Genotyping for Severe Drug Hypersensitivity

ANAPHYLAXIS AND DRUG ALLERGY (DA KHAN AND M CASTELLS, SECTION EDITORS)

DOI: 10.1007/s11882-013-0418-0

Cite this article as:
Karlin, E. & Phillips, E. Curr Allergy Asthma Rep (2014) 14: 418. doi:10.1007/s11882-013-0418-0
Part of the following topical collections:
  1. Topical Collection on Anaphylaxis and Drug Allergy

Abstract

Over the past decade, there have been significant advances in our understanding of the immunopathogenesis and pharmacogenomics of severe immunologically-mediated adverse drug reactions. Such T-cell-mediated adverse drug reactions such as Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN), drug-induced liver disease (DILI) and other drug hypersensitivity syndromes have more recently been shown to be mediated through interactions with various class I and II HLA alleles. Key examples have included the associations of HLA-B*15:02 and carbamazepine induced SJS/TEN in Southeast Asian populations and HLA-B*57:01 and abacavir hypersensitivity. HLA-B*57:01 screening to prevent abacavir hypersensitivity exemplifies a successful translational roadmap from pharmacogenomic discovery through to widespread clinical implementation. Ultimately, our increased understanding of the interaction between drugs and the MHC could be used to inform drug design and drive pre-clinical toxicity programs to improve drug safety.

Keywords

Genotyping Altered peptide repertoire DILI DRESS Human leukocyte antigen Drug hypersensitivity Major histocompatibility complex Pharmacogenetics Pharmacogenomics Stevens-Johnson syndrome Toxic epidermal necrolysis Translation SCAR 

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.Vanderbilt University School of MedicineNashvilleUSA
  2. 2.Institute for Immunology and Infectious DiseasesMurdoch UniversityPerthAustralia

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