Drug Reaction with Eosinophilia and Systemic Symptoms: A Complex Interplay between Drug, T Cells, and Herpesviridae

Ganeshanandan, Luckshman; Lucas, Michaela

doi:10.3390/ijms22031127

Cited by 9 publications

(5 citation statements)

References 84 publications

(116 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A typical feature of DIHS/DRESS is the reactivation of latent HHVs, namely HHV-6, HHV-7, Epstein–Barr virus (EBV), and Cytomegalovirus (CMV) [ 22 , 49 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 ]. Herpes viruses are known to promote the reactivation of other viruses upon reactivating themselves with a peculiar reactivation sequency, as originally reported by Kano 2006 [ 63 ] and recently reviewed by Anci 2021 [ 58 ].…”

Section: Aetiology and Pathogenesismentioning

confidence: 99%

“…Nonetheless, evidence of antigen-specific CD4+ T-cell activation and expansion in DRESS has also consistently been reported [ 49 , 125 , 126 ]. Drug-reacting cells typically produce large amounts of cytokines potentially associated with a broad spectrum of inflammatory phenotypes that include IL-4, IL-5, IL-13, IFN-γ, and TNF-α [ 60 ]. Multiple aspects of T-cell biology may contribute to pathophysiological mechanisms underlying DRESS [ 22 ].…”

Section: Aetiology and Pathogenesismentioning

confidence: 99%

See 1 more Smart Citation

Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS): Focus on the Pathophysiological and Diagnostic Role of Viruses

et al. 2023

View full text Add to dashboard Cite

Drug reaction with eosinophilia and systemic symptoms (DRESS) is a heterogeneous, multiorgan and potentially life-threatening drug-hypersensitivity reaction (DHR) that occurs several days or weeks after drug initiation or discontinuation. DHRs constitute an emerging issue for public health, due to population aging, growing multi-organ morbidity, and subsequent enhanced drug prescriptions. DRESS has more consistently been associated with anticonvulsants, allopurinol and antibiotics, such as sulphonamides and vancomycin, although new drugs are increasingly reported as culprit agents. Reactivation of latent infectious agents such as viruses (especially Herpesviridae) plays a key role in prompting and sustaining aberrant T-cell and eosinophil responses to drugs and pathogens, ultimately causing organ damage. However, the boundaries of the impact of viral agents in the pathophysiology of DRESS are still ill-defined. Along with growing awareness of the multifaceted aspects of immune perturbation caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the ongoing SARS-CoV-2-related disease (COVID-19) pandemic, novel interest has been sparked towards DRESS and the potential interactions among antiviral and anti-drug inflammatory responses. In this review, we summarised the most recent evidence on pathophysiological mechanisms, diagnostic approaches, and clinical management of DRESS with the aim of increasing awareness on this syndrome and possibly suggesting clues for future research in this field.

show abstract

Section: Aetiology and Pathogenesismentioning

confidence: 99%

Section: Aetiology and Pathogenesismentioning

confidence: 99%

Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS): Focus on the Pathophysiological and Diagnostic Role of Viruses

et al. 2023

View full text Add to dashboard Cite

show abstract

“…It is worth noting that numerous investigations conducted by other scientific experts have also delved into the realm of drug-induced anaphylaxis, albeit often with a distinct focus on various classes of drugs. In the work of L. Ganeshanandan and M. Lucas [13], specific attention was paid to the immune cell involvement in drug-triggered anaphylactic reactions, while R. Joulia et al [14] embarked on an exploration of the profound implications associated with mast cell-derived mediators. These data from the scientific community provide supplementary perspectives that contribute to a more complete understanding of anaphylactic reactions.…”

Section: Discussionmentioning

confidence: 99%

Clinical trial research on furagin-induced anaphylactic shock: assessing mechanisms and preventive strategies

Lisiecka

2023

ЕМ

View full text Add to dashboard Cite

Background. The study investigates the pressing issue of furagin-induced anaphylactic shock, addres-sing the immediate need to understand its mechanisms and create preventive strategies. Anaphylactic shock due to furagin, a widely used antimicrobial drug, has raised serious concerns. The goal is to elucidate the underlying mechanisms and risk factors of furagin-induced anaphylactic shock. Materials and methods. This research delves into this critical subject through a controlled longitudinal study on both humans and induced anaphylaxis in rats. Results. Using an advanced blind controlled longitudinal design, the study evaluates allergic reactions in humans and induced anaphylaxis in rats. It also explores the safety, tolerability, and pharmacokinetics of furagin over five days in adult patients. Moreover, the study assesses the efficacy of antihistamine pre-treatment in reducing allergic reactions. Results reveal a dose-dependent trend in allergic reactions in rats, demonstrating the effectiveness of antihistamine pre-treatment in reducing the severity of allergic symptoms. Patients with previous allergies, especially to medications, exhibited increased susceptibility to furagin-induced anaphylactic symptoms. The study underscores the potential for antihistamine pre-treatment as a preventive strategy and contributes to the understanding of allergic responses. This research informs clinical practice by providing insights into risk factors and preventive measures for furagin-induced hypersensitivity, ultimately enhancing patient safety. Conclusions. The study findings hold promise for personalized interventions and advance our understanding of drug-induced hypersensitivity reactions.

show abstract

“…DRESS syndrome is considered a T-cell-mediated hypersensitivity reaction with a drug-specific immune response and involvement of the human herpes virus reaction with a subsequent antiviral immune response [ 23 ]. Interestingly, imatinib is suspected to induce clonal T-cell subsets producing IL-5 [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

Successful Treatment of Imatinib-Induced DRESS Syndrome Using Reslizumab without Cessation of Imatinib: A Case Report

2021

View full text Add to dashboard Cite

Drug reaction with eosinophilia and systemic symptoms (DRESS) is a severe cutaneous adverse drug reaction; reported cases are sometimes imatinib mesylate induced. The main treatment is the withdrawal of the causative drug, and most cases with imatinib-induced DRESS syndrome required withdrawal of imatinib. However, in such cases involving anticancer drugs, this may compromise cancer treatment. Herein, we report a patient with imatinib-induced DRESS syndrome that was successfully treated with reslizumab while continuing imatinib treatment. A 65-year-old female presented with facial edema and generalized skin rash after being given 400 mg imatinib 2 weeks ago for metastatic gastrointestinal stromal tumor. After stopping imatinib, the clinical symptoms improved. Imatinib desensitization was performed, and it was administered again. However, the clinical symptoms reappeared more severely 2 months after restart of imatinib, and the peripheral absolute eosinophil count increased to 1,690/μL. A diagnosis of imatinib-induced DRESS syndrome was made, based on the Registry of Severe Cutaneous Adverse Reactions (RegiSCAR) criteria. Imatinib desensitization was repeated, but the clinical symptoms reappeared, and the peripheral eosinophilia persisted. We administered reslizumab, an interleukin-5 monoclonal antibody, without cessation of imatinib. The absolute eosinophil count decreased immediately, and the clinical symptoms improved gradually. After 2 weeks, the clinical symptoms reappeared mildly, but after administering reslizumab again, these disappeared completely. Reslizumab can be considered in the management of DRESS syndrome in cases wherein the causative medication needs to be continued.

show abstract

Drug Reaction with Eosinophilia and Systemic Symptoms: A Complex Interplay between Drug, T Cells, and Herpesviridae

Cited by 9 publications

References 84 publications

Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS): Focus on the Pathophysiological and Diagnostic Role of Viruses

Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS): Focus on the Pathophysiological and Diagnostic Role of Viruses

Clinical trial research on furagin-induced anaphylactic shock: assessing mechanisms and preventive strategies

Successful Treatment of Imatinib-Induced DRESS Syndrome Using Reslizumab without Cessation of Imatinib: A Case Report

Contact Info

Product

Resources

About