Saito Mikio, Yagi Motohiro, Uno Katsuji, Takanaka Koichiro
The Shibata Center Pharmacy, Kyoeido Ltd, Shibata, Niigata, Japan.
Biol Pharm Bull. 2008 Feb;31(2):299-304. doi: 10.1248/bpb.31.299.
In 133 patients suspected of hypersensitivity to drugs and 102 control patients without hypersensitivity to drugs, the identification of allergenic drugs was performed by the drug-induced lymphocyte stimulation test (DLST) and the leukocyte migration test (LMT) to compare their usefulness in identifying drug allergies. In the 133 subject patients, the positive rate was 24.8% on the DLST and 60.9% on the LMT (agreement rate; 77.4%); thus, the LMT showed a significantly higher positive rate than the DLST (p<0.000001, chi(2)-test). In the 102 control patients, the positive rates on the DLST and LMT were 6.9%. In addition, the LMT showed a higher positive rate than the DLST for many hypersensitivity symptoms such as skin eruptions and hepatic injury, and for many drug efficacy categories of the suspected drugs such as antibacterial drugs, etc. Furthermore, the positive rate of the DLST did not change when adjusted for the patients' serum and sex, while that of the LMT increased when adjusted for the patients' serum and was found to be higher in females than in males. Our findings indicate that the LMT may be more useful than the DLST in identifying the causative drug in drug allergies and that its interpretation is influenced by the patient's serum and sex.
在133例疑似药物过敏患者和102例无药物过敏的对照患者中,通过药物诱导淋巴细胞刺激试验(DLST)和白细胞迁移试验(LMT)进行致敏药物鉴定,以比较它们在识别药物过敏方面的效用。在133例受试患者中,DLST的阳性率为24.8%,LMT的阳性率为60.9%(符合率为77.4%);因此,LMT的阳性率显著高于DLST(p<0.000001,卡方检验)。在102例对照患者中,DLST和LMT的阳性率均为6.9%。此外,对于许多过敏症状如皮疹和肝损伤,以及对于许多疑似药物的药效类别如抗菌药物等,LMT的阳性率高于DLST。而且,调整患者血清和性别后,DLST的阳性率不变,而LMT的阳性率在调整患者血清后升高,且发现女性高于男性。我们的研究结果表明,在识别药物过敏的致病药物方面,LMT可能比DLST更有用,并且其结果受患者血清和性别的影响。