EPIDEMIOLOGY AND PATHOGENESIS OF DELAYED DRUG ALLERGIC REACTIONS



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Abstract

The actual frequency of delayed drug hypersensitivity reactions (DDHR) is unknown to date, since most of the epidemiological studies are based on the history and the clinical manifestations of the disease, without confirmation of the diagnosis with in vitro or in vivo tests. Based on the European epidemiological studies of severe skin reactions to medicines, the «RegiSCAR» was created. It is shown that DDHR is the most heterogeneous group of allergic reactions, both in pathogenesis and in the clinical manifestations. They belong to the IV type of allergic reactions, mediated by T-lymphocytes sensitized to medicines. Most of the DDHR proceed with skin involvement in the pathological process. Different forms of inflammation are caused by the kind of activated immune cells. The pathogenesis of DDHR is very complicated, as a rule, due to several subtypes of immune reactions. Mechanisms for the presentation of chemical or drug antigens remain controversial. At present, there are three concepts in this regard: hapten, prohapten and the theory of pharmacological interaction with immune receptors. In this article, a literature review dedicate to the current view of the epidemiology and pathogenesis of DDHR.

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About the authors

T S Romanova

NRC Institute of Immunology FMBA of Russia

Email: ts_romanova@mail.ru
24, Kashirskoe Shosse, Moscow, 115478, Russia

T N Myasnikova

NRC Institute of Immunology FMBA of Russia

24, Kashirskoe Shosse, Moscow, 115478, Russia

L G Khludova

NRC Institute of Immunology FMBA of Russia

24, Kashirskoe Shosse, Moscow, 115478, Russia

V V Smirnov

NRC Institute of Immunology FMBA of Russia

24, Kashirskoe Shosse, Moscow, 115478, Russia

T V Latysheva

NRC Institute of Immunology FMBA of Russia

24, Kashirskoe Shosse, Moscow, 115478, Russia

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