Halevy S, Cohen A D, Grossman N
Dermatology Dept, Skin Bank and Investigative Dermatology Laboratory, Soroka University Medical Center and Faculty of Health Sciences, Beer Sheba.
Harefuah. 2001 Feb;140(2):121-4, 190.
Diagnosis of cutaneous adverse drug reactions is an accepted terminology. Is a challenge. Drug-specific T-cell clones (CD4+ or CD8+), with a Th1- or a Th2-type cytokine-release pattern, may be generated from the peripheral blood in CADRs. In vitro drug-induced cytokine-release suggests a drug-specific immune response, and may implicate the drug as a possible inducer of the skin reaction. We evaluated the diagnostic role of in vitro drug-induced interferon-gamma (IFN-gamma) release from peripheral blood lymphocytes in patients with CADRs. We studied 22 patients with CADRs following intake of 45 drugs (1-4 drugs per patient). Drugs were classified into 3 categories of suspicion. 17 patients who took 39 drugs of the same type (1-4 drugs per patient) without developing adverse reactions, served as controls. In vitro drug-induced release of IFN-à from peripheral blood lymphocytes, following in vitro challenge with the unmodified drugs, was evaluated. The mean IFN-gamma increase following 45 drug tests (60.8 +/- 85.2%) was higher (p < 0.05) than in controls after 39 drug tests (30.1 +/- 27.7%). Significance was greater (p < 0.005) when the mean IFN-gamma increase for the 24 highly suspected drugs (75.1 +/- 93.4%) and that for the controls were compared. This study suggests that the in vitro drug-induced IFN-gamma release test may serve as a diagnostic tool in CADRs.
皮肤药物不良反应的诊断是一个公认的术语。这是一项挑战。在药物引起的皮肤不良反应中，具有Th1或Th2型细胞因子释放模式的药物特异性T细胞克隆（CD4 +或CD8 +）可能从外周血中产生。体外药物诱导的细胞因子释放提示药物特异性免疫反应，并可能提示该药物是皮肤反应的可能诱导剂。我们评估了外周血淋巴细胞体外药物诱导的干扰素-γ（IFN-γ）释放在药物引起的皮肤不良反应患者中的诊断作用。我们研究了22例服用45种药物（每位患者1 - 4种药物）后发生药物引起的皮肤不良反应的患者。药物被分为3类可疑药物。17例服用39种相同类型药物（每位患者1 - 4种药物）但未出现不良反应的患者作为对照。评估了用未修饰的药物进行体外刺激后外周血淋巴细胞体外药物诱导的IFN-γ释放。45次药物测试后IFN-γ的平均增加量（60.8±85.2%）高于39次药物测试后对照组的增加量（30.1±27.7%）（p < 0.05）。当比较24种高度可疑药物的IFN-γ平均增加量（75.1±93.4%）与对照组的增加量时，差异更显著（p < 0.005）。这项研究表明，体外药物诱导的IFN-γ释放试验可能作为药物引起的皮肤不良反应的诊断工具。
