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磺胺类药物所致超敏反应的临床表现及遗传影响

Clinical Manifestations and Genetic Influences in Sulfonamide-Induced Hypersensitivity.

作者信息

Asyraf Pungki Afifah, Kusnadi Ivanna Fauziyah, Stefanus Jonathan, Khairinisa Miski Aghnia, Abdulah Rizky

机构信息

Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, Indonesia.

Center of Excellence in Pharmaceutical Care Innovation, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, Indonesia.

出版信息

Drug Healthc Patient Saf. 2022 Jul 21;14:113-124. doi: 10.2147/DHPS.S347522. eCollection 2022.

Abstract

Drug hypersensitivity is an inflammatory or immune reaction induced by drugs. It can be fatal if not appropriately treated and cause the risk of long-term complications. Sulfonamides are classified as antimicrobial drugs with a broad spectrum effective for gram-positive and gram-negative bacteria. This antibacterial agent works by competitively inhibiting folic acid synthesis, which prevents the growth and proliferation of microorganisms. In its use as antibiotics, sulfonamides can also cause adverse reactions in specific individuals. It has been widely reported that sulfonamide antimicrobials cause hypersensitivity reactions mediated by IgE or T cells. This review identifies symptoms or signs that can appear, as well as genes associated with sulfonamide hypersensitivity reactions, as sulfonamide may cause hypersensitivity in the form of uveitis, skin rash, Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN), parotitis, angioedema, drug reaction with eosinophilia and systemic symptoms (DRESS), and pruritus. In addition, several genes were found to be associated with sulfonamide hypersensitivity, including HLA-A29, HLA-B12, HLA-DR7, HLA-B44, and HLA A*11:01.

摘要

药物超敏反应是由药物引起的炎症或免疫反应。若治疗不当,可能会致命,并导致长期并发症的风险。磺胺类药物属于抗菌药物,对革兰氏阳性菌和革兰氏阴性菌均有广谱抗菌作用。这种抗菌剂通过竞争性抑制叶酸合成发挥作用,从而阻止微生物的生长和繁殖。在作为抗生素使用时,磺胺类药物也可能在特定个体中引起不良反应。已有广泛报道称,磺胺类抗菌药物会引发由IgE或T细胞介导的超敏反应。本综述确定了可能出现的症状或体征,以及与磺胺类超敏反应相关的基因,因为磺胺类药物可能会引起葡萄膜炎、皮疹、史蒂文斯-约翰逊综合征(SJS)/中毒性表皮坏死松解症(TEN)、腮腺炎、血管性水肿、伴有嗜酸性粒细胞增多和全身症状的药物反应(DRESS)以及瘙痒等形式的超敏反应。此外,还发现了几个与磺胺类超敏反应相关的基因,包括HLA-A29、HLA-B12、HLA-DR7、HLA-B44和HLA A*11:01。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/59a8/9315057/7ea94b44920e/DHPS-14-113-g0001.jpg

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