Drug hypersensitivity in the fast lane: What clinicians should know about phenotypes,endotypes, and biomarkers |
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| Affiliation: | 1. Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada;2. Divison of Allergy, Marqués de Valdecilla University Hospital-Instituto de Investigacion Marques de Valdecilla (IDIVAL), Santander, Spain;3. Allergy Section, Alicante General University Hospital-ISABIAL, ARADyAL Spanish Network, Alicante, Spain;4. Division of Allergy & Clinical Immunology, Department of Medicine, University Hospital Complex of A Coruna, A Coruna, Spain;1. Department of Allergy and Clinical Immunology, Clínica Universidad de Navarra, Pamplona, Spain;2. Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain;3. RETIC de Asma, Reacciones Adversas y Alérgicas (ARADYAL), Madrid, Spain;4. Department of Dermatology, Clinica Universidad de Navarra, Pamplona, Spain;5. Allergy Section, Hospital Universitario Central de Asturias, Oviedo, Spain;6. Allergy Service, Hospital General Universitario Gregorio Marañón, Madrid, Spain;7. Biomedical Research Network on Rare Diseases (CIBERER)-U761, Madrid, Spain;8. Gregorio Marañón Health Research Institute, Madrid, Spain;9. Allergy Section, Hospital Universitari Joan XXIII de Tarragona, Tarragona, Spain;10. Departament de Medicina i Cirurgia, Institut d''Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Tarragona, Spain;11. Allergy Section, Internal Medicine Department, Hospital Universitari Vall d''Hebron, Barcelona, Spain;12. Department of Allergy and Clinical Immunology, Complexo Hospitalario Universitario de A Coruña, A Coruña, Spain;13. Department of Medicine, The Medical University of South Carolina, Charleston, SC;1. Departments of Medicine, Pediatrics and Otolaryngology, University of Tennessee Health Science Center, Memphis, Tennessee;2. The Tankersley Clinic, Memphis, Tennessee;3. Department of Otolaryngology, Division of Rhinology and Endoscopic Sinus-Skull Base Surgery, Division of Allergy, Eastern Virginia Medical School, Norfolk, Virginia;4. ALK-Abelló, Bedminster, New Jersey;1. Department of Adult Allergy, Guy''s and St Thomas'' NHS Foundation Trust, Guy''s Hospital, London, UK;2. Peter Gorer Department of Immunobiology, Guy''s Hospital, King''s College London, London, UK;3. Division of Rheumatology and Clinical Immunology, Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, China;1. Allergy Unit, IBIMA-Regional University Hospital of Malaga UMA, Malaga, Spain;2. Andalusian Center for Nanomedicine and Biotechnology - BIONAND, Malaga, Spain;3. Allergy & Clinical Immunology, Johns Hopkins University School of Medicine, Baltimore, Md;4. Pediatric Allergy Unit, Child and Adolescent Department, Geneva University Hospitals, Geneva, Switzerland;5. Division of Allergy & Immunology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas;6. Clinical Immunology, Angioedema and Allergy Unit, Chaim Sheba Medical Center, Pediatric Allergy Clinic, Safra Children''s Hospital, Tel Hashomer, Ramat Gan, Israel;7. Faculty of Pediatric Medicine, Sackler Medical School, Tel Aviv University, Tel Aviv, Israel;8. New England Food Allergy Treatment Center, West Hartford, Conn;9. Allergy and Clinical Immunology Department, Centro Hospitalar do Porto, Porto, Portugal;10. Allergy, Immunology and Rheumatology Division, Department of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand;11. Department of Allergy, Tongji Hospitals, Tongji Medical College of Huangzhong University of Science and Technology, Wuhan, China;12. Department of Allergy, Southern California Permanente Medical Group, Kaiser Permanente San Diego Medical Center, San Diego, Calif;1. Allergy Research Group, Instituto de Investigación Biomédica de Málaga-IBIMA, Hospital Civil, Málaga, Spain;2. Allergy Unit, Hospital Regional Universitario de Málaga, Hospital Civil, Málaga, Spain;3. Asthma and Immunoallergic Diseases Research Group, Instituto de Investigación Hospital 12 de Octubre (i+12), Madrid, Spain;4. Allergy Unit, Hospital Universitario 12 de Octubre, Madrid, Spain;5. Allergy Unit, Hospital Comarcal de Melilla, Melilla;6. Unidad Mixta de Investigación IIS La Fe-UniversitatPolitècnica deValència, Hospital Universitari i Politècnic La Fe, Avenida de Fernando Abril Martorell 106, Valencia, Spain;7. Department of Allergy, Hospital Universitari i Politècnic La Fe, Valencia, Spain;8. Allergy Service, University Hospital of Salamanca, Salamanca, Spain;9. Institute for Biomedical Research of Salamanca (IBSAL), Salamanca, Spain;10. Nanostructures for Diagnosing and Treatment of Allergic Diseases Laboratory, Andalusian Center for Nanomedicine and Biotechnology-BIONAND, Parque Tecnológico de Andalucía, Málaga, Spain;11. Departamento de Medicina, Universidad de Málaga, Facultad de Medicina, Málaga, Spain;1. Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and Infla-Med Centre of Excellence, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium;2. Faculty of Medicine and Health Sciences, Department of Paediatrics, University of Antwerp, and Antwerp University Hospital, Antwerp, Belgium |
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| Abstract: | ObjectiveTo review novel concepts in drug hypersensitivity and the management of immediate hypersensitivity reactions.Data SourcesEnglish language literature on MEDLINE and Embase surrounding drug hypersensitivity and desensitization.Study SelectionsReferences were selected based on relevance, date of publication, and originality.ResultsThere are numerous citations looking at categorizing drug reactions, pathogenesis, biomarkers, and desensitization. Current understanding supports the use of a phenotype-endotype-biomarker model for categorizing immediate hypersensitivity reactions. Drug desensitization is a powerful therapeutic strategy that enables temporary induction of tolerance to medications that triggered immediate reactions.ConclusionImmediate hypersensitivity reactions are diverse in presentation and pathogenesis. Drug desensitization is an effective intervention with sufficient evidence to support its more widespread availability. |
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