Premium
The measurement of drug‐induced interferon γ‐releasing cells and lymphocyte proliferation in severe cutaneous adverse reactions
Author(s) -
Suthumchai N.,
Srinoulprasert Y.,
Thantiworasit P.,
Rerknimitr P.,
Tuchinda P.,
Chularojanamontri L.,
Rerkpattanapipat T.,
Chanprapaph K.,
Disphanurat W.,
Chakkavittumrong P.,
Tovanabutra N.,
Srisuttiyakorn C.,
Sukasem C.,
Klaewsongkram J.
Publication year - 2018
Publication title -
journal of the european academy of dermatology and venereology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.655
H-Index - 107
eISSN - 1468-3083
pISSN - 0926-9959
DOI - 10.1111/jdv.14890
Subject(s) - medicine , culprit , peripheral blood mononuclear cell , drug , lymphocyte , drug allergy , interferon , immunology , adverse effect , cytokine , adverse drug reaction , pharmacology , in vitro , biochemistry , chemistry , myocardial infarction
Background The lymphocyte transformation test ( LTT ) is a standard laboratory method to identify culprit drugs in patients with a history of drug‐induced non‐immediate hypersensitivity and is mainly performed during the recovery phase. The measurement of drug‐specific interferon γ ( IFN ‐γ)‐releasing cells has been introduced to confirm culprit drugs, even during the acute phase of drug allergy. Objectives This study aimed to evaluate the capability of the enzyme‐linked immunospot assay ( ELIS pot) to detect drug‐specific IFN ‐γ‐releasing cells during the acute phase and the capability of LTT to identify culprit drugs during the recovery phase in patients presenting with severe cutaneous adverse reactions ( SCAR s). Methods Peripheral blood mononuclear cells ( PBMC s) from 23 SCAR patients were collected during the acute and recovery phases and assayed for drug‐specific IFN ‐γ‐releasing cells and lymphocyte proliferation, respectively. Results Drug‐specific IFN ‐γ‐releasing cells were detectable in 73.9% of SCAR subjects (55.6% and 85.7% in patients who were and were not taking systemic steroids, respectively), whereas LTT results were positive in 52.2% of SCAR subjects. The frequencies of drug‐specific IFN ‐γ‐releasing cells were significantly higher in patients with positive LTT than in those with negative LTT (260.1 ± 110.0 and 46.6 ± 20.7 cells/10 6 PBMC s, P = 0.01). A significant correlation between the results of the IFN ‐γ ELIS pot assay and LTT was demonstrated ( r = 0.65, P value <0.01). Conclusion The IFN ‐γ ELIS pot assay could be a useful tool to identify culprit drugs in SCAR patients when culprit drug identification is urgently needed during the acute phase of drug allergy.