Pichler Werner J
Division of Allergology, Clinic for Rheumatology and Clinical Immunology/Allergology, Inselspital, University of Bern, CH-3010 Bern, Switzerland.
Curr Allergy Asthma Rep. 2002 Jan;2(1):9-15. doi: 10.1007/s11882-002-0032-z.
In recent years, increasing evidence has indicated an important role for T cells in various drug-induced diseases. A detailed analysis of patients with various drug allergies revealed the existence of drug-specific T cells in the circulation or in eluate from skin infiltration in bullous, pustular, and maculopapular drug eruptions. The drug-specific T cells use the ab-T cell receptor CD4+ or CD8+ and react with drugs acting as haptens (covalently bound to larger molecules, such as penicillins), but also recognize drugs if they are bound only in a labile way to major histocompatibility complex molecules (noncovalent drug presentation). Functional analysis revealed a predominant IL-5 production by drug-specific CD4+ T cells in maculopapular exanthema (MPE) and bullous skin diseases, while patients with acute generalized exanthematous pustulosis have a peculiar T cell subset secreting high amounts of IL-8. Moreover, in MPE CD4+, perforin+ T cells were found in vitro and in immunohistology that had cytotoxic potential and killed keratinocytes in vitro and in vivo.
近年来，越来越多的证据表明T细胞在各种药物性疾病中发挥着重要作用。对各种药物过敏患者的详细分析显示，在大疱性、脓疱性和斑丘疹性药疹患者的循环系统或皮肤浸润洗脱液中存在药物特异性T细胞。药物特异性T细胞利用αβ-T细胞受体CD4+或CD8+，并与作为半抗原的药物（共价结合到较大分子，如青霉素）发生反应，但如果药物仅以不稳定的方式与主要组织相容性复合体分子结合（非共价药物呈递），它们也能识别药物。功能分析显示，在斑丘疹性皮疹（MPE）和大疱性皮肤病中，药物特异性CD4+T细胞主要产生IL-5，而急性泛发性脓疱性皮病患者有一个特殊的T细胞亚群分泌大量IL-8。此外，在MPE中，体外和免疫组织学研究发现了CD4+、穿孔素+T细胞，它们具有细胞毒性潜力，在体外和体内均可杀死角质形成细胞。
