Drug hypersensitivity: epidemiology and risk factors.
Drug hypersensitivity: epidemiology and risk factors.
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药物过敏：流行病学和危险因素。
DOI：
10.2174/138161206778194088
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发表时间：
2006
影响因子：
3.1
通讯作者：
P. Demoly
中科院分区：
文献类型：
--
作者：
L. Guglielmi;P. Guglielmi;P. Demoly
药物过敏是异质性和多因素的疾病，总是夸大的免疫介导的反应的结果。先前描述的免疫机制模型（主要基于Gell和Combs的分类）不能完全解释这些疾病的生理病理学;因此，识别风险因素似乎很重要。临床和生物学测试是有用的诊断工具，但其灵敏度和可靠性有限，当然不能预测。流行病学数据提供了关于药物超敏反应患病率的信息：女性、合并感染（HIV、疱疹）和并发疾病（系统性红斑狼疮）均为显著风险因素。另一个与宿主相关的因素是患者的遗传易感性，目前正在我们的实验室进行调查。大多数遗传学研究关注HLA单倍型关联或药物代谢酶基因编码的多态性。我们小组目前的一项研究似乎涉及IL-10启动子内的多态性，IL-10是一种具有抗炎特性的细胞因子。药物的化学性质和治疗方案也会影响药物过敏的发展。
Drug allergies are heterogeneous and multifactorial diseases and are always the consequence of an exaggerated immune-mediated reaction. Previously described models of immunologic mechanisms (mainly based on Gell and Combs' classification) cannot fully explain the physiopathology of these diseases; it seems therefore important to identify risk factors. Clinical and biologic tests are helpful diagnostic tools but are limited in their sensitivity and reliability and are certainly not predictive. Epidemiologic data supply information concerning the prevalence of drug hypersensitivity: female gender, concomitant infections (HIV, herpes) and concurrent illnesses (systemic lupus erythematosus) are all significant risk factors. Another host-related factor is the genetic predisposition of patients and is currently under investigation in our laboratory. Most genetic studies concern HLA haplotype association or polymorphism in genes encoding drug-metabolising enzymes. A current study by our group seems to implicate polymorphisms within the promoter of IL-10, a cytokine with anti-inflammatory properties. The chemical properties of the drug and the treatment regimen also influence the development of drug allergies.