Okumura Akihisa, Tsuge Ikuya, Kubota Tetsuo, Kurahashi Hirokazu, Natsume Jun, Negoro Tamiko, Watanabe Kazuyoshi
Department of Pediatrics, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan.
Eur J Paediatr Neurol. 2007 Nov;11(6):385-8. doi: 10.1016/j.ejpn.2007.03.001. Epub 2007 Apr 10.
We evaluated drug-specific T cell responses in a patient with refractory partial seizures and paroxysmal kinesigenic choreoathetosis successfully treated with clinical desensitization to phenytoin. Drug-induced lymphocyte transformation test before desensitization was negative with a stimulation index of 130%. The frequencies and cytokine-producing phenotypes of phenytoin-specific T cells were examined simultaneously by using a carboxyfluorescein succinimidyl ester (CFSE) dilution assay. Before desensitization, the proportion of CFSElow CD4+ cells in whole CD4+ was 3.09%; 13.6% of CFSElow CD4+ cells were stained with anti-interferon gamma antibody. After desensitization, phenytoin-specific CFSElow CD4+ cells decreased to background level. These results indicate that CFSE dilution assay will be useful for the diagnosis and monitoring of drug hypersensitivity.
我们评估了一名难治性部分性癫痫和发作性运动诱发性舞蹈手足徐动症患者的药物特异性T细胞反应，该患者通过苯妥英临床脱敏治疗成功。脱敏前的药物诱导淋巴细胞转化试验为阴性，刺激指数为130%。通过使用羧基荧光素琥珀酰亚胺酯（CFSE）稀释试验同时检测苯妥英特异性T细胞的频率和产生细胞因子的表型。脱敏前，全CD4+细胞中CFSElow CD4+细胞的比例为3.09%；13.6%的CFSElow CD4+细胞被抗干扰素γ抗体染色。脱敏后，苯妥英特异性CFSElow CD4+细胞降至背景水平。这些结果表明，CFSE稀释试验将有助于药物超敏反应的诊断和监测。
