PMID- 34273396
OWN - NLM
STAT- MEDLINE
DCOM- 20211108
LR  - 20211108
IS  - 1872-7905 (Electronic)
IS  - 0022-1759 (Linking)
VI  - 496
DP  - 2021 Sep
TI  - Detection of drug-specific immunoglobulin E (IgE) and acute mediator release for 
      the diagnosis of immediate drug hypersensitivity reactions.
PG  - 113101
LID - S0022-1759(21)00146-0 [pii]
LID - 10.1016/j.jim.2021.113101 [doi]
AB  - The diagnosis of a drug hypersensitivity reaction (DHR) is complex. The first 
      step after taking the clinical history is to look for a sensitization to confirm 
      or exclude the diagnosis and to identify the culprit drug. Skin tests are the 
      primary means of detecting sensitization in DHR, but are associated with a risk 
      for a severe reaction and may be contraindicated. In vitro tests offer the 
      potential to support or confirm a diagnosis of DHR and influence medical decision 
      making. For immediate-type DHR, a few validated assays for measurement of 
      specific IgE (sIgE) are commercially available to a limited number of drugs. In 
      addition, several home-made sIgE radioimmunoassays have been used in other 
      studies. The sensitivity of the sIgE assay is drug-dependant and generally low 
      (0-85%) for betalactams and reported heterogeneous for other drugs ranging from 
      26% for chlorhexidine and 44% for suxamethonium to 92% for chlorhexidine. 
      However, as all these studies included patients, in whom DHR was confirmed only 
      by skin tests and not by provocation, the results have to be interpreted 
      carefully and may be unreliable. Determination of mediators during an acute phase 
      of a reaction may indirectly support the diagnosis of a DHR by demonstrating mast 
      cell and basophil mediator release. Negative in vitro tests do not exclude a DHR 
      or imputability of a drug, but a positive result may support causality and 
      eliminate the necessity for a drug provocation test. Unfortunately, evidence is 
      limited with a lack of well-controlled studies in larger numbers of 
      well-phenotyped patients, which results in susceptibility for bias and a need for 
      future multicenter studies.
CI  - Copyright (c) 2021. Published by Elsevier B.V.
FAU - Brockow, Knut
AU  - Brockow K
AD  - Department of Dermatology and Allergy Biederstein, School of Medicine, Technical 
      University of Munich, Munich, Germany. Electronic address: knut.brockow@tum.de.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20210714
PL  - Netherlands
TA  - J Immunol Methods
JT  - Journal of immunological methods
JID - 1305440
RN  - 0 (Biomarkers)
RN  - 37341-29-0 (Immunoglobulin E)
SB  - IM
MH  - Animals
MH  - Antibody Specificity
MH  - Basophils/*drug effects/immunology/metabolism
MH  - Biomarkers/blood
MH  - Cell Degranulation/*drug effects
MH  - Drug Hypersensitivity/blood/*diagnosis/immunology
MH  - Histamine Release/*drug effects
MH  - Humans
MH  - Hypersensitivity, Immediate/blood/*diagnosis/immunology
MH  - Immunoglobulin E/*blood
MH  - *Immunologic Tests
MH  - Mast Cells/*drug effects/immunology/metabolism
MH  - Predictive Value of Tests
MH  - Risk Factors
OTO - NOTNLM
OT  - Drug allergy
OT  - Drug hypersensitivity
OT  - Histamine
OT  - Mediators
OT  - Specific IgE
OT  - Tryptase
EDAT- 2021/07/18 06:00
MHDA- 2021/11/09 06:00
CRDT- 2021/07/17 20:10
PHST- 2021/01/19 00:00 [received]
PHST- 2021/07/01 00:00 [revised]
PHST- 2021/07/09 00:00 [accepted]
PHST- 2021/07/18 06:00 [pubmed]
PHST- 2021/11/09 06:00 [medline]
PHST- 2021/07/17 20:10 [entrez]
AID - S0022-1759(21)00146-0 [pii]
AID - 10.1016/j.jim.2021.113101 [doi]
PST - ppublish
SO  - J Immunol Methods. 2021 Sep;496:113101. doi: 10.1016/j.jim.2021.113101. Epub 2021 
      Jul 14.