations. The recognition of the immunopathological mechanisms involved in the HS reactions is crucial for the diagnostics, treatment and management of patients with drug HS

Keywords : Adverse drug reaction; drug allergy; drug hypersensitivity; haptens; p-I concept; prohaptens.

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