Gelincik Aslı, Demir Semra, Şen Fatma, Bozbey Uğur Hamza, Olgaç Müge, Ünal Derya, Çolakoğlu Bahauddin, Aktaş Esin Çetin, Deniz Günnur, Büyüköztürk Suna
Division of Immunology and Allergy, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
Institute of Oncology, Istanbul University, Istanbul, Turkey.
Asia Pac Allergy. 2019 Jan 28;9(1):e9. doi: 10.5415/apallergy.2019.9.e9. eCollection 2019 Jan.
Little is known about the mechanism of desensitization in hypersensitivity drug reactions.
The aim of this study was to evaluate the effects of drug desensitization on some cytokine levels in patients desensitized for drug hypersensitivity reactions.
Patients with a hypersensitivity reaction to any drug for whom desensitization was planned with the culprit drug, patients who could tolerate the same drugs and healthy subjects who were not exposed to these drugs were enrolled. Bead-based Milliplex MAP multiplex technology was used to determine interleukin (IL)-4, IL-5, interferon-γ and IL-10 levels in the sera of the subjects as a baseline and 24 hours after desensitization had been completed in the patients.
A total of 26 patients (16 female [61.5%]; mean age 48.46 ± 15.97 years old), 10 control patients (5 female [50%]; mean age 47.4 ± 15.4 years old) and 5 healthy subjects (3 female [60%]; mean age 34.2 ± 5.6 years old) were enrolled. Four of the 26 patients did not tolerate the procedure and were grouped as the 'unsuccessful desensitization group' whereas 22 patients successfully completed the procedure and formed the 'successful desensitization group.' Baseline cytokine levels in the 3 groups were not statistically different. Postdesensitization IL-10 levels in the successful desensitization group were significantly higher than their initial levels ( = 0.005) whereas none of the cytokine levels significantly changed in the unsuccessful desensitization group. The rise in IL-10 levels was greater in chemotherapeutic desensitizations when compared to other drugs ( = 0.006).
Successful desensitization independent of the hypersensitivity reaction type seems to be related to the increase of IL-10.
关于药物超敏反应中脱敏机制的了解甚少。
本研究旨在评估药物脱敏对因药物超敏反应而进行脱敏治疗的患者某些细胞因子水平的影响。
纳入计划使用致病药物进行脱敏治疗的对任何药物有超敏反应的患者、能耐受相同药物的患者以及未接触过这些药物的健康受试者。采用基于微珠的Milliplex MAP多重技术测定受试者血清中白细胞介素(IL)-4、IL-5、干扰素-γ和IL-10水平,作为基线水平以及患者脱敏完成后24小时的水平。
共纳入26例患者(16例女性[61.5%];平均年龄48.46±15.97岁)、10例对照患者(5例女性[50%];平均年龄47.4±15.4岁)和5例健康受试者(3例女性[60%];平均年龄34.2±5.6岁)。26例患者中有4例不耐受该程序,被归为“脱敏不成功组”,而22例患者成功完成该程序,形成“脱敏成功组”。3组的基线细胞因子水平无统计学差异。脱敏成功组脱敏后IL-10水平显著高于初始水平(P = 0.005),而脱敏不成功组的细胞因子水平均无显著变化。与其他药物相比,化疗药物脱敏时IL-10水平的升高幅度更大(P = 0.006)。
与超敏反应类型无关的成功脱敏似乎与IL-10的增加有关。