Advances in understanding of the pathogenesis and therapeutic implications of drug reaction with eosinophilia and systemic symptoms: an updated review

Frontiers in Medicine

Medicine

Shuen-Iu Hung¹  Wei-Kai Hung²  Chuang-Wei Wang³  Wen-Hung Chung⁴  Chun-Bing Chen⁵  Chih-Chun Lee⁶ 

[1] Cancer Vaccine and Immune Cell Therapy Core Laboratory, Department of Medical Research, Chang Gung Memorial Hospital, Linkou, Taiwan;Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan;Cancer Vaccine and Immune Cell Therapy Core Laboratory, Department of Medical Research, Chang Gung Memorial Hospital, Linkou, Taiwan;Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan;Cancer Vaccine and Immune Cell Therapy Core Laboratory, Department of Medical Research, Chang Gung Memorial Hospital, Linkou, Taiwan;Chang Gung Immunology Consortium, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan;Department of Dermatology, Xiamen Chang Gung Hospital, Xiamen, China;Xiamen Chang Gung Allergology Consortium, Xiamen Chang Gung Hospital, Xiamen, China;Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan;Cancer Vaccine and Immune Cell Therapy Core Laboratory, Department of Medical Research, Chang Gung Memorial Hospital, Linkou, Taiwan;Chang Gung Immunology Consortium, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan;Department of Dermatology, Xiamen Chang Gung Hospital, Xiamen, China;Xiamen Chang Gung Allergology Consortium, Xiamen Chang Gung Hospital, Xiamen, China;College of Medicine, Chang Gung University, Taoyuan, Taiwan;Immune-Oncology Center of Excellence, Chang Gung Memorial Hospital, Linkou, Taiwan;Whole-Genome Research Core Laboratory of Human Diseases, Chang Gung Memorial Hospital, Keelung, Taiwan;Department of Dermatology, Beijing Tsinghua Chang Gung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China;Department of Dermatology, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China;Genomic Medicine Core Laboratory, Chang Gung Memorial Hospital, Linkou, Taiwan;Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan;Cancer Vaccine and Immune Cell Therapy Core Laboratory, Department of Medical Research, Chang Gung Memorial Hospital, Linkou, Taiwan;Chang Gung Immunology Consortium, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan;Department of Dermatology, Xiamen Chang Gung Hospital, Xiamen, China;Xiamen Chang Gung Allergology Consortium, Xiamen Chang Gung Hospital, Xiamen, China;School of Medicine, National Tsing Hua University, Hsinchu, Taiwan;College of Medicine, Chang Gung University, Taoyuan, Taiwan;Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan;Immune-Oncology Center of Excellence, Chang Gung Memorial Hospital, Linkou, Taiwan;Department of Medical Education, Chang Gung Memorial Hospital, Keelung, Taiwan;

关键词: drug reaction with eosinophilia and systemic symptoms;    DIHS;    hypersensitivity;    eosinophilia;    HHV-6;   

DOI  :  10.3389/fmed.2023.1187937

 received in 2023-03-16, accepted in 2023-06-05,  发布年份 2023

来源: Frontiers

【 摘 要 】

Drug reaction with eosinophilia and systemic symptoms or drug-induced hypersensitivity syndrome (DRESS/DIHS) is one type of severe cutaneous adverse reaction (SCAR). It is featured by fever, widespread skin lesions, protracted clinical course, internal organ involvement, and possibly long-term autoimmune sequelae. The presence of high-risk human leukocyte antigen (HLA) alleles, hypersensitivity reaction after culprit drug ingestion, and human herpesvirus reactivation may all contribute to its complex clinical manifestations. Some recent studies focusing on the roles of involved cytokines/chemokines and T cells co-signaling pathways in DRESS/DIHS were conducted. In addition, some predictors of disease severity and prognosis were also reported. In this review, we provided an update on the current understanding of the pathogenesis, potential biomarkers, and the relevant therapeutic rationales of DRESS/DIHS.

【 授权许可】

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Copyright © 2023 Chen, Hung, Wang, Lee, Hung and Chung.