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Immunological Principles of Drug Hypersensitivity

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Allergy Frontiers: Clinical Manifestations

Part of the book series: Allergy Frontiers ((ALLERGY,volume 3))

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Abstract

Drug Hypersensitivity Reactions account for about one of six of all adverse drug reactions. T lymphocytes were shown to play a central role in mediating drug allergy and are involved in all types of immune response to the drugs. Upon antigen-specific stimulation T cells secrete various cytokines and can orchestrate different effector mechanisms of immune response including immediate, IgE mediated reactions like anaphylaxis or urticaria and delayed types like maculopapular, bullous or pustular exanthemas. Small chemical substances like drugs may activate the innate and adaptive immune system by covalent binding and modification of soluble or cell bound proteins, which are then recognized as a foreign antigenic proteins. Drug can also directly interact with immune receptors like the highly polymorphic T cell receptors and thus induce specific immune activation. This new concept is named pharmacologic interaction with immune receptors (p-i concept). Understanding of complex immune mechanisms and risk factors involved in allergic reaction to small chemical substances may not only lead to the improvement in drug allergy diagnosis and treatment but also allow us to understand better the immune mechanisms in general.

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  1. Division of Allergology, Clinic for Rheumatology and Clinical Immunology/Allergology, Inselspital, University of Bern, Bern, CH-3010, Switzerlande

    Anna Zawodniak & Werner J. Pichler

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  1. Anna Zawodniak
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  1. Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, Japan

    Ruby Pawankar

  2. Southampton General Hospital, University of Southampton, Tremona Road, Southampton, UK

    Stephen T. Holgate

  3. Childrens's Mercy Hospital and Clinic, UMKC School of Medicine, 2401 Gillham Road, Kansas City, MO, 64108, USA

    Lanny J. Rosenwasser

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Zawodniak, A., Pichler, W.J. (2009). Immunological Principles of Drug Hypersensitivity. In: Pawankar, R., Holgate, S.T., Rosenwasser, L.J. (eds) Allergy Frontiers: Clinical Manifestations. Allergy Frontiers, vol 3. Springer, Tokyo. https://doi.org/10.1007/978-4-431-88317-3_25

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