Emergence of circulating monomyeloid precursors predicts reactivation of human herpesvirus-6 in drug-induced hypersensitivity syndrome

Abstract

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Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS): An Interplay among Drugs, Viruses, and Immune System

“…Monomyeloid cells are one of the reservoirs of latent HHV-6 infection in humans [106]. One previous study has shown that circulating CD11b + CD13 + CD14 − CD16 high monomyeloid precursor cells in patients with DRESS syndrome, or DiHS, harboring HHV-6 express a skin homing molecule, C-C motif chemokine receptor (CCR) 4 [107].…”

New aspects of drug‐induced hypersensitivity syndrome

“…17,18 In addition, under conditions of immunosuppression, HHV-6 may be reactivated from latently infected monocytes. Recently, Hashizume et al 19 reported that the numbers of monomyeloid precursors were increased in the peripheral blood of DIHS patients. These cells were not observed in control subjects.…”

“…As monomyeloid precursors express cutaneous lymphocyte-associated antigen, it is possible that these cells infiltrate into the skin. 19 Human herpesvirus 6 reactivation is considered to require immunosuppression. Shiohara's group has reported several immune defects, such as a marked decrease in serum immunoglobulin (Ig)G levels and circulating B-cell number at the onset stage, as well as dysfunction of regulatory T cells.…”

Recent progress of elucidating the mechanisms of drug hypersensitivity

“…5A and C). The monocytes transiently observed in DIHS are different from conventional monocytes in terms of side scatter counts (SSC) and phenotype [37]. Monocytes from DIHS patients show higher SCC (Fig.…”