Lymphocyte Transformation Test for Medicinal Herbs Yields False-Positive Results for First-Visit Patients

Mantani, Naoki; Kogure, Toshiaki; Tamura, Jun’ichi; Shimada, Yutaka; Terasawa, Katsutoshi

doi:10.1128/cdli.10.3.479-480.2003

Cited by 30 publications

(29 citation statements)

References 12 publications

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“…DLST is used for the diagnosis of druginduced pneumonia and drug-induced hepatitis only in Japan (Kunichika et al 2002;Mantani et al 2003). Recent reports indicated that the DLST is unreliable for the diagnosis of drug-induced liver injury (Mantani et al 2003).…”

Section: Discussionmentioning

confidence: 99%

“…Recent reports indicated that the DLST is unreliable for the diagnosis of drug-induced liver injury (Mantani et al 2003). DLST for drug-induced pneumonia is based on Tamura's criteria in Japan (Tamura 1983).…”

Section: Discussionmentioning

confidence: 99%

“…The drug-induced lymphocyte stimulation test (DLST) is widely used for the diagnosis of drug-induced pneumonia and liver injury in Japan, whereas in Western countries, DLST for specific drug hypersensitivity is considered to be unreliable or experimental (Beers and Berkow 1999;Mantani et al 2003). DLST is used for the diagnosis of drug-induced pneumonia only in Japan (Kunichika et al 2002).…”

confidence: 99%

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Drug-Induced Lymphocyte Stimulation Test is not Useful for the Diagnosis of Drug-Induced Pneumonia

Matsuno

Okubo

Hiroshige

et al. 2007

Tohoku J. Exp. Med.

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Diagnosis of drug-induced pneumonia, which represents pulmonary toxicity caused by certain drugs, is difficult, as a large number of different drugs can elicit various immune-mediated diseases with distinct pathomechanisms. The drug-induced lymphocyte stimulation test (DLST) is widely used for diagnosing drug-induced pneumonia in Japan. Recent reports, however, indicate that DLST is not reliable for diagnosis of drug-induced pneumonia. To diagnose drug-induced pneumonia, a provocation test with the suspected drug is the most reliable method of assessing the relationship between the drug and pneumonia. We examined the correlation between the DLST and the provocation test in 6 cases of suspected drug-induced pneumonia. DLST was performed in all of the patients. The causes of pneumonia in all patients were confirmed by a provocation test. The DLST was positive in 3 of 6 cases of suspected drug-induced pneumonia, but the suspected drugs were ruled out by the provocation test. If we had relied solely on the DLST, these 3 cases would have been labeled as false allergy. The results of the DLST did not coincide with the results of the provocation test in any of the cases. Our results suggest that the DLST is not useful for the diagnosis of drug-induced pneumonia. Following provocation with the causative drug, reappearance of pulmonary infiltration was not observed in any of the cases. These findings indicate that a carefully performed provocation test is the safe and most reliable method.drug-induced lymphocyte stimulation test (DLST); drug-induced pneumonia; provocation test; challenge test; patch test

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Drug-Induced Lymphocyte Stimulation Test is not Useful for the Diagnosis of Drug-Induced Pneumonia

Matsuno

Okubo

Hiroshige

et al. 2007

Tohoku J. Exp. Med.

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“…Further methods are in development, such as the lymphocyte migration test or cytokine release of CD14 positive cells from patients with iDILI when incubated with lysates of drug-pulsed HepG2 cells 19. Yet, the use of the drug lymphocyte stimulation test is limited by low sensitivity and false positive results 20 21. The use of patient derived hepatocytes for testing of individual susceptibility and causality is extremely limited by invasiveness, especially in the setting of drug-induced liver failure.…”

Section: Introductionmentioning

confidence: 99%

Monocyte-derived hepatocyte-like cells for causality assessment of idiosyncratic drug-induced liver injury

Benesic

Leitl

Gerbes

2015

Gut

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“…It is undeniable that both the DLST and LMT may have false positives, and indeed, a certain number of false positives have been reported for these tests. [26][27][28][29][30][31] In our present study, both the DLST and the LMT showed a positive rate of 6.9% for the 102 control patients, and both tests also showed significantly higher positive rates in the test subjects than in controls. Accordingly, these results indicate that both tests may have sufficient specificity for use in patients with drug allergies.…”

Section: Positive Rates Of the Dlst And Lmt According Tomentioning

confidence: 69%

Comparative Study of the Usefulness of the Drug-Induced Lymphocyte Stimulation Test and the Leukocyte Migration Test in Drug Allergies

Saito¹,

Yagi²,

Uno

et al. 2008

Biological & Pharmaceutical Bulletin

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The detection of the causative drug in drug allergies is essential in order to prevent secondary allergic reactions and is also extremely important so that appropriate medical treatment can be administered when such reactions occur. However, in vivo tests are problematic in that challenge tests are too risky, the intradermal skin test is a low-sensitivity test that has few risks but may cause penicillin-induced anaphylactic shock, 1) and the patch test is also a low-sensitivity test but may induce contact dermatitis.2) Therefore, more effective in vitro tests, which pose few risks to patients, are needed.In vitro, specific antibodies for the allergens in patient's serum can be detected by enzyme-linked immunosorbent assay (ELISA) or the radioallergosorbent test (RAST). The specific immunoglobulin E (IgE), IgG, and IgM antibodies are measured by ELISA and specific IgE antibodies are identified by the RAST. The advantages of these methods detecting specific antibodies are that their test samples, i.e., the patient's serum can be preserved for a long time. On the other hand, their disadvantages are that they show a low rate of detection and are applied to only a part of causative drugs such as penicillin antibiotics and only specific allergic symptoms such as anaphylactic shock and hemolytic anemia.3,4) Furthermore, they must be performed as soon as the allergic symptoms develop because the specific antibodies disappear in about a month.There has been a recent increase in the use of methods to prove cell-mediated immunity, that is, the presence of drugsensitized lymphocytes. Such methods include the drug-induced lymphocyte stimulation test (DLST) and the leukocyte migration test (LMT).3,5-11) The advantages of these methods detecting drug-sensitized lymphocytes are that they show a higher rate of detection than the methods detecting specific antibodies and can be applied to many causative drugs and allergic symptoms.3,4) On the other hand, their disadvantages are that their test samples, i.e., the patient's mononuclear cells can't be preserved for a long time. Therefore, the methods detecting drug-sensitized lymphocytes may be more useful to detect the causative drugs in many drug allergies than the methods detecting specific antibodies if their tests are putted into practice soon after drawing bloods. However, there have been few reports to date comparing the effectiveness of these tests. Therefore, we performed both the DLST and LMT in patients suspected of drug hypersensitivity as well as in patients without drug hypersensitivity and compared the usefulness of the two tests. MATERIALS AND METHODS Subjects (Patients Suspected of Drug-Induced Hypersensitivity)The subjects consisted of 133 patients (60 males and 73 females; age range 1-84 years; mean age 47.8 years) who were suspected of suffering from drug-induced hypersensitivity. These patients had manifested hypersensitivity symptoms while taking drugs and were unlikely to suffer worsening of the underlying disease, and their symptoms improved when they stopped...

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Lymphocyte Transformation Test for Medicinal Herbs Yields False-Positive Results for First-Visit Patients

Cited by 30 publications

References 12 publications

Drug-Induced Lymphocyte Stimulation Test is not Useful for the Diagnosis of Drug-Induced Pneumonia

Drug-Induced Lymphocyte Stimulation Test is not Useful for the Diagnosis of Drug-Induced Pneumonia

Monocyte-derived hepatocyte-like cells for causality assessment of idiosyncratic drug-induced liver injury

Comparative Study of the Usefulness of the Drug-Induced Lymphocyte Stimulation Test and the Leukocyte Migration Test in Drug Allergies

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