Review and expert evaluation of the materials of the European meeting on hypersensitivity to drugs (DHM 2022)
DOI:
https://doi.org/10.15574/SP.2022.127.69Keywords:
drugs, hypersensitivity, viruses, herpes, COVID-19, vaccines, skin, immune systemAbstract
The review article discusses the current data on the mechanisms of hypersensitivity drugs reactions (HDRs). The relevance of the problem is associated with a significant prevalence of adverse drug reactions, in the structure of which immune allergic reactions occupy a significant proportion. Adverse drug reactions, according to the literature, occur in 10-20% of hospitalized patients and about 25% of outpatients. A serious problem of HDRs is their overdiagnosis, which affects the results of individual treatment and can have serious consequences in case of misdiagnosis, because it causes appropriate restrictions in the use of necessary drugs.
Purpose - to analyze current views and recommendations on the problem of drug allergy; to highlight the issues of the 2022 meeting, which highlighted the problems of drug hypersensitivity. In particular, to show the relationship between viral infections and severe skin reactions, such as skin lesion syndrome with eosinophilia and systemic disorders. The article reviews and proposes algorithms that can be used to prevent the development of complications caused by HDRs. The materials of the article are based on the results of the European Meeting organized by the European Association of Allergists and Immunologists in 2022 in Verona, Italy.
In the conclusions it is noted that despite the interest of the health care system and the large number of studies and publications on the problem of drug allergy, today there is an urgent need for accurate diagnostic approaches that will ensure the correct identification of the suspected drug by a combination of necessary tests and determine the cause for the possibility of prescribing appropriate treatment. The new mechanisms, phenotypes and endotypes of HDRs to drug responses discussed in the review are the future keys to preventing further exposure to harmful drugs. Preliminary pharmacogenomic screening (identification of specific human leukocyte antigen genotypes associated with severe skin adverse reactions) for patients of certain groups before prescribing high-risk drugs may become the future for Ukraine.
No conflict of interests was declared by the author.
References
Agol VI. (2012, Dec). Cytopathic effects: virus-modulated manifestations of innate immunity? Trends Microbiol. 20(12): 570-576. doi: 10.1016/j.tim.2012.09.003. Epub 2012 Oct 13. https://doi.org/10.1016/j.tim.2012.09.003; PMid:23072900 PMCid:PMC7126625
Agut H, Bonnafous P, Gautheret-Dejean A. (2015, Apr). Laboratory and clinical aspects of human herpesvirus 6 infections. Clin Microbiol Rev. 28(2): 313-35. https://doi.org/10.1128/CMR.00122-14; PMid:25762531 PMCid:PMC4402955
Ahluwalia J et al. (2015). Human herpesvirus 6 involvement in paediatric drug hypersensitivity syndrome. British Journal of Dermatology. 172(4): 1090-1095. https://doi.org/10.1111/bjd.13512; PMid:25369238 PMCid:PMC4382397
Al‐Ahmad M, Rodriguez BT. (2017). Pattern of inpatient referrals to a drug allergy unit in Kuwait. Eur Ann Allergy Clin Immunol. 49(6): 276‐280. https://doi.org/10.23822/EurAnnACI.1764-1489.18; PMid:29249136
Amrol DJ. (2020). Delabeling Penicillin Allergy. URL: https://www.jwatch.org/na52898/2020/12/28/delabeling-penicillin-allergy.
Anci E, Braun C, Marinosci A, Rodieux F, Midun E, Torres MJ, Caubet JC. (2021, Mar 10). Viral Infections and Cutaneous Drug-Related Eruptions. Front Pharmacol. 11: 586407. https://doi.org/10.3389/fphar.2020.586407; PMid:33776753 PMCid:PMC7988096
Banerji A et al. (2021, Jul 28). COVID-19 Vaccines Tolerated in Patients with Paclitaxel and Docetaxel Allergy Authorea. https://doi.org/10.22541/au.162748552.24180526/v1
Barbaud A et al. (2022). Allergies and COVID-19 vaccines: An ENDA/EAACI Position paper Allergy. 00: 1-22. https://doi.org/10.1111/all.15241; PMid:35112371
Bianchi L et al. (2022). Comment on "Caution against injudicious vaccine allergy skin test and adverse reactions after intradermal COVID‐19 vaccine testing". Contact Dermatitis. 86(3): 237. https://doi.org/10.1111/cod.14014; PMid:34812501 PMCid:PMC9011852
Blumenthal KG, Robinson LB, Camargo CA Jr, Shenoy ES, Banerji A, Landman AB, Wickner P. (2021, Apr 20). Acute Allergic Reactions to mRNA COVID-19 Vaccines. JAMA. 325(15): 1562-1565. https://doi.org/10.1001/jama.2021.3976; PMid:33683290 PMCid:PMC7941251
Bousquet PJ et al. (2009). Position Paper. Pharmacovigilance of drug allergy and hypersensitivity using the ENDA-DAHD database and the GA2 LEN platform. The Galenda project Allergy. 64: 194-203. https://doi.org/10.1111/j.1398-9995.2008.01944.x; PMid:19178398
Bruusgaard-Mouritsen MA, Jensen BM, Poulsen LK, Duus Johansen J, Garvey LH. (2022, Jan). Optimizing investigation of suspected allergy to polyethylene glycols. J Allergy Clin Immunol. 149(1): 168-175.e4. Epub 2021 May 28. https://doi.org/10.1016/j.jaci.2021.05.020; PMid:34052265
Cheville NF (ed), Lehmkuhl H. (2009). Cytopathology of Viral Diseases. Chapter 13. https://doi.org/10.1002/9780813810379.ch13
Das S, Chaudhury A. (2011). Recent Advances in Lipid Nanoparticle Formulations with Solid Matrix for Oral Drug Delivery. AAPS PharmSciTech. 12: 62-76. https://doi.org/10.1208/s12249-010-9563-0; PMid:21174180 PMCid:PMC3066374
Demoly P, Adkinson NF, Brockow K et al. (2014). International Consensus on drug allergy. Allergy. 69(4): 420‐437. https://doi.org/10.1111/all.12350; PMid:24697291
Dhopeshwarkar N, Sheikh A, Doan R et al. (2019). Drug‐induced anaphylaxis documented in electronic health records. J Allergy Clin Immunol Pract. 7(1): 103‐111. https://doi.org/10.1016/j.jaip.2018.06.010; PMid:29969686 PMCid:PMC6311439
Edwards IR, Aronson JK. (2000). Adverse drug reactions: definition, diagnosis and management. Lancet. 356: 1255-1259. https://doi.org/10.1016/S0140-6736(00)02799-9; PMid:11072960
Fiszenson-Albala F, Auzerie V, Mahe E, Farinotti R, Durand-Stocco C, Crickx B, Descamps V. (2003, Nov). A 6-month prospective survey of cutaneous drug reactions in a hospital setting. Br J Dermatol. 149(5): 1018-1022. https://doi.org/10.1111/j.1365-2133.2003.05584.x; PMid:14632808
Folster-Holst R, Kreth HW. (2009). Viral exanthems in childhood - infectious (direct) exanthems. Part 2: Other viral exanthems. JDDG. 7: 414-418. https://doi.org/10.1111/j.1610-0387.2008.06869.x; PMid:18808380
Ford M, Sahbudin I, Filer A, Steven N, Fisher BA. (2018). High proportion of drug hypersensitivity reactions to sulfasalazine following its use in anti‐PD‐1‐associated inflammatory arthritis. Rheumatology (Oxford). 57(12): 2244‐2246. https://doi.org/10.1093/rheumatology/key234; PMid:30107548
Gabrielli S, Clarke AE, Eisman H et al. (2018). Disparities in rate, triggers, and management in pediatric and adult cases of suspected drug‐induced anaphylaxis in Canada. Immun Inflamm Dis. 6(1): 3‐12. https://doi.org/10.1002/iid3.201; PMid:29094518 PMCid:PMC5818453
Griffin DE. (2022). Why does viral RNA sometimes persist after recovery from acute infections? PLoS Biol. 20(6): e3001687. https://doi.org/10.1371/journal.pbio.3001687; PMid:35648781 PMCid:PMC9191737
Hyun S-J et al. (2017). Comprehensive analysis of cytomegalovirus pp65 antigen-specific CD8+ T cell responses according to human leukocyte antigen class I allotypes and intraindividual dominance. Frontiers in immunology. 8: 1591. https://doi.org/10.3389/fimmu.2017.01591; PMid:29209324 PMCid:PMC5702484
Ichiche M et al. (2003). Severe thrombocytopenia secondary to cytomegalovirus infection in an immunocompetent adult. European Journal of Internal Medicine. 14 (1): 56-59. https://doi.org/10.1016/S0953-6205(02)00210-8; PMid:12554013
Jaoui A, Delalande D, Siouti S et al. (2019). Safety and cost effectiveness of supervised ambulatory drug provocation tests in children with mild non‐immediate reactions to beta‐lactams. Allergy. Epub ahead of print. https://doi.org/10.1111/all.13871; PMid:31087349
Kardaun SH, Sekula P, Valeyrie-Allanore L, Liss Y, Chu CY et al. (2013, Nov). RegiSCAR study group. Drug reaction with eosinophilia and systemic symptoms (DRESS): an original multisystem adverse drug reaction. Results from the prospective RegiSCAR study. Br J Dermatol. 169(5): 1071-1080. https://doi.org/10.1111/bjd.12501; PMid:23855313
Kawamura Y et al. (2011). Different characteristics of human herpesvirus 6 encephalitis between primary infection and viral reactivation. Journal of clinical virology. 51(1): 12-19. https://doi.org/10.1016/j.jcv.2011.02.002; PMid:21376661
Kim MH, Lee SY, Lee SE et al. (2014). Anaphylaxis to iodinated contrast media: clinical characteristics related with development of anaphylactic shock. PLoS One. 9(6): e100154. https://doi.org/10.1371/journal.pone.0100154; PMid:24932635 PMCid:PMC4059752
Kowalski ML. (2013). Position Paper Classification and practical approach to the diagnosis and management of hypersensitivity to nonsteroidal anti-inflammatory drugs. Allergy. 68: 1219-1232. https://doi.org/10.1111/all.12260; PMid:24117484
Kuyucu S, Caubet JC. (2018). Hypersensitivity reactions to antiepileptic drugs in children: epidemiologic, pathogenetic, clinical, and dia‐nostic aspects. J Allergy Clin Immunol Pract. 6(6): 1879‐1891.e1. https://doi.org/10.1016/j.jaip.2018.07.003; PMid:30104171
Laksono BM, de Vries RD, McQuaid S, Duprex WP, de Swart RL. (2016, Jul 28). Measles Virus Host Invasion and Pathogenesis. Viruses. 8(8): 210. https://doi.org/10.3390/v8080210; PMid:27483301 PMCid:PMC4997572
Mardivirin L et al. (2010). Amoxicillin-induced flare in patients with DRESS (Drug Reaction with Eosinophilia and Systemic Symptoms): report of seven cases and demonstration of a direct effect of amoxicillin on Human Herpesvirus 6 replication in vitro. European Journal of Dermatology. 20(1): 68-73. https://doi.org/10.1684/ejd.2010.0821; PMid:19822481
Mattingly TJ 2nd, Fulton A, Lumish RA et al. (2018). The cost of self‐re‐ported penicillin allergy: a systematic review. J Allergy Clin Immunol Pract. 6(5): 1649-1654 e4. https://doi.org/10.1016/j.jaip.2017.12.033; PMid:29355644
McNeil BD, Pundir P, Meeker S, Han L, Undem BJ, Kulka M, Dong X. (2015, Mar 12). Identification of a mast-cell-specific receptor crucial for pseudo-allergic drug reactions. Nature. 519(7542): 237-241. https://doi.org/10.1038/nature14022; PMid:25517090 PMCid:PMC4359082
Mims CA. (1966, Dec). Pathogenesis of rashes in virus diseases. Bacteriol Rev. 30(4): 739-760. https://doi.org/10.1128/br.30.4.739-760.1966; PMid:5342519 PMCid:PMC441013
Mims CA. (1964, Mar). Aspects of the pathogenesis of virus diseases. Bacteriol Rev. 28(1): 30-71. https://doi.org/10.1128/br.28.1.30-71.1964; PMid:14127970 PMCid:PMC441209
Meng J, Rotiroti G, Burdett E, Lukawska JJ. (2017). Anaphylaxis during general anaesthesia: experience from a drug allergy centre in the UK. Acta Anaesthesiol Scand. 61(3): 281‐289. https://doi.org/10.1111/aas.12858; PMid:28164272
Mota I, Gaspar A, Benito‐Garcia F, Correia M, Chambel M, Morais‐Almeida M. (2018). Drug‐induced anaphylaxis: seven‐year single‐center survey. Eur Ann Allergy Clin Immunol. 50(5): 211‐216. https://doi.org/10.23822/EurAnnACI.1764-1489.66; PMid:30028111
Muraro A et al. (2014). EAACI food allergy and anaphylaxis guidelines: diagnosis and management of food allergy. Allergy. 69; 8: 1008-1025. https://doi.org/10.1111/all.12429; PMid:24909706
Murphy KR et al. (2021). Insights from American College of Allergy, Asthma, and Immunology COVID-19 Vaccine Task Force: Allergic Reactions to mRNA SARS-CoV-2 Vaccines. Ann Allergy Asthma Immunol. 126: 319e320. https://doi.org/10.1016/j.anai.2021.01.017; PMid:33493641 PMCid:PMC7825848
Ojeda P, Sastre J, Olaguibel JM, Chivato T, Investigators partici‐pating in the National Survey of the Spanish Society of A, Clinical Immunology A. (2018). Alergologica 2015: a national survey on allergic diseases in the adult Spanish population. J Investig Allergol Clin Immunol. 28(3): 151‐164. https://doi.org/10.18176/jiaci.0264; PMid:29939133
Onorati M et al. (2016). Zika virus disrupts phospho-TBK1 localization and mitosis in human neuroepithelial stem cells and radial glia. Cell reports. 16(10): 2576-2592. https://doi.org/10.1016/j.celrep.2016.08.038; PMid:27568284 PMCid:PMC5135012
Ostrov DA. (2012, Jun 19). Drug hypersensitivity caused by alteration of the MHC-presented self-peptide repertoire. PNAS. 109; 25: 9959-9964. https://doi.org/10.1073/pnas.1207934109; PMid:22645359 PMCid:PMC3382472
Parham P. (2009). The Immune System. 3rd Edition. Garland Science.
Petrova G, Ferrante A, Gorski J. (2012). Cross-reactivity of T cells and its role in the immune system. Crit Rev Immunol. 32(4): 349-372. https://doi.org/10.1615/CritRevImmunol.v32.i4.50; PMid:23237510 PMCid:PMC3595599
Piccorossi A. et al. (2020). Epidemiology and drug allergy results in children investigated in allergy unit of a tertiary-care paediatric hospital setting. Italian Journal of Pediatrics. 46: 5. https://doi.org/10.1186/s13052-019-0753-4; PMid:31924232 PMCid:PMC6954623
Pichler WJ. (2002). Pharmacological interaction of drugs with antigen-specific immune receptors: the p-i concept. Curr Opin Allergy Clin Immunol. 2: 301-305. https://doi.org/10.1097/00130832-200208000-00003; PMid:12130944
Pichler WJ, Adam J, Watkins S, Wuillemin N, Yun J, Yerly D. (2015). Drug hypersensitivity: how drugs stimulate T cells via pharmacological interaction with immune receptors. Int Arch Allergy Clin Immunol. 168: 13-24. https://doi.org/10.1159/000441280; PMid:26524432
Pichler WJ, Beeler A, Keller M, Lerch M, Posadas S, Schmid D, Spanou Z, Zawodniak A, Gerber B. (2006). Pharmacological interaction of drugs with immune receptors: the p-i concept. Allergol Int. 55: 17-25. https://doi.org/10.2332/allergolint.55.17; PMid:17075282
Pradeu T, Cooper EL. (2012, Sep 17). The danger theory: 20 years later. Front Immunol. 3: 287. https://doi.org/10.3389/fimmu.2012.00287; PMid:23060876 PMCid:PMC3443751
Pritchett JC et al. (2012). The Link between Hypersensitivity Syndrome Reaction Development and Human Herpes Virus-6 Reactivation. International Journal of Hepatology. 2012: 723062. https://doi.org/10.1155/2012/723062; PMid:22666603 PMCid:PMC3362035
Rasa S, Nora-Krukle Z, Henning N et al. (2018). Chronic viral infections in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). J Transl Med. 16: 268. https://doi.org/10.1186/s12967-018-1644-y; PMid:30285773 PMCid:PMC6167797
Rawlins MD. (1981). Clinical pharmacology: adverse reactions to drugs. BMJ. 282: 974-976. https://doi.org/10.1136/bmj.282.6268.974; PMid:6781682 PMCid:PMC1504743
Rich RR, Fleisher ThA, Shearer WT et al. (2019). Clinical Immunology Principles and Practice. 5th Edition. Elsevier: 1392.
Sabat R, Wolk K, Loyal L, Döcke WD, Ghoreschi K. (2019, May). T cell pathology in skin inflammation. Semin Immunopathol. 41(3): 359-377. Epub 2019 Apr 26. https://doi.org/10.1007/s00281-019-00742-7; PMid:31028434 PMCid:PMC6505509
Santos RB, Galvao VR. (2017). Monoclonal antibodies hypersensitivity: prevalence and management. Immunol Allergy Clin North Am. 37(4): 695‐711. https://doi.org/10.1016/j.iac.2017.07.003; PMid:28965635
Shimabukuro TT, Cole M, Su JR. (2021, Feb 12). Reports of anaphylaxis after receipt of mRNA COVID-19 vaccines in the US - December 14, 2020 - January 18, 2021. JAMA. 325(11):1101-1102. https://doi.org/10.1001/jama.2021.1967; PMid:33576785 PMCid:PMC8890485
Shiohara T, Iijima M, Ikezawa Z, Hashimoto K. (2007, May). The diagnosis of a DRESS syndrome has been sufficiently established on the basis of typical clinical features and viral reactivations. Br J Dermatol. 156(5): 1083-1084. Epub 2007 Mar 23. https://doi.org/10.1111/j.1365-2133.2007.07807.x; PMid:17381452
Shiohara T, Mizukawa Y. (2019, Jul). Drug-induced hypersensitivity syndrome (DiHS)/drug reaction with eosinophilia and systemic symptoms (DRESS): An update in 2019. Allergol Int. 68(3): 301-308. Epub 2019 Apr 16. https://doi.org/10.1016/j.alit.2019.03.006; PMid:31000444
Smith AK, Circle SJ. (1972). Chemical Composition of the Seed. In: Smith A.K. and Circle S.J. (Eds.) Soybeans: Chemistry and Technology. V.1, Proteins, Avi Publishing, Westport: 61-92.
Stevenson B, Trevenen M, Klinken E, Smith W, Yuson C et al. (2020, Feb). Multicenter Australian Study to Determine Criteria for Low- and High-Risk Penicillin Testing in Outpatients. J Allergy Clin Immunol Pract. 8(2): 681-689.e3. Epub 2019 Oct 8. https://doi.org/10.1016/j.jaip.2019.09.025; PMid:31604129
Takahashi R et al. (2009, Jun 15). Defective Regulatory T Cells In Patients with Severe Drug Eruptions: Timing of the Dysfunction Is Associated with the Pathological Phenotype and Outcome. The Journal of Immunology. 182(12): 8071-8079. https://doi.org/10.4049/jimmunol.0804002; PMid:19494333
Thong BY, Tan TC. (2011). Epidemiology and risk factors for drug allergy. Br J Clin Pharmacol. 71(5): 684‐700. https://doi.org/10.1111/j.1365-2125.2010.03774.x; PMid:21480948 PMCid:PMC3093074
Tohyama M et al. (2007). Association of human herpesvirus 6 reactivation with the flaring and severity of drug‐induced hypersensitivity syndrome. British Journal of Dermatology. 157(5): 934-940. https://doi.org/10.1111/j.1365-2133.2007.08167.x; PMid:17854362
Tohyama M, Hashimoto K. (2011). New aspects of drug‐induced hypersensitivity syndrome. The Journal of dermatology. 38(3): 222-228. https://doi.org/10.1111/j.1346-8138.2010.01176.x; PMid:21342223
Virgin HW, Wherry EJ, Ahmed R. (2009, Jul 10). Redefining chronic viral infection. Cell. 138(1): 30-50. https://doi.org/10.1016/j.cell.2009.06.036; PMid:19596234
Watanabe T, Kimura A, Kuroyanagi H. (2018, Nov 28). Alternative Splicing Regulator RBM20 and Cardiomyopathy. Front Mol Biosci. 5: 105. https://doi.org/10.3389/fmolb.2018.00105; PMid:30547036 PMCid:PMC6279932
White SR, Bird SM, Merrall ELC, Hutchinson SJ. (2015). Drugs-Related Death Soon after Hospital-Discharge among Drug Treatment Clients in Scotland: Record Linkage, Validation, and Investigation of Risk-Factors. PLoS ONE. 10(11): e0141073. https://doi.org/10.1371/journal.pone.0141073; PMid:26539701 PMCid:PMC4634860
Wolz MM, Sciallis GF, Pittelkow MR. (2012, Oct). Human herpesviruses 6, 7, and 8 from a dermatologic perspective. Mayo Clin Proc. 87(10): 1004-1014. Epub 2012 Jul 21. https://doi.org/10.1016/j.mayocp.2012.04.010; PMid:22819486 PMCid:PMC3538396
Wong A, Seger DL, Lai KH, Goss FR, Blumenthal KG, Zhou L. (2019). Drug hypersensitivity reactions documented in electronic health record within a large Health System. J Allergy Clin Immunol Pract. 7(4): 1253‐1260. https://doi.org/10.1016/j.jaip.2018.11.023; PMid:30513361 PMCid:PMC6456421
Downloads
Published
Issue
Section
License
Copyright (c) 2022 Modern pediatrics. Ukraine
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The policy of the Journal “MODERN PEDIATRICS. UKRAINE” is compatible with the vast majority of funders' of open access and self-archiving policies. The journal provides immediate open access route being convinced that everyone – not only scientists - can benefit from research results, and publishes articles exclusively under open access distribution, with a Creative Commons Attribution-Noncommercial 4.0 international license (СС BY-NC).
Authors transfer the copyright to the Journal “MODERN PEDIATRICS. UKRAINE” when the manuscript is accepted for publication. Authors declare that this manuscript has not been published nor is under simultaneous consideration for publication elsewhere. After publication, the articles become freely available on-line to the public.
Readers have the right to use, distribute, and reproduce articles in any medium, provided the articles and the journal are properly cited.
The use of published materials for commercial purposes is strongly prohibited.