Université Paris-Saclay, INSERM, Inflammation Microbiome Immunosurveillance, Orsay, 91400, France.
Université Paris-Saclay, INSERM, CEA, Center for Research in Immunology of Viral, Autoimmune, Hematological and Bacterial Diseases (IMVA-HB), Le Kremlin Bicêtre, 94270, France.
Toxicol Sci. 2024 Jun 26;200(1):11-30. doi: 10.1093/toxsci/kfae046.
Drug hypersensitivity reactions (DHRs) are a type of adverse drug reaction that can occur with different classes of drugs and affect multiple organ systems and patient populations. DHRs can be classified as allergic or non-allergic based on the cellular mechanisms involved. Whereas nonallergic reactions rely mainly on the innate immune system, allergic reactions involve the generation of an adaptive immune response. Consequently, drug allergies are DHRs for which an immunological mechanism, with antibody and/or T cell, is demonstrated. Despite decades of research, methods to predict the potential for a new chemical entity to cause DHRs or to correctly attribute DHRs to a specific mechanism and a specific molecule are not well-established. This review will focus on allergic reactions induced by systemically administered low-molecular weight drugs with an emphasis on drug- and patient-specific factors that could influence the development of DHRs. Strategies for predicting and diagnosing DHRs, including potential tools based on the current state of the science, will also be discussed.
药物过敏反应（DHRs）是一种药物不良反应，可发生于不同类别的药物，并影响多个器官系统和患者人群。根据涉及的细胞机制，DHRs 可分为过敏或非过敏反应。而非过敏反应主要依赖于先天免疫系统，而过敏反应则涉及适应性免疫反应的产生。因此，药物过敏是指已证明存在免疫机制（抗体和/或 T 细胞）的 DHRs。尽管经过数十年的研究，仍未建立可靠的方法来预测新化学实体引起 DHRs 的潜力，或正确将 DHRs 归因于特定机制和特定分子。本综述将重点关注系统给予的低分子量药物引起的过敏反应，并强调可能影响 DHRs 发展的药物和患者特定因素。还将讨论预测和诊断 DHRs 的策略，包括基于当前科学状况的潜在工具。
