T cell reactions in patients showing adverse immune reactions to drugs.

OBJECTIVE AND DESIGN

To better understand how T cells react to small compounds, we investigated the in vitro T cell reactivity to drugs from drug allergic patients.

MATERIAL AND SUBJECTS

Peripheral blood mononuclear cells (PBMC) of three drug allergic individuals were stimulated in vitro by different drugs.

METHODS

Proliferation was assayed by 3H-thymidine incorporation. Upregulation of activation parameter on T cells was done by immunofluorescence and cytokine release determined via standard ELISA.

RESULTS

Drugs can stimulate both CD4 and CD8 T-cell subsets. PenG-stimulated PBMC showed a heterogenous cytokine pattern and clones secreted high amounts of INF gamma. In contrast, sulfamethoxazole and lidocaine-stimulated PBMC secreted high levels of IL-5 and lidocaine-specific clones can be Th1 or Th2-like.

CONCLUSION

Drug specific T cells play a pivotal role in drug hypersensitivity reactions, both by regulating the immune response and probably also as specific effector cells with different patterns of cytokine release.