Current Perspective Regarding the Immunopathogenesis of Drug-Induced Hypersensitivity Syndrome/Drug Reaction with Eosinophilia and Systemic Symptoms (DIHS/DRESS).
Current Perspective Regarding the Immunopathogenesis of Drug-Induced Hypersensitivity Syndrome/Drug Reaction with Eosinophilia and Systemic Symptoms (DIHS/DRESS).
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DOI：
10.3390/ijms22042147
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发表时间：
2021-02-21
影响因子：
5.6
通讯作者：
Asada H
中科院分区：
文献类型：
--
作者：
Miyagawa F;Asada H
药物诱导的超敏反应综合征/药物反应伴嗜酸性粒细胞增多和全身症状（DIHS/DRESS）是一种严重类型的不良药疹，与多器官受累和人类疱疹病毒6型再活化相关，在长期暴露于某些药物后出现。通常，在DIHS/DRESS过程中发生两波疾病活动;然而，一些患者经历疾病的多波恶化和缓解。严重的并发症，其中一些与巨细胞病毒再激活有关，可能是致命的。DIHS/DRESS与其他药物反应不同，因为它涉及疱疹病毒再活化，并可导致随后发生自身免疫性疾病。疱疹病毒和DIHS/DRESS之间的关联现在已经得到了很好的建立，DIHS/DRESS被认为是由于几种疱疹病毒和全面的免疫应答之间复杂的相互作用而产生的，包括药物特异性免疫应答和抗病毒免疫应答，每种免疫应答都可能由不同类型的免疫细胞介导。CD4和CD8 T细胞似乎都参与了DIHS/DRESS的发病机制，但发挥不同的作用。CD4 T细胞主要是响应药物抗原而引发药物过敏，然后出现针对病毒感染细胞的疱疹病毒特异性CD8 T细胞，导致组织损伤。调节性T细胞动力学也被认为有助于DIHS/DRESS的各种症状。然而，这种复杂疾病的病理机制在很大程度上仍然未知。特别是，病毒感染如何导致DIHS/DRESS的发病机制以及DIHS/DRESS中出现自身免疫性后遗症的原因尚未阐明。本文综述了DIHS/DRESS的临床特点，包括相关的并发症和后遗症，并讨论了我们对DIHS/DRESS的免疫发病机制的最新进展。
Drug-induced hypersensitivity syndrome/drug reaction with eosinophilia and systemic symptoms (DIHS/DRESS) is a severe type of adverse drug eruption associated with multiorgan involvement and the reactivation of human herpesvirus 6, which arises after prolonged exposure to certain drugs. Typically, two waves of disease activity occur during the course of DIHS/DRESS; however, some patients experience multiple waves of exacerbation and remission of the disease. Severe complications, some of which are related to cytomegalovirus reactivation, can be fatal. DIHS/DRESS is distinct from other drug reactions, as it involves herpes virus reactivation and can lead to the subsequent development of autoimmune diseases. The association between herpesviruses and DIHS/DRESS is now well established, and DIHS/DRESS is considered to arise as a result of complex interactions between several herpesviruses and comprehensive immune responses, including drug-specific immune responses and antiviral immune responses, each of which may be mediated by distinct types of immune cells. It appears that both CD4 and CD8 T cells are involved in the pathogenesis of DIHS/DRESS but play distinct roles. CD4 T cells mainly initiate drug allergies in response to drug antigens, and then herpesvirus-specific CD8 T cells that target virus-infected cells emerge, resulting in tissue damage. Regulatory T-cell dynamics are also suggested to contribute to the diverse symptoms of DIHS/DRESS. However, the pathomechanisms of this complex disease remain largely unknown. In particular, how viral infections contribute to the pathogenesis of DIHS/DRESS and why autoimmune sequelae arise in DIHS/DRESS are yet to be elucidated. This review describes the clinical features of DIHS/DRESS, including the associated complications and sequelae, and discusses recent advances in our understanding of the immunopathogenic mechanisms of DIHS/DRESS.
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DOI：
10.1073/pnas.0409500102
发表时间：
2005-03-15
影响因子：
11.1
作者：
Hung, SL;Chung, WH;Chen, YT
通讯作者：
Chen, YT
影响因子：
--
作者：
Kano, Y;Inaoka, M;Shiohara, T
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Shiohara, T
影响因子：
10.3
作者：
Descamps, V;Bouscarat, F;Belaich, S
通讯作者：
Belaich, S
影响因子：
12.4
作者：
Chen, Y. -C.;Chiang, H. -H.;Chu, C. -Y.
通讯作者：
Chu, C. -Y.
影响因子：
1.2
作者：
Hagiya, Hideharu;Iwamuro, Masaya;Otsuka, Fumio
通讯作者：
Otsuka, Fumio