51. In vitro tests for drug hypersensitivity reactions: an ENDA/EAACI Drug Allergy Interest Group position paper
- Author
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Knut Brockow, Cristobalina Mayorga, Pascal Demoly, J Rodrigues-Cernadas, Jose Julio Laguna, Javier Fernández, Gülfem Çelik, Jean-Louis Guéant, G Zanoni, Paul Whitaker, Alla Nakonechna, Joanna Makowska, Alessandra Vultaggio, H. N. G. Oude Elberink, Patrizia Bonadonna, Jean-Christoph Roger J-P Caubet, A. Romano, Maria I. Montañez, Sébastien Viel, María José Torres, Paul Rouzaire, Groningen Research Institute for Asthma and COPD (GRIAC), Biomedical Research Institute of Málaga (IBIMA), Allergy Unit [Malaga, Spain] (National Network ARADyAL), Hospital Regional Universitario de Málaga = Regional University Hospital of Malaga [Spain], Division of Immunology and Allergy [Ankara, turkey], Department of Chest Diseases [Ankara, Turkey], Division of Immunology and Allergy [Ankara, Turkey], Ankara University School of Medicine [Turkey]-Ankara University School of Medicine [Turkey]- Division of Immunology and Allergy [Ankara, Turkey], Ankara University School of Medicine [Turkey]-Ankara University School of Medicine [Turkey], Equipe de recherche sur les traitements individualisés des cancers (ERTICa), Université d'Auvergne - Clermont-Ferrand I (UdA), Regional Adult Cystic Fibrosis Unit [St James' Hospital Leeds], St James‘s University Hospital, Allergy Unit [Verona, Italy], Azienda ospedaliera universitaria integrata di Verona [Italy], Immunoallergology Department [Hospital de São João], Hospital de São João [Porto], Immunoallergology Unit [Careggi Hospital], Department of Biomedicine [Careggi Hospital], Azienda Ospedaliero-Universitaria Careggi [Firenze] (AOUC)-Azienda Ospedaliero-Universitaria Careggi [Firenze] (AOUC), Department of Dermatology and Allergy Biederstein, Technische Universität Munchen - Université Technique de Munich [Munich, Allemagne] (TUM), Pediatric Allergy Unit [Geneva University Hospitals], Department of Child and Adolescent [Geneva University Hospitals], Geneva University Hospital (HUG)-Geneva University Hospital (HUG), Department of Immunology, Rheumatology and Allergy [Medical University of Łódź], Healthy Ageing Research Center [Medical University of Łódź] (HARC), Medical University of Łódź (MUL)-Medical University of Łódź (MUL), Allergy and Immunology Clinic [Royal Liverpool and Broadgreen University Hospital], Royal Liverpool and Broadgreen University Hospital NHS Trust, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), The Andalusian Center for Nanomedicine and Biotechnology (BIONAND), Allergy Unit [Cruz Roja-Madrid], Hospital Central de la Cruz Roja San Jose y Santa Adela, Section of Immunology [University of Verona], Department of Pathology and Diagnostics [Verona], Università degli studi di Verona = University of Verona (UNIVR)-Università degli studi di Verona = University of Verona (UNIVR), Nutrition-Génétique et Exposition aux Risques Environnementaux (NGERE), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Allergy Section [Alicante], Universidad de Alicante, Service d'immunologie [Centre Hospitalier Lyon Sud - HCL], Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hospital Regional Universitario de Málaga [Spain], Azienda Ospedaliero-Universitaria Careggi (AOU Careggi)-Azienda Ospedaliero-Universitaria Careggi (AOU Careggi), and University of Verona (UNIVR)-University of Verona (UNIVR)
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Allergy ,diagnosis ,T-Lymphocytes ,[SDV]Life Sciences [q-bio] ,Provocation test ,BASOPHIL ACTIVATION TEST ,030207 dermatology & venereal diseases ,0302 clinical medicine ,HLA Antigens ,Active phase ,Immunology and Allergy ,Medicine ,media_common ,GENERALIZED EXANTHEMATOUS PUSTULOSIS ,ddc:618 ,NONSTEROIDAL ANTIINFLAMMATORY DRUGS ,3. Good health ,Practice Guidelines as Topic ,BETA-LACTAM ANTIBIOTICS ,LYMPHOCYTE-TRANSFORMATION TEST ,IgE ,Drug ,STEVENS-JOHNSON-SYNDROME ,medicine.medical_specialty ,media_common.quotation_subject ,Immunology ,Drug allergy ,T cells ,In Vitro Techniques ,CETUXIMAB-INDUCED ANAPHYLAXIS ,NEUROMUSCULAR BLOCKING-AGENTS ,03 medical and health sciences ,invitro ,Humans ,Intensive care medicine ,Skin Tests ,business.industry ,Task force ,Immunity ,Immunoglobulin E ,medicine.disease ,030228 respiratory system ,Interest group ,Position paper ,business ,MAST-CELL TRYPTASE ,Biomarkers ,drug hypersensitivity ,TOXIC EPIDERMAL NECROLYSIS - Abstract
International audience; 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.
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- 2016