In vitro tests for drug hypersensitivity reactions: an ENDA/EAACI Drug Allergy Interest Group position paper
In vitro tests for drug hypersensitivity reactions: an ENDA/EAACI Drug Allergy Interest Group position paper
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DOI：
10.1111/all.12886
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发表时间：
2016-08-01
期刊：
影响因子：
12.4
通讯作者：
Torres, M. J.
中科院分区：
文献类型：
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作者：
Mayorga, C.;Celik, G.;Torres, M. J.
药物超敏反应（DHR）对于门诊和医院护理来说都是一个非常令人担忧的问题。这些患者的评估是复杂的，因为体内测试具有次优的灵敏度，并且可能是耗时的，昂贵的和潜在的风险，特别是药物激发测试。目前有几种体外方法，可分为两大类：有助于表征反应活性阶段的方法和有助于识别罪魁祸首药物的方法。这些体外方法的效用取决于所涉及的机制，这意味着它们不能用于评价所有类型的人力资源报告。此外，其有效性尚未由该领域专家之间的协商一致协议加以界定。因此，欧洲过敏和临床免疫学学会的欧洲药物过敏网络和药物过敏兴趣小组组织了一个工作组，提供有关DHR体外诊断方法的数据和建议。我们发现，虽然有很多体外试验，但很少有能被推荐为B级或以上的，主要是因为缺乏良好对照的研究，大多数信息来自受试者较少的小型研究，结果并不总是在后来的研究中得到证实。因此，有必要在大量特征良好的DHR患者中验证目前可用的体外试验，并开发新的诊断试验。
Drug hypersensitivity reactions (DHRs) are a matter of great concern, both for outpatient and in hospital care. The evaluation of these patients is complex, because invivo tests have a suboptimal sensitivity and can be time-consuming, expensive and potentially risky, especially drug provocation tests. There are several currently available invitro methods that can be classified into two main groups: those that help to characterize the active phase of the reaction and those that help to identify the culprit drug. The utility of these invitro methods depends on the mechanisms involved, meaning that they cannot be used for the evaluation of all types of DHRs. Moreover, their effectiveness has not been defined by a consensus agreement between experts in the field. Thus, the European Network on Drug Allergy and Drug Allergy Interest Group of the European Academy of Allergy and Clinical Immunology has organized a task force to provide data and recommendations regarding the available invitro methods for DHR diagnosis. We have found that although there are many invitro tests, few of them can be given a recommendation of grade B or above mainly because there is a lack of well-controlled studies, most information comes from small studies with few subjects and results are not always confirmed in later studies. Therefore, it is necessary to validate the currently available invitro tests in a large series of well-characterized patients with DHR and to develop new tests for diagnosis.