Pavlos Rebecca, White Katie D, Wanjalla Celestine, Mallal Simon A, Phillips Elizabeth J
Institute for Immunology and Infectious Diseases, Murdoch University, 6150 Murdoch, Western Australia, Australia.
Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
Immunol Allergy Clin North Am. 2017 Nov;37(4):785-815. doi: 10.1016/j.iac.2017.07.007.
Adverse drug reactions (ADRs) are a significant source of patient morbidity and mortality and represent a major burden to health care systems and drug development. Up to 50% of such reactions are preventable. Although many ADRs can be predicted based on the on-target pharmacologic activity, ADRs arising from drug interactions with off-target receptors are recognized. Off-target ADRs include the immune-mediated ADRs (IM-ADRs) and pharmacologic drug effects. In this review, we discuss what is known about the immunogenetics and pathogenesis of IM-ADRs and the hypothesized role of heterologous immunity in the development of IM-ADRs.
药物不良反应（ADR）是患者发病和死亡的重要原因，也是医疗保健系统和药物研发的重大负担。高达50%的此类反应是可预防的。尽管许多ADR可根据靶向药理活性进行预测，但由药物与脱靶受体相互作用引起的ADR也已得到认识。脱靶ADR包括免疫介导的ADR（IM-ADR）和药物的药理作用。在本综述中，我们讨论了关于IM-ADR的免疫遗传学和发病机制的已知情况，以及异源免疫在IM-ADR发生发展中所假定的作用。
