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Pharmacogenomics and Cutaneous Adverse Drug Reactions

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Advances in Diagnosis and Management of Cutaneous Adverse Drug Reactions

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Abstract

Cutaneous adverse drug reactions (cADRs) are unpredictable and may range from mild maculopapular exanthema (MPE) to life-threatening severe cutaneous adverse drug reactions (SCARs), including drug reaction with eosinophilia and systemic symptoms (DRESS), Stevens–Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN). Increasing pharmacogenomic studies showed specific HLA alleles are strongly associated with cADRs. The pathogenic checkpoints of cADRs include genetic polymorphisms affecting the immune synapse of HLA/drugs/T cell receptor interactions, specific HLA loci, T cell-mediated responses, and drug metabolism. Recently, pharmacogenomic screening for specific HLA alleles or high-risk genes prior to drug prescriptions to prevent cADRs has been widely implemented in clinical practice.

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Abbreviations

cADRs:

Cutaneous adverse drug reactions

CBZ:

Carbamazepine

CYP2C9*3:

Cytochrome P450 family 2 subfamily C member 9*3

DRESS:

Drug reaction with eosinophilia and systemic symptoms

HLA:

Human leukocyte antigens

HSS:

Hypersensitivity syndrome

LTG:

Lamotrigine

MPE:

Maculopapular exanthema

OXC:

Oxcarbazepine

PHT:

Phenytoin

SCAR:

Severe cutaneous adverse reactions

SJS:

Stevens–Johnson syndrome

TCR:

T cell receptors

TEN:

Toxic epidermal necrolysis

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Acknowledgments

Source of Funding: This work was supported in part by grants from the Ministry of Science and Technology, Taiwan (MOST 104-2314-B-182A-148-MY3, MOST 104-2325-B-182A-006, MOST 106-2314-B-182A-037-MY3), and Chang Gung Memorial Hospital (CLRPG2E0051~3, CORPG3F0041~2).

Conflict of Interest: The authors report no disclosures relevant to the manuscript.

Author information

Authors and Affiliations

  1. Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taipei, Keelung, Taiwan

    Ren-You Pan, Chun-Bing Chen & Wen-Hung Chung

  2. Chang Gung Immunology Consortium, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan

    Ren-You Pan, Chun-Bing Chen & Wen-Hung Chung

  3. Whole-Genome Research Core Laboratory of Human Diseases, Chang Gung Memorial Hospital, Keelung, Taiwan

    Chun-Bing Chen & Wen-Hung Chung

  4. Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan

    Chun-Bing Chen & Wen-Hung Chung

  5. Department of Dermatology, Xiamen Chang Gung Hospital, Xiamen, Fujian, China

    Chun-Bing Chen & Wen-Hung Chung

Authors
  1. Ren-You Pan
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  2. Chun-Bing Chen
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  3. Wen-Hung Chung
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Corresponding author

Correspondence to Wen-Hung Chung .

Editor information

Editors and Affiliations

  1. University of Toronto Medical School, Sunnybrook Health Sciences Centre, Toronto, ON, Canada

    Neil H. Shear

  2. Department of Dermatology, Emek Medical Center, Afula, Israel

    Roni P. Dodiuk-Gad

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© 2019 Springer Nature Singapore Pte Ltd.

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Pan, RY., Chen, CB., Chung, WH. (2019). Pharmacogenomics and Cutaneous Adverse Drug Reactions. In: Shear, N., Dodiuk-Gad, R. (eds) Advances in Diagnosis and Management of Cutaneous Adverse Drug Reactions. Adis, Singapore. https://doi.org/10.1007/978-981-13-1489-6_3

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  • DOI: https://doi.org/10.1007/978-981-13-1489-6_3

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  • Publisher Name: Adis, Singapore

  • Print ISBN: 978-981-13-1488-9

  • Online ISBN: 978-981-13-1489-6

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