Department of Dermatology, University of Occupational and Environmental Health, Kitakyushu 807-8555, Japan.
Int J Mol Sci. 2021 Jul 14;22(14):7527. doi: 10.3390/ijms22147527.
In accordance with the development of human technology, various medications have been speedily developed in the current decade. While they have beneficial impact on various diseases, these medications accidentally cause adverse reactions, especially drug eruption. This delayed hypersensitivity reaction in the skin sometimes causes a life-threatening adverse reaction, namely Stevens-Johnson syndrome and toxic epidermal necrolysis. Therefore, how to identify these clinical courses in early time points is a critical issue. To improve this problem, various biomarkers have been found for these severe cutaneous adverse reactions through recent research. Granulysin, Fas ligands, perforin, and granzyme B are recognized as useful biomarkers to evaluate the early onset of Stevens-Johnson syndrome and toxic epidermal necrolysis, and other biomarkers, such as miRNAs, high mobility group box 1 protein (HMGB1), and S100A2, which are also helpful to identify the severe cutaneous adverse reactions. Because these tools have been currently well developed, updates of the knowledge in this field are necessary for clinicians. In this review, we focused on the detailed biomarkers and diagnostic tools for drug eruption and we also discussed the actual usefulness of these biomarkers in the clinical aspects based on the pathogenesis of drug eruption.
随着人类技术的发展，在过去十年中，各种药物迅速发展。虽然它们对各种疾病都有有益的影响，但这些药物会意外地引起不良反应，尤其是药物疹。这种皮肤的迟发性超敏反应有时会导致危及生命的不良反应，即史蒂文斯-约翰逊综合征和中毒性表皮坏死松解症。因此，如何在早期时间点识别这些临床过程是一个关键问题。为了解决这个问题，通过最近的研究，已经发现了各种生物标志物来评估这些严重的皮肤不良反应。颗粒溶素、Fas 配体、穿孔素和颗粒酶 B 被认为是评估史蒂文斯-约翰逊综合征和中毒性表皮坏死松解症早期发病的有用生物标志物，其他生物标志物，如 microRNA、高迁移率族蛋白 B1 (HMGB1) 和 S100A2，也有助于识别严重的皮肤不良反应。由于这些工具已经得到了很好的发展，因此临床医生有必要了解该领域的最新知识。在这篇综述中，我们重点介绍了药物疹的详细生物标志物和诊断工具，并根据药物疹的发病机制讨论了这些生物标志物在临床方面的实际用途。
