An Updated Review of the Diagnostic Methods in Delayed Drug Hypersensitivity
- Author(s)
- Copaescu, A; Gibson, A; Li, Y; Trubiano, JA; Phillips, EJ;
- Journal Title
- Frontiers in Pharmacology
- Publication Type
- Review
- Abstract
- Delayed drug hypersensitivity reactions are clinically diverse reactions that vary from isolated benign skin conditions that remit quickly with no or symptomatic treatment, drug discontinuation or even continued drug treatment, to the other extreme of severe cutaneous adverse reactions (SCARs) that are associated with presumed life-long memory T-cell responses, significant acute and long-term morbidity and mortality. Diagnostic "in clinic" approaches to delayed hypersensitivity reactions have included patch testing (PT), delayed intradermal testing (IDT) and drug challenges for milder reactions. Patch and IDT are, in general, performed no sooner than 4-6 weeks after resolution of the acute reaction at the maximum non-irritating concentrations. Functional in vitro and ex vivo assays have largely remained the province of research laboratories and include lymphocyte transformation test (LTT) and cytokine release enzyme linked ImmunoSpot (ELISpot) assay, an emerging diagnostic tool which uses cytokine release, typically IFN-gamma, after the patient's peripheral blood mononuclear cells are stimulated with the suspected drug(s). Genetic markers such as human leukocyte antigen have shown recent promise for both pre-prescription screening as well as pre-emptive and diagnostic testing strategies.
- Keywords
- Hla; T cells; delayed hypersensitivity reaction; drug allergy; enzyme linked ImmunoSpot (ELISpot); lymphocyte transformation test (LTT); severe cutaneous adverse reactions; skin testing; commercial or financial relationships that could be construed as a potential; conflict of interest.
- Department(s)
- Infectious Diseases
- PubMed ID
- 33597867
- Publisher's Version
- https://doi.org/10.3389/fphar.2020.573573
- Open Access at Publisher's Site
https://doi.org/10.3389/fphar.2020.573573- Terms of Use/Rights Notice
- Refer to copyright notice on published article.
Creation Date: 2025-09-05 01:45:02
Last Modified: 2025-09-05 01:46:46