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KMID : 1143120190090030020
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Asia Pacific Allergy
2019 Volume.9 No. 3 p.20 ~ p.20
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Human leukocyte antigen-associated severe cutaneous adverse drug reactions: from bedside to bench and beyond
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Nguyen Dinh Van
Vidal Christopher
Chu Hieu Chi
van Nunen Sheryl
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Abstract
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Despite their being uncommon, severe cutaneous adverse drug reactions (SCARs) result in a very great burden of disease. These reactions not only carry with them a high mortality (10%?50%) and high morbidity (60%) with severe ocular complications, alopecia, oral and dental complications and development of autoimmune diseases, but also create a substantial economic burden for patients' families and society. SCARs are, therefore, an important medical problem needing a solution in many countries, especially in Asia. The clinical spectrum of SCARs comprises Stevens-Johnson syndrome, toxic epidermal necrolysis, DRESS (drug rash with eosinophilia and systemic symptoms) (also known as drug hypersensitivity syndrome or drug-induced hypersensitivity syndrome) and acute generalised exanthematous pustulosis. Recent crucial advances in determining genetic susceptibility and understanding how T cells recognise certain medications or their metabolites via the major histocompatibility complex and the effects of cofactors, have led to the implementation of cost-effective screening programs enabling prevention in a number of countries, and to further understanding of the patho-mechanisms involved in SCARs and their significance. In this review, we document comprehensively the journey of SCARs from bedside to bench and outline future perspectives in SCARs research.
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KEYWORD
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Severe cutaneous adverse drug reactions, Human leukocyte antigen, T-cell-mediated reactions
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